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HomeMy WebLinkAbout0118A . .,.. --:... _�...,.�,w ,.,� ... r,w�, .. :,:� � . .�. ._ . , ,u�,. .... .,. �._ WORKERs �oMP�N�;,fi;QN oE��AR,,T�oN �6A663 10�81 APPLrC��`IdIV F4R ELEt�'RICAL PERMIT � i hEre6y affrrm thol I have a certificple of consenf to self CE-806G , �,.. insure,or o cert fim 4 Wo ke.s;Compensafion InsuranCe, COUN'rY OF LOS ANGE�ES `µ�Q BUILDfNG AND SAFETY � or a cerhfied copy ihereof(Sec.380y0.��L,a,�b,.C.l .:�.,,..,�.�.,,,,_.r„�a,,�q,,.�--�r.,,�y:,�:.? . ., -- P❑olicy No�-drr,�ea_�empanyL.l�r7E�i C.� . ...,§��FORAPPLICi1NT70FILLIN . ... , J08 p1.�S,s l�. •`�'. �I�I n ���.s y-� EACH NO. FEE ADDRE55 <X Certified copy is here6y furnished. „S'Ti�'�'� .XJj. New Res denhol Bldgs.& ools ❑ . 1&2�Pamll 5 Ft. �y — $ LOCALITY Certified mpy is filed with;he couMy boilding'�nsPeC- y' Q' NEAREST tion departmenr. Mu�!i-fomily Sq.FL CROSSST. [� t� ������ ��� Residen+ial Swimming Pools OWNER OR �.�,! �n��� Dofe ��-� App�icant FIRM NAME �� d 417L�Y�6LJ . ., ..:.:.�.�:�.:_�.._..,.........:....:. CERTIFICATE OF EXEMPTICS�1 FR(��IV���WORKERS' Ootlets:Rec�Li9ht_Sw.� MA�� � COMPENSATION INSURANCE AD�RESS a / (�a L First 20 (Thia saativn need noi be complefed if fhe work involved by Total No. � Add'+tionol CiTY Tel.No.73 � fhe permit is for one hundred dollars(5100)or lass.) P�AN CHECK„ . - I certify+ha�in the performance ot ihe work for which this APPLICANT ... ... .��:- - . :....,..:.:.'---.-,;-:.+.-::=.aa..,�>: parmit ls lssued,1 sha�l no�employ any persan in any monne� so os lo bemme su6jed to the Workers'Compensation Laws. ll9hting Fixtur¢s Firsi 20 ADDRESS ,,,,,. ,µ.,�„w,�p,�,�.uar>.e+�^r.a�aa __, � - � - ��� To�al No. ,Additional. ��TY Tel.No. �,.. Date � APL licant , ., ,.::..:., � . :.M....: _ ... ....:.... .. .�..::_,..x Fized Appliances Not O er 1 HP PERMrt NOTICE TO APPLICANT: If, after making this Certif cpre of Ron e._Heate O.W._- I APPLI,.AN7 �'m ,CL�� 1�.1 C Exemplion, yo� should become subject �o the Norkers' 9 Compensation provisions of the Lo6or Code,you must forih- Oven `Dryer �-W.M._.... AODRESS with comply with such provisions or fhis permit sho0 ba iop �FAU —.W.H.— ��ry � ����Tel,No. deemed revoked. �--.� ��"��� ' '� Hood _.Fan _O�her_. � UCENSED CONTRACTORS�DECLARATION� Dis _Room Air Cond. — UCENSE OR //l Q� '.,Class. C i hereby afSlrm ihat 1 am Ocensed nder p ov sions of Chapier 9 p' REG.NUMBER 't L .��• �- }� (commencing with Sedion 7000)of Divismn 3 of t6e Business power Apparatus&large Appliances, OISTRIC �NO. PR�ESSED BY II: and Professions Code,and my li<ense is in full force and effect. � � ..1--4.