Loading...
HomeMy WebLinkAbout0820A (4) �•�-� R� S PE SATIDNDECLARATION 76A663 APPLICATION fOR ELECTRICAL PERMIT � � - CE�806G f2�801 � I )1 hereby effitm that � ha�e e rertieicete oF consent to self COUNTYOF LOSANGELES BUILDINGANDSAfETY � msure,or a certiflcate of Workers'Compensation Insurance,or . � � � - . ., �`. ��e certiTied�copy1 her /(Sec.3800,I,ab.C.) • - ON f�� ��FOR APPLICANT TO FILL IN . Jpg � . �9'J /�/L I� ��Policy Na. Company EACH NO. FEE ADDRESS � �-i7C � New Fesidential Bldgs.&Pools � � Certified copy ia hereby fumished. � �1&2-Family,Sq.Ft, $ �" S LOCAI.�TV ��J ` �, � Certified copy Is filed with the c nty truilding irtspe.ti n Multi-family Sq.Ft. � � CROSS ST � . departme t. Residential Swimming Pools OWNEH OR ` . � FIRM IJAME AK�S�D� Date1�.�Aovs�e�i - .. . n,+n�� 33 D . — � � Outlets:flec._Light_Sw._ qDDRE55 O� �E. First YD p . CERTIF[CATE OF E%EM TION FR WORKERS' Total Np. Additianal � CITY . `, 7ei No.��;/� " � COMPENSATION INSURANCE � � � � . . � PLAN CHECK 'r� � � (This secNon need not b¢aompleted��the woik involved . pPPL�CANT � �w,�DE � � Q lighting Fixtures � First 20 ApDRE55 �V . by the permit is for one hundred dallazs(5100)oc IessJ qdditional � �' ��� . � - Total No. � . I cerNfy that in the performance pf the work Po�which this � CITY . �• Tel No. (�- �O Fixed Appliances Not Dver 1 HP F- �permi}is issued,I shall pot emD�oy any person in any manner PERMIT 1 � �0� � / O so es to become subject to the Workers'CompenaaHon Lawe. Renge_.,Heater D.W.�_ � APPLICANT vi'i' a w. . � - ' � . Oven �.�ryef_W.M._ . AOORESS 33'v �,,T• ��]'� � Date Appllcant � Top _FAU� _W.H.._ . � CITv /9' Tel No.�-�/-/7,f'7 � Hood_fan ,^Other____ . NOTICE TO APPLICANT:II,after meking this Certiflcate of pisp. ,Room Air Cond._ LICENSE Oii &O�73CIass �.^ Exemption, you shoutd become subjecc to the Workers' REG.NUMBER C J . Compensattor provislona oP fhe Labor Code,you mast forSfi- power Apparatus&Large Appliances DISTRICT NO. PROCESSED BY � with comply with such provisions or thfa permit shatl be� gize&Type HP,KW,KVA,or KVA � deemed revoked. � � � . . � � Up to 7 InCt. FlNAL Over 1 to 101nC1. �� DATE 1 . vc.�ioario�v . LICENSED CONTRACTORS DECLARATION . Over 10[0 50�Incl, � �"' � , ' 1 hereby eftirm that I am licensed under provisions of Chapter Dver 60 to tOD Ina FINAL �� � � � eV . 9(commencing with Section 7000)ot Division 3 of the Busl- � Over 100 . � ness and Protessions.Code,and�my license[s in full force and � .. . eftect. � � Services � � � ' - - - � ' - � gg�q.?3 C� D-200 Amp.Under 600 V � � Licenae Numtei Lic.Class p07-0000 Amp.Under 600 V � - - . Contractor��rOG . Date � Dver 1000 AmP�.or Wer 600 V . , , HDME OWNER-BUILDER DECLARATION 7emp.Power Pole&Appurtenances � � c��2.(�A� - . SiBn with One Branch Circun � . 7 hereby sPfirm�that 1 am exempt Trom the Contractor's . � .�•�• • License Law for the following reason(Section 7031.5,8usi- Additional.5ign Brench CirCuits . � #- •2. . � ness and Professions Code: � � � � Misa Conduits&Conduetars � . ' � -��'���'S� �- . � � Ir as owner.oP the property,will do the xrork and the .Qther 1See Complete Fee Schedule)— •�• .3 E.5.0� �sfructure is not Intended or oftered for sale (Section � � . - 7044,Buainess and ProPeasions Code). . S_ � � CONSTRUCTION LENDING AQENCY - , � �•��" 8�� , � I hereby aftirm that there is e constmction lending agency � - , , , for the performance of the work for whf h thi� pERM1T FEE iSubTotal! � ' issued(Sec.3097,Civ.C.).' ' � . ' � LendePs Name pLAN CHECKING FEE (One-Fourth Permit Fee1 ' Lender's Addtess � PERMIT ISSUING FEE . � �� � i certifY thet I have read this ap0���a�{on and siate tha(the T07AL FEE . � ' � .