Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
1122 DIAMOND BAR BLVD (3)
_ � � WORKE�RS'COMPFNSATIONDECLARATION . ' 76Afi63 � ��� 'E�CTR�CAL PERMIT � � , ;CE-806G;z-$o, APPLIGATION��FOR �L . �- �I herahy affirm chat t hsve�a cectificate of consent co self COUNTY OF LOS RNGELES . � � � BUILDING AND SAFETY insure,or e certit�icytC of Workers'Compensa�iun Insurance,oc - . � �ii certified copy[herebf(Sec.3g00,Lab.G7.) . �ry �A� �v,�/�y��-�y 11/ �J��! ^�,.' ,�q: FOF APPLICANT TO FILL IN JOB II e�u�- �It'u'"v�N��'���+-V i PolicyNotL2Y�sLlCompanyN�(-� �-(`f4' � "�� EACH NO. FEE �+DDRESS r� , . New Residential Bldgs.&Pools � _ S LOCALITV(��.f,Qn1i� ��,d�.. � Certified copy is hereby furnished. 1&2�Family,5q.Ft. � � Multi-family Sq.Ft. — NEaREST �,��� ❑� Certified coVY�s filed�vith the cnunty building inspec[ion CFOSS ST � /��• - . Residentisl Swimming Pools OWNER OR . - depnr[ment. G,.���� � ], FIRMNAME �"C� ��"'�`i�r� , � `�ov7�! ✓ 0 .� z� Uale ApVlicant.�l.i-r.•�/_/�)�_.__' Outlets:Rec.�Lic�h[f�Sw.. , MAIL a � �OJ� 'S'%. FirSt 20 ADDRESS_ � CL:RTiF'I(IATEOF�XEMPTI0NPE2UMW02KER5' TotalNo,_� Additional aTv/v�/f7f, ��T(.-r. TeiNo.��rj���jdl/ � COP.71'ENSATION IPSSURANCL PLAN CHECK.�,l�, .�}/ � y� �a . , � APPLICANT �/�/✓! �GS`���G�'� ��""'�' ���� (Tliis section need not be completed if fhe wosk�involved Lighting Fixtures First 20 4,�'7 �;�,/tJ � �V ADDRESS Il1 ST' by tLe permit is fm one hundred dollars (5100) or IessJ � / � Additional '4= � � Toial No. �i �' A Tel No.���-". 3� C� I certify thul in the yerformance of the work for which this Fixed ApplianCes Not OVer 1 HP CITV �/�J� d�l��,__ __ 3/ .� �permit is issued,I shall not empluy;my person in any mamier PERMIT � � U -�zi�as tu become eubject tu tLe Workers'C'omVensotiun Laws. Range—Heater �.W._ APPLICANT���� � W 4.. � � " , � Oven _Drye�_W.M._ A�DRESS �� '.� � Top _FAU _W.H.._ .__._ ..___ .Date Applicant _ CITY �( Tel No. �d � . Hood—.Fan _Other_ ,.....--.. NOTICF:"PO APPLICANT:if,after muking[his Curiificate of pis Room Air Cond.._ LICENSE OR /�� A/�v� ISxemp[ion, you shnWd�hecome subject in tlie Workers' P , REG.NUMBERr�'l�7✓ 7Class '"'�� � . { �Compensatiun pruvisivns of the I.ahur Codc,you must forU.- �. �power Apparatus&Large Appliances DISTRICT NO. PROCESSED BY �; with comply with such�Piovisions or this Permit shutl be ' gize&Typ'�HP,KW,KVA,or KVAR 1� ��� deemed revoked. Up to 1 Incl. _— � FINAL Over 7 to 10 Incl. _ OATE •"'7��., �f VALiDAT10N �LICI?NSP:ll CONTRACTI'ORS U6CLARATION _ Over 10 to 50 Inci. � 1 hereNy affirm that I am licenSeJ�mder prOvision5 of Chupter Over 5D to 100�inC. FINAL� � _ , 6V ��� 9 (comnieneing with Section 7000)of I)ivision 3 of the Rusi- Over 100 !'�4�y;t�;' ��=�'�`' ness and Pro£e5sions.Code,en3 my license ie+n full force and � . - .. effect. � / . �Services . � � � � _p;�, �� 0-200 Amp.Under 600 V �. � �.icense Number � �' Lic.Class�;� '� ( .201-1000 Amp.Under 600 V -�j4>U(Fl GU�.