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HomeMy WebLinkAbout1180 DIAMOND BAR BLVD (18) _ �WORK�as•�otitpFN�A,�<�Nv�.���.AaA���oN ' �6A663 AFPUCATION .FOR ELECTRICAL PERMIT - � .. . . CE-SO6G(2-801. � . � . . . . t hereby atfirm thut I hnve a certieic3te of consent tci sele COUNTY OF LOS ANGELES BUILDING AND SAPETY � insure,or a certi�catr of�Vorkers'Compensation Insurance,or- - p�� , u cerLfied�/c�bpy thereof(Sec/.,�3800,Lub.C.) - � ���� ��++�-h�.^��Lk'1✓��.... I�P.T C'76Gf�BCr> l:. �� � �J� C FOR APPLICANT TO FILL IN . ADDRESS I�M6� I�AR �J�� � � QdJ � �1'oiicY Uo. � ComptmY�.�i_s.c.r,-- �"rc CA _ � New Residential Bldgs.&Poois EACH NO. FEE . � � Ce�[ified copy is hereby furnished. i&2-Family,Sq.Ft. � — $ LOGALITY jj�A���;a,� ��� - � � Multi-family Sq.Ft. NEAREST �� — . Certified copy is tited with the county buIIding inspec!ion�� CR055 ST � department. � , Residential Swimming Pools OWNER OR ' . i � FIRM NAME����G✓� �����' ' Data � 'L'�` Appticenl Outlets:Rec��ight_Sw.. �d qD�RESS �C First 20 � CL:Itl'IPICAI'�E OF lXGMPTION FROM WORKF.RS' Total No. Additional . CITV Tei No. �� � -COMPi�.NSA9'ION WSURANCE � .���.,, - PLAN CHECK ,!y � � (This section need not�be completed if the work involved�'':' �. Jc�APPucANT �,p:.' Lighting Fixtures First 20 AODRE55 � � � �,;by the permib is for one hundxed dotlars (5100) or IussJ . - r - -. � � Total No.,�� Additional �.. I certity thut in the pertbrmance of the Nrork for which this �. .Fixed Appliances Not Over 1 HP CITV Tel No. �', ��pennit is issued,[�hall nut employ sny�person in any manner . � PERMIT ` so as to become subject tn the Workers'Compensation La�vs. ' Range_Heater_D.W._ ��,�� APPLICANT �LA_�V_� nL ' ��. �.: - - Oven ._,Dryer_W.M._ � AODRESS L..�(�� �� ��,, /�"eK.�. � v7�. . Uatc Applicant ,-� ToP __FAU�_W.H.._ - �'�. � � " Hood_Fan _Other�� �' CITY � �. Tei No.,�(�����Z �' . ......... _.._... . .. � NO'1'ICIf,'IO APPLICAN7':If after making this Ccrtificate of Disp. _Room Air Cond._ `tl - . U�LICENSE OR �/ !� , � Examption, you ¢hould become subjecl tu tiie Workurs' � REG.NUMBER���f_RS Class ���.3 ��Cumpensatior prov�s�ons of thc Lubor Code,you must fortl.- , power Apparatus&Large Appliances DISTFiICT No PRO�SED BY � tvith comply with su�h provisions or this permit ihn(1 bc Size&Type HP,KW,KVA,or KVAR } � deemed revoked. - . . � � .� ����` . 3 � Up to i Incl. � Over t to i0lnci. � � DATEL � _-7 �l . VALIDATION I LIC�NSLD CONTRACTORS UF('LARA'PION Go T I,�- . . Over 10 to 50 IncL _ , � •.I hercby affirm that I am licensed under prnvisions of Chapter Over 50 to 700 Inc. FINAL 6V a � �� � 9 (mmmen�inK µ'ftb Sectwn 7000)of Division 3 of the Busi Over 700 / � � ness and ProfeFsions.Cude,and my license is in fuli force and - � .�eftect. '��Services � - ' � � � (� �.License NumberJl����/ Lic.Class r..i�L �'Z00 Amp.Under 600 V � ���',,� 7 r 207-1000 Amp.Under600 V i Contrnctori,({`l L���GI'� Date .5~ �✓"� j ( Over 1000 Amp.'or Over 600 V , � � G���v� � � HObiF.OWNB[t-B111LI71R ll�C1,A1tATlUN ��Temp.Power Pole&ApPurtenances � � j��. m.�e�o e 2 � � k �- Siqn with One Branch Circurt ���j F I hereby :i4firm that 1 am exempt lri�r th�; Contractor's :�„��_.,,_ , t, I,icense Law fnr the following reusun (Section 7031.5,Bu�i- '""„""'�' y-"'�"""�""""' �� m v�j��U . �� nes.c and Yrof'essions Code): ^ � o y 3 g��Q y � . - '�-� Misc.Conduits&Cnnductors � . o � � 1, ae owner of'the property,will du the work and the Other(See Complete Fee Schedulel— � . structure is nnt intended ur nffered for s.de (Sr.c[ion � � - Q�'�(�-'�8� 7044,Business ssnd Pmfessions Code). - --'--'---� .� . CONS'IRUCT[ON LENPING AVLNCY . ---- � I h�ereby affinn �hat there is n cunstructiun lending ageneV � � for the perfonnanca of the work for whieh Ntis pennit is : pERM1T FEE (Sub-Totall �A ��issued(Sec.3097,Civ.C.). � 'i � . � , �.[xnder's Name.. .--- -� ?�qN CHECKING FEE (One-Faurth Permit Feel - � � .�Lender's Address � pERMiT ISSUWG FEE � 1 c •[hn[ I have � this applicatio an state that thc TOTAL FEE ��� � . , � ��i ove i ortnatio�i is urre t.I ugree to c ply wi[h alt Coimty . — - � Jinanc d t ia reg l.�tin iI icai �vidng, imd � � . � . h reby a�i oc e e esen nf thi.Cnunty to enter upon � ' ��e abov � er io ed pr �ty f r i sp •tion purposes. �� g7;;�:,�kgVEKSE POR EXPLANATORY LANGUAC.F: ' ' S'� � Sigi�alure erf Permit[ee Date . , � - - + , I � . , , � � � �° � ' j , �: �� � 1 ,, : � ;� , . � } � � � �, � � � , ., E � � � �-° - `tJ � � � �� :. .. � � {� ���; � , � :� ` ' _ � 1 � � ! � , , , ; I � , �. � 1 1, ` ; � :: � . . � 1 t - � � -, �; �` r . � ,-�; , , � � t i � . * � �.. l€ � I . 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