��" , � � � ebove information ia cotrect.I agree to comply.with all Co�mty . . - � � . ordinances and State Iaws regWating Elettrical wiring, and �: � - � - , . � � � � hereby author[ze repnsrntatives ot tAis County to enter upon � � , . . �� the above-mentioned pcopert� r r__or insPectfon PurPosea. � . SEE�REVERSE FOR EXPLANA70RY LANGUAGE . . . . . . . /Il/ + �%�°�+� _I� � ��I�r , ignature rmittee Dale 1 . � � ( � '������ 1�1�:�'� )�3.� '!�� ��A����A� �_. �� ,�:, � . - � � ,3iao;i�.�s .�:-+A'�.. r.�'ti . � .a�* '.,.l'+,•.i3 , .: ��. . _. .�'��� .. �.r . �. �. ...._ ..._... � � � .... _ ._.. }'��F at[h7dr � i� Cir.'�Mb . . j .4•- ..••"� �iA�('1�{k'�VALS. '���� DATE SI �TUR .�� �. _. . ...-. BktIRH9�BR[��&1�� �'^-E@,�� I ,. _,_. _-. _ . _�, � :�' �(�..♦ I� �. . '��i 'uNDERs�6 w RK .. i. ... �..� � � whfch.��uires q`p��ft ta co+�srruc�t, �rer. tmp�are. ":� I-, 4 �. - � . - � ���� ' ' demolish,or repair�any sri'"urture prror�ro trs iasuo»ce, � " � �S , � - - �� _ . A�so.re uires the a l�nnt for,Such permit Jo �l�'e � ' '� ,� ��-- adu�t+'CONaUr7 �- L..::� --� � ---- � . ��,'�•,signed atatemenr thar he is 7icensedr ursupttt.ro'�he - � - ''x -� �. � rovisinns o the�Cantmcror's Licen e iLa �, ��, . _ y� h.-- :-wtR�rvc . -`�� � , , - . � � cotimnrteacmr.wirh��5ec[ion 7000J of4DV�m 3pof the ''`� ` � �� � � .' .'FtXTURES a,. �: �.'--, ---.. .. ''.�� � � .." ..: �' �Businesr And ProJessiors CodeJ or th�t he rs exempt ..�� � ._.`�� � ��..., -.�;,- .,,.-.. ..'y . � ,..__. ,___.._. ...�.�: � . . . ' .-���.- � '-therefrom and rhe 8aiis for ihe ulfe8�d ezemPitorc..Any . ��-_. -_` �- ._� POWERA(iTHOR12E� � . � . - Violpti0170JS¢C1i011�7O.�J.5I1yRttyQpJ1I[COIItfOfOpelmlt , . - ��� UT1UiY�Ca NOTIFIED ` ..' � . -. ....... . . � subjects ihe a iicant to e civrl penalry of na1 more�fhon � ��� .. . �• , . . . -. , fib¢�hundreddo!(ars�$500J.: ��� � ' . '-_. •. ��".-. ctnlaLF . ,�i'ic�e L.Qn...�d.cktt� � .,. � � �' � �O i,as ow�icc�f the ropect� will do fhe'woik,and� � ��' '' Nb7ES` ' �'E " �-''� ' � �- .- ��� � . , . e s ucture i not in end d o[offered iq�sale �.� !h tr , 5 t . '. ' = . ! �� `"� � ''" � (Sec, 704,�Business and.Professrons Code:'�Tke�Con• ' �"1� .�i.o�' ' 4 ��A���� __,�� .�f�..4,.-� I _ _ . .. - Fractar's�Licemse�.,law does._nnt qpp(y.ta an owner of . �, ,�'� i . � �, property who bui(ds or fmproves rhereon.and who does �f' �� " f ��-1 "� �� i � � e � �� .cuch work himsel rovided,hnt such i �_�� _.. : _.... ' ... t•,,� , . , , . , ..., � 1 P 1 +nProvements� _ . �� ,.-�, . ,; ,..� ,, „ � ,. ., , � . . . ... .-are�noh�intereded-or ofjered fo��sq(e. !f,-however,�iAe � � - - - � ' , "��� �- � " building or improvemenr is,spld w(thin one year,af . �. � T _ . �i , , comp(etion, xhe. owner-buildet�will-}�ave rhe,{1ur$en . . . � . of provinK lhut he;did rtot build.or.improve.for,rMe� ' .�,.*: : ' .. ' ,� ,, � , ,�..x � . � . ,., .:��, ��, . �Purpose.ofanle.J , . � . . . �, ,-y E)•':7 � , }{ , ` /. am exe un e ,. f � , t� ., . , mpt d r Sec ,. . ,. `; , • __ -; u� _ .- ' i , _� �__ _ _. 8'&P.C.for this reason ` � p . - ,r,-�. � � , . .. , _ � ��,. . ,� � • , . . _._ ._.....�.__ � r ,r-. . ,.. . � - :�. . , .,. . . � _. ,_____. . , .....- ��- � .� � . _. . . . �.. , i ' , t �:. . � . . , ' . . . ... . . • . �. ,., . . � ' � . � .� Date 4 3 <,. ,_..._ . � - c .: , _ _ ,. , , �F , �• ` ` , �Ta�ner y , --- � i: '. . � _ ._ � a � ., � , �,.. �,, � ,� �. , ;. .: _. --, ; 1 ,,,, , ._ _... ,.._ _.._ . __. , . . . , , „ . ,.; , , „ ,, ; � , ! �, _ l _.�. _ __ ;_ _..__. r , ` .,. , �; � , _ _ ._,... . _.. _ .._ _ ..._ . ,... , i , , , � . ,_ , �� , �, �� . � - . . , . -..__ . .._ 11 . . . . � . . . . � ! i .. .,;� . ., �.r ... , ,�., i, .. .. i.� i �' ,._ _ � . . �. , � , � ' . . . . � � . , ... 'i . . . .. . . .. t _,i 1 .� _ . _ �.. , . . . . ' . .-_ . „t.. . � . ,. .,_.. , . , . � .. . , ' . , . . . . � ,,, ... r;, .... , . .,. .. . � � . . k .t i ,p _. . � _r �k � . . l