`>I 5.../a-�iI �: OverM1ODO.Amp�,orOver6D0;V Contractor �'{,�,�. ���+`�. D;�te,=�. � � _ IIOME OWN7'.R-RUII,ll£R DECLARATiON iTemp.Power Pole&Appurtenances � . ` I here6y affirm that I am exempt from ttir Contiactor's Sign with Ono Branch Cirwit ` I.icense Law for the foliowing scason(Section 7031.5, Busi- ��Add4tional S'�gn 8ranch Circuits . �� ness and l'rofessions L;ode): . '• - - � tMisc.Conduits&Conductors � 1, us owner of'the propeny,will do Ihe work und the . �Other f5ee Complete Fee SChedulel—•- structure is not intenJed ur offered fm� sale (Sectiun . � . 7U44,Husincss and Pmfessionti Code). � �� � '�, COP[STRUCT[ON LENDING AGFNpY � � ' I hcreby affirm ihat there �s a cunstniction lending agency ♦ fbr the performance of the wurk for which this Vermit is pERMIT PEE (Sub-Total� t �;' .issued(Sec.3097,Civ.C.). , . � . � ](�C,[1,q �' LenJe�'s Name - pLAN CHECKING FEE (Dne-Fourth Permit Fee) . _ . Lendcr's Address pERMiT ISSUING FEE �n e a m m� Y�1 certitb that I ha�e rend this applicx[�on and state that the TOTAL FEE • ' � ��J�/ �. ahove information is correct.I agrec to comply with all County — ' . �- ordinances und State laws regulating Electrical wiring. .ind . �.����� ` : hecehy uuttwcize[epcesentat(ves of[his County to entec upnn � 1 the above�mentit>n i pr per y f r' e ti purpusus. C�` SEF.-RL;V�RSE FOR GXPLANATORY LANGUAGF: k , � - �S-j2-�! � Signa[ure af Pe ittee•� Dute �� � t . � � . � � . ' � ,, �� _ � , .. � � ° ;� � tt � . t t � \ ` � . � � , .. � , . . � � i ' \ � .`j \\ �.�.. .� � . � F r�'�'�.y . t S. � � `s �. �1.. . �, . .p. \ . ' .� '� \'Z � ; _ , � \ E � � � �,,.--�'`�_ p�\Q � ` , 3 ` i A�� �t ,,,,..�,!�'a \ ��G�`'r �0 .y.p. _ ..� �' S � � ! ��`� `� ` ; � l�.... � \ :..� � Z;� �i�}��L'� "� ��� �,. Q �� .� . "`.� ., �� ` ' � � `�1 Y. � \� 1 �, �� > � -�.�'�\��a ,,��� m��`G� . ..� � `'� � � i� � ��E � �� .. �� � � . ; � \� � ;D-�\G ���,� `'��Z �� � '� � � . � . t ` '' , �. \ � 1 ` 1 �p `�� � u�1 ���� �� � � ``� - t � `� �`� ��� �� ' �'', �� ���. � �` .`� � � `p �� �� �� �� 1� ��� �� � _ "t i , � . �i �, ; ` ', � t � � �a !- ;.� � ` t � =r � , � t , , �s � � i � , y ; z , ��--q � °�� � ,, � ,, � �� t ; �; � � ` �r , � -�-- � �� `; ` '� , � � �� , 1 '� � � �� ,. -r �. � 4� � � , , \ 'i ,� \ ��� .` \ . �� t ��� � `��', '� � � \ ;� } `j \ � 't � � t� . � '�t � ` i i � � y i ,\ C i � � �� �t � � q l � � � �%� . � � i � �� • ? � ��t i \ � �� ���� � \ ��� �m � � �� ��� `.a i � � E t � �l .` y i � '; `.t,;. -.1` \ -`� �� � ° \,� � .�\ _i ! �`, ` ` .. \ �� 1 , � �; t �� i i`� 4 � ��� � � . �'� � ;_ `� 1� '3 1 � � � . � ��� � � �� t ��. `. � � � �` � �� . �1 �+•�� � . . 's i� . ` , ,` i �`� � 4 �i � . � ' � - ;'t . tEF .` , `\ � � ,4 V'G< .. � 1 �t t `; . ` `, ; ` ��y l 't 1 t t s 1, � :, �i 5 4 ��� . '` i '�� E '� . ,��� � ;, � � �'t�.,nsi . .. ; �� ,�,5 \1 ti � � '�; ` 1 i , 'i} i;� ` � .