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HomeMy WebLinkAbout0920A (5) _. > ,_ � �;- """�"`"�"T`o"°E"A�AT�°" ` za�„o"��,"e' qppLfCA;TI�N F�R`ELECTRICAL PERMIT n ... .�. ;;, � f hereby affirm rhat 1 have a certificotz of consenr to �fa�- . � insure'or cr ce�flficate.o{Workers'Crtmpensatron Insuran�,- _� - ' -_ CCjUNTY OF l0S ANGfLES .�� DEPT.OF PUBLIC WORKS � -- � � � �-or a ceriified copy thereof(Sec.3800,tab.G)�� �.- � --- " � ---� � - , .. . .... �_. _.- �. .., �_. _ : .. _. . � .. PoliGy No � Cnmpony`��- -. -.�`- � ,. FOR APPLICAM TO FILt{N ,. ._ !09 _y t�Q��/�T�. �tertif'ed copy is hereay furnrehed. � New Residenhd_Bldgs.&Poo4s EACH ND FEE� �ADCRESS �w�/ — .. �CerYfied���copy is filed with the coonty buiidinq inspeo- 1�2-Famlly,Sq ft < $ — 5 LOCAIITY"��Lj�(�f� _ � lion depar+menL .. - � �Mvl?i.family Sq.-FL - --- IJEAREST _. . . - ��:-' . CROSS Si. • �Dote � ,�- ��A {cam� Residemial Swimming Pools .: � DwNeR OR.'.. .. ' :-.. .:. ..,_ .,.�_._.. . ... �PP � , ... � 'rIP.M NFME �/�� �M� --- CERTIF�CATE OF EXEMPTION FRbM WORKERS' Outiets.Rec Li ht�5w� �t � �'L ,f�� ,-. �' � - GOMPENSA7ION INSUFtANCE - � � + l� �� no0RE55 �iT��" � -��. := -�� - �Q First 20 + (This sedion.need not�be:completed iF the work imalved�6y ToYal No.l.�__ � -Additionof -� � � QTY -_ Tel.No���� -ihe permit ts for one hundred-.dokiars(S10Q)or less.) - � �� ptqN FHECK .- . �� 1�cerhfy ihat.in ihe performance:of the work for which ihis - APPUCaNT .. . - �--. --perm't's issued,I sholl not employ any perion-in-ony manner"�- ��9Ming Fixt�res First 20 � � ADDRE55 � - so os to eco e subjeU to+he Wo•kers'Compe-at�on laws . a � - � _ .-�. fqG /�// Add�fional - -- Dat�� � �•(+►_� Tarol No. � . . .. - � CITY .__ Tel.No. _ i Appl�codA�^��M�G�"_ � Fixed ApPlmnces Not Over 1 NP � � PERM.iT ��:y�..�,� . ._ . . NO CE TO APPLICANT: If, after making thrs Certificnte ot - APVLiCALON �'1`�j' �N1�aN:Gv Ekemphon;-�yoo st+vuld become su b�Pct to the Workers'. Ran9e— Heoter—D.W. .— � . . . - -- ��Com ensation ovisions of Yhe Labo�Code,� o��m�St forth-� Oven .�pr er �W.M.— � A�DRESS� �'"~����y�./�/ .P q� .. Y Y - fs/�clr Gll�G f�' .._ : ; �with�tomply with such�provision5 or ihis perm�� shall 6e -Top. --- FAU —W.H � — CfTY ? '� Tel,No. � r � �deemed revoked ._... . .. .-,-.. " Hood. ... — - ���� � � �� � - --.- Fan C)iher__ _ ---- LICENSE�CONTRACTORS.DECLARATION .� � . �� _� � � - uCeNSE OR ' Disp .-�Room Air Cond. � ''� � Class. -- I hereby aff rm ihai I am�icensed under provisions af Chppfer 9�- - . - REG�.NUMBER ._ . � -�(commenang wdh Sec�ion 7000�ot Divis on 3�of the Bvs�ness" � power Apporatus&Lorge Appliances DISTRKT NO� - - �� PROS{�D BY Y� and Professions Code,ond my Lc nse is m full force and effect. :. . . � ( ��yy�j ,�/ Siie d Type HP,K4V,KVA,or KVAR- .