`��j^� � � ��^7 � / �,� Size&iype HP,-KW,KVA,or KVAR .. � � � -�-� " License Number �`���7 Lic Class�.LL_ Up�0 1 Ind. F�Np'� Q qyfy�..� /-C� Over 5 to 10 incL �A� l� � f VALIDATION� '- . .Coniractor��"�E'1r/�'� c�ctDate � Over IO ta 5�Incl. � ❑ .....'.. '. FINAL I am exempr under Sec. . ........:...---��3�,+."�_�� Over 50 to 100 Irx. gY �j . .....-...�� _ � � Over 100 ..„.......,,.. . , . Z B.&P.C.�for this reason � .-.^�".-'..:...>�-':^';�' � ����+ 'Doie: � � ,.. Servi<es,5whd.,MCC 8 Pane�boards � ..:�. :...,.".."•"....,_ •.. 0-200 Amp.Under 800 V . s�g�os�re ,->.Ww#w•.-...-.,��•^�,".;�' 201-1000 Amp.Under boo v �G 1 i:8 A ❑ � - Over 1000 Amp.or Over 600 V Exemption 4or Reg.Maint.Elect. :�a a c x t 2 � SINGIE FAMILY� � � . Temp.Power Pole 8 Appurtenances � ° � C(a(�{, HOME OWNER-BUfLDER DECLARATIDN Sign wi�h One Branch Circuit I hereby affirm thot I,om exempt from�he Controctot's license" _ qdditionol Sign 8ronth C+rcuiss 5 a: � J 1,(,'.F,� Law for the foilawing reason(Seclion 7031.5,Business ond Professions Code}: �... aMisc Conduits&Condudars i: �.2 v 8 6 I,as owner of ihe property, ill do the work ond the Other See Com lete Fee Schedvle snodure is not iMended or offered for sole (Section � P �— ► - 7044,&usiness and Professions CodeJ. .. ., �� _..........,.,:._..:�;:�.;,.�,..:r.x.;. CONSTRUCTION LENDWG AGENCY . ..,.�,.,:..:.._, .._ 1 here6y afifirm ihal there is o consirudion lendrng agehcy for �� � Sub-To1ol ihe performonce of ihe work for which ihis permit is issued pERMIT FEE ( 1 (Sec.3097,Civ.C.). � � PIAN CHECKING�FEE �n ('� lender's Nnme . -... r�,..�.,��...:-.w,w.x.x�r.;�^-:E'is:�so� �. .... :..._.....•t' 7 -.,.:,...,._,.... PERMIT ISSUING FEE Lender's Address � �� �� ""`"` "E'�"` �� � :. I certify�hat I have reod th�s applicotion and s�o�e ihpt ihe`µ TOTAL FEE .-,� ;,;_.,,�,. �� ^-„y,xr� ..,_... .�..,. ,..,, z..::.. . above Informotion is correct.I oyree to mmply with ofl CooNy ordinonces and Siaie laws regulorinq Elechical wiring, and - . _ �"'��� _.._ ...,., hereb a�ihorize represen�atives of this Coonty to enter upon _ � - �� - .' � �� � ��~ 1he a �e-mentioaed propert� or inspection purposes. .:,,""� �,�.u�,.. ���� �' "'"�`''�.N����y��5������� �,_ SEE REVERSE FOR E��ANATORY[ANGUAGE , �"'�`�°"'"�'�"'�"� � ,>M�.„� ,. J -�IJf. ,-.:..,, �.. , .. ., ,. , ... ..�.-.. gnoture o`Permiflee Date . � ... . . . . �.-...�.�..:�.�.-,.-*"'�'. ;u«..�.--�.:-,..�..�.V.a..+.�� ... . .._. _ _ _ ___ _.._. .�� U _. �:��v ; .,_.:: _ _..._. `.__._. __.�:.�. R __._, � _... -�. �.. :,� ..K,.�_.. ,.,� ,�.. _� :s . .�.,, - . � �..,_. . �.:_ _._.,_.:�_'_::3-.o .. ._._.._...� _,._...i . . .,_< !o .i ., . 7n3^.5. . , . �, ., - 'I � ' . . .. 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