��'. ,, � j �; %G�l � � ,� �, ;t \ ,.\ � ` y,� i ; � � �ic � t � �i} �\ �� � ; , �� � , , �''i� ` � iS 1 e , .'{ 'S . i ,- i i ; t 1 �� 'j � , �k � �� � i � ��1 1 � ` � i �`.� '� b t ti , 'i, �� \ i�, ,�1 � � ��1 � ``� � �� y `\ 4 i l � 4 ' ` 1 ,�.'� i �{ � � �l �` ' 1 1 �� � . �'�' `,'t ; � �, jt �`` I` ii •t� • i ' '`y �4 � t .., �:. .. ' . 1 1} ,,}. t� } . 1 e.�4 . . . , � � � �`;y �, ���, �:� � e ,� i � ` '�l, � �� '.`} ��.�` 'j,} `�5� ` ..' ,'' . � `�Y, �, ��.4� t} ,`` . �, . .. . . .. �`,\ . �y' it � 't `t i{� '` ` . 1 . . . �� . � � . , 1� s , . 1 . � �� . . . ` '� y' S ; S . . �! { • . t ,l � ��� . � . . ` `t; t . . .. . �1 `,t `'�S . � '','i �.'� ;,t ... `} `l 'iS !� ;� ' . ' ,., � r Y„w . 'f � .1'i� t� • . . � � Y. . `} � . i'' t - 1 . J . o a�.4 R-'�7 . , ,a.l t� . .! ,� }�� �� � . � � .. ::"' C �' w .ca V _. v'� 'G '�"• \ t . S `\t �`',; . n' `=�•� tD r' m,° - 'sz ?'?�. � � . , � . , , ; , . . , � , t � - . "'' �, /,r , . t .-e C G � S �. , . . , t .. . . .e . _.- � n ""i � n � < - < t�" C . ' S . " � 4: "` p .. .. .. h• � �1� { , 1 4 Yi ' �'� `� ^S � -..:� ��.e^�.�! ...'. �"'°. ' c0 n j /. �' �S �l . . �^f>^� 'r.+j .. � ry"'�n'' �`�,�'�u � '-O+a�^ �',u"; t ``f t ��� _ � �a. � � � '' r a ;�C'� =?�'�� � �'" N m .° �: 3 . � ,. =':' F' n� t�-�,��'� s " £ �'� `'';i !; Q= o �q . � � �, � � r. o ��� o"=��� .yo� ��:. 'j � „u� � � � � � �ry � va�;��4:� . � > �a �'{ i f c . � _. G �, o' �c .%-, ,r v. +•, a � � � 3 �'",OT. �� '-��v�, ''J .�.� '� *��,-,{� � ,�'t . . . .,•, �, y'� ...J r� ie a a^q s�.a �..z� .;,,� o .� ��fa .,.�O � j C+ +"pP�;� . ' �i'"Y '"`'.t . I''' %. _.�^� ,r �"' ".�A � h `.'a��.Q. u�y�� r ."�J di'..na� r�� � l � . , ^ � s, ... a � � `� a � : �a .a p;�.. ,_�,z' �",r ^ ed' `ru^ �1 � �,"' °iA � 'S' "� �-4 � �-.��"«..C"3"' .�-a+.�� O.�A ,-�.,'^ :o � ^ �w'7 G' ��a v':;rY',;�� i+ C i ? . ;� - ,_,,,c •. � O .`...v � � � . r_. �, �= � ..� s � �� 1 ��,, �j � . �� �.'� �- �':c�'Or ~V �.. i5 . n .���7. � �b � . . �S . ' � -.. �:�.L^-�.� p`� l' 1 � � M O N �3'~ C ��,.,'N� y+/} , - .. ' . 'i`� �`:; "`' O.� Y '. ry � F �'CS A X C� w.'C`< O A `G .c^'.e s� `�'"` .. •;.� � �:a'C�� ;a ...,r~ N v� t� y p w ' '� G ��' , . � � .'�t' � '.� . O. . ,r. . .. yy,n �'� "> �.�' p�n eo �, ,n ""• O «. '�� . . j '� . , . �'^"�','r. !� �. j�y�O.p- N��� Q;rjp �,��.;+'� n p .t�"+� . � ' � `i � `�. -_-$ n -' � �.� ✓ ^.b"�W' a ` � �'. � w. Y a s; O �?�, � '�� ,Y a.--.`:J Y;.s; V `o � �o A �-a� s � u•v% 4 -: c = ' .., n � s x.-.,,� �a r, m�.- �, �CO ^ 3^cS G'"�O ti� H� �� � � a`•' �--��� . j °. 1 �"�. Y� � �. '� �p �� �s'. ;' ,..�x-�� A�/�,���,,-�'� � ., i\. �� { �u � r. � � �..4. ; � � � ,� c., G, ` � . . . C ty �. 0 .. � A " e'�.,�C ' ���J^ � � a V��C � " ,-�a. ' rr�. . . . . � . . � ' � .� < . � - � / � � � � / . ' . .i . � ��,�/ � � .�"'�.�-"�.� � f�r,�.r ��� ��� i ��'