�"" ' � �✓ C.�7 license Number/'✓ .f� - tc,Class�_ FINAL . � - � � . � _ . -_ Up to 1 lncl. . . �� +� � �� - . Over 1 to 70 Iod . �- dATE �,-`:..'�`� .�� VAL1DAf10N � .. . ��-Contract ,,,,�... • ate �� . .Over 10 ta 50 Incl. . .� FINAL i � � ..... .O.. ❑ I om exempt�nder Sec. �= �- � '- `� - -Over 5�to t001nc By �. -�U�i��,r`A � � �� B&BC.fo�this reason - --�� - -�- Qyer 100 . . � � p g� . d -. - - `- �� Servires,Swbd.,N1CC&Panelboards N ... ,:.pa1e: Z . � 0 200 Amp:Under 600 V - . , ��.�9 z G�'��'...��-�- — . Signawre � 201 lODO Amp U�der 6�Q-V� . � - � - � -�❑ .... . ..�. -- � .. . .. -Over 100D Rmp.or Over 600 V '�._'���.. ... Exemptlon far Req.Mmnt Elect - �.SINGIE FAM�LY -- � . v /.C`r--1i Q'� . HOME OWNER-BUILDER-DECLAR�ATION . . 7emp.Power Pdle&Appurtenances.: . . . . I hereby offirm rhat i am exempt from ihe Cornroctor's License � Sign with pne Brancn Orcuit . Lnw for ihe following reason(Section 7031.5,,Business'and Additianal Sign Branch Circu�ds . _. ,._ - --Professions CodeJ: � . � - . � Misa Cooduits&Conduvtors � ❑6 as owner of the.propeny, will do the work and ihe �. �Other(See Complele FeA Schedule)_ - � ' - structore�s nat intended or offered for saie(Section 7044, - . Business and Prafessions Code). � _ - . � -- � � -.--CONSTRUCTION LENDING AGENCY . - ``"`"� ` LL � �--" � � 1 hereby affirm thot there is a construc�ion lending agenEy for :,, " "- --�- � � -�he performa�ce of�the work-for which this permrt is issued� PERMI7FEE (Svb�oipi} . (Sec.3097,�Civ..C.). .. . � _ . ._ . ... . .. - . . � � . �. - � - � - � � PLAN�CHECKING�fEE- � . . . - � - Lender's Name .=_• � �""`° - .. �� . . . �) .. �. . . . . - �-- - _ . � PERMIT�ISSUWGFEE ( � _ Lender`s Address , .��.�:_... °-� ,..�`:'; .-��;: _ _.__. . - .:.: :.,,:. I cerrify rhot 1 have redd this applimnon ond stare rhot rhe TOTAL FEE . , , .,.: ,, , :-.:. � �'` �--.. �+°� . . .. ... _ . - . . � above information is correct.1 agree-to comply with oll Counry � � - .. � - - -- . . - � _ "-� .� - � . �� -- . . �ordinances and Stote I requlating Elecfrical wiring�,and . �- - - . - -�� - ���� - � � . -- � . � - - - hereby out ri r entativ�es of ih�s County to enter upon , ...._. � - - .-� �-- _ .� . � � the - ' n ty for inspection 'urposes ---� "� � �- SEE REVERSE FOR EXPLANATORY LANGUAGE - � � : . . . I . . .. ... . � . ._,. . .. _. _�5... Signature ermiftea . . pate . - - ' �, - ; ;: _ � �-'� � APPR(3VAL5 ... �DA7'c '.�SPEGTDR'S _ . .. . � �WNEfl•'B�!lLQEi�D��`s.ARATfC3N '�� ' � StGNP.7URE - .... : . �`. . .�. � . ..-_ . . . ._ . . - . . ... .. = SE41p POWEFt POLE . � . . . � . . . . � �� ----.�--- . t irec2by�f;irm.thst! atn axernpt fram 9he ConfvaCfor's� .- .. - " UN�ERSIABVdORK�. � - . . . . . - . . - .. . ' -LicenaeLawfocthsfo!lowfngreason(SecJonTJ3f�.5.Busrness - -- � � ROliGS1^6NaUiT.� , �-. � ' � - andPro!ess,'orwG�e):Ar.yoiryarcountywhichrsquiresapermir � , . y �. - r �� t��'��^ � � � - � .�G.CQi�etlUCi;.81tEf,.rmAtOtiZ,.tl2fi01ish.6r�BG2it 2Py StfUCtilre, � - - � � � ��R�h�`- �- � � - �";� . � - priorrarrsissuence,alsore�,wbesrheapplicar,t�D�suchpermirto ' „ a� - . FIXTURES � -�����`- � - �� - �� . .:� . � �- file a srgr�ad statement lhaP he rs IreenseB�ursuaht te the,��ovl- . - - - "'' sroas ot ths Contraciar's Li�ense Law(Chap�er.9.(co,^rmexing ',,..; .:... . .. . � -:- '�. . . , . . _. . .:'� w�6--• . PQWEAAUTHORIZED -� - - � - �_`. �-�.-- .-�``� � � wrthSectron7bpl})oiIIfv;sior3ot[hz8usfriesssndPro€essions r - -�- . . . Codejorthatha;sexemp[iharsfromandtneb3srstor�the2lleg8d . .. _ .. . UT7LlTVCO.iVOjlFI'e13��- - � ��� . � : - exemptionAiry.vioi&t+onotSectian70315bY��Y�PW�canttora . ... .. .. . Fih3AL -;-...�' ;.�.. .. `�� , - _ - . ' ._. . �,,. .�e�mt.soDjects"rhe a�frcanf ro-a arvit nanaltv ot nat mor�rhan . . ... nfer on e»n�- ._,.. -.' f vs fiu'rnJreC da�ars{"�560):. - � � : '_ . .. . +Y07E& � � . . _ - . . ..,_ . . :_, ..._ . . . _.. , .. ... .a-.•;s_. .. •.. .�-. . .,,.. ..�. �_.;.� •y�.�,.. �- ., ..`,"5 � -- � . -� � - . _ . .-.- �J t�5 awe��r o#tn�p�srtY wit,6o if7s+k+sek�2� , . .. _ . , ._ -- . -. .. . . .. ii�e slrasture is nof intended or offeren for saie. , - „" '- , : �,,�� :,; ' :_:. . � . . .-� ..:- .:,. .. � �.- " " �'��iSec.7044..8vsirress arrd Fraiessions Cad&r..The CwrP��cYor's ,, � ..�..... ., . .;y.; `.._ . r,..i k -�::. . . . .. ..:� .. ��:LicenseLawdoesnatapa�ytasnawneroip�operrywhobuirtlsor��. _-_ .._. . _... � _. � . . �. . .._ �mproves Phereon:arrtl who zloes such work himself prov'rded thaf� �... , '. ...-�..-. �� - _,��.-�. such tmprovemenfs 2re nof�infended br�-o(/ered�w sa�e. If. . ��" "`�'' - "�- . .....___-. �. .. .. - . . .'- . however.the burld;ng or.improvercant is sold withrn o�-yea:�l - . . - _. . . ....� . . ... � ...�� .. ._ .-compr�tron,the owner-builder wilf nave tf7e 4arden of Frav7ng that- . . .... . . -� . . . . . ...` ' - . � .�..ne,drd rtot ouli�cr;mprove for lne.P++rpos¢�f sa7e.1 - _. . . .. .._.. . �.-..:_ .... .._ . � 1�;$X'�i�1�tuTii(�.FSB�xY=..���-;� �-�.«` . . . n r . . . _.. . . . .. �� ... ,. . . � : ._,: �.. r..a,..�.: �&�.C.fbe YiSis�an ` `. ; . ��. _ _ �ate..... — — �wn�' '' . . . v : , � ... : � ,;} � . `v� -�=