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1576A (9)
i .. _. _ _. .. _.,_�,,�_..A._._ , . _ _ . . . ____ {- ��U�F� TION DECLARA210N �� �76a663` ��-��. APPLiCAT14N��OR �E1.fCTRiGAL��-PERMIT �;�",50� ( . - - -� � ' � .. -. �CEbO6G 1280} � ' � f hereby�eftirm that'1 have n�,'certificete of consent to self � COUNTY OP.LOS ANGELES�� BUILDING AND SAFET � 1 � � lnsure,pr�a cartificate uf Wotkers'Compensatlon Insurance,or - � �-. - � , , - � .. � �a certiYed copy thereoP(Ser.3800,Lab.C.) . . � � � � � � � � ' �- - �� '. � .� -��. FOR APPLICANT 70 Fi46 tN,���. . . . �JOB.;� . .�" � . . � �. Po�icv N�§3-00021�omvanr STATE FUtVD CQ qDORess 2003 C'HES77V1TP'CREEK RD ' - � � � New Rasldential Bldgs.&Pools EACN NO. �F6E - � � CerHfied copy is hembY(umished. , � .1&'2•Pami1V,SQ.F;. � �` $'�.. '�" $' :' . GOCALITY� DS/�4�1� ��Bl� l.'A.917C�� . _ �. . � � '� .�Multi-familV S[i.Ft. �� '""". � � . . . . CertiCied copy is fited with the oounry buildIng inspection � CRO&S SS � . �'� - � � � . ���Q' � � �� � Resitlential Swimming Poola� � aepartmerre owrveR oA ��W�TER THftASH ' j . . � � ,- .. , ' . . . � ,�.FIRM NAME . � APPlicant J�Y �U� �� butietsc Rec.l Ligbt .3w. MAIL�` � � .. ,. -Date � . ., . � .. .'�€irst 2�� ��6Q� � ADOHESS $(iN1E � .. � '���.. -' �� � ��. CER7aFICATE OF�X£MPTION FROM WORKERS" �,Tota1 No::�...�� Additional �-�� '� - CITYDIA�OIdD.BAR �� T91 No,(71Q�59� � �� . COMPENSpTtON INSURANCE� - ' � � . �� , , � , . � �'��. . � �. � . . - .�... .�- i �.. , .,- . , � PLAN CHECK . (This section need not be completed if the work invotved avPu qrv7 I � by the�permlt is�far one hundted dollara($100)or 1ess.) Lighting flxtures. First ZQ , qpORESS - � � . � � - Totel No. Additional � �F ' � aC �. 1 certiPy that in the performence of[he work for which this � � �-�:permit�is issued,t ahall not employ eny person in any manner �Fixed Appliances Not_Over:i HP � pERMiT � T��N°' U ao ns to become aubject�to tAe Workers'Compensation Lewa. Raoge�Heater_p.W.+ PP ICANT - 'AIR ��� S�" � a i . . , j ,.. . . .Oven �.-0rYer_.W.M.,:,___ AqDRE5S � . .. . � '. �.� � 14744 ARMTNTA,t ST �1 i Z `�Data �.. �AUPlicant ' � Tov -�FAU _W.H...�.._ . Gi7VVAN NUYS 'CA• T��N'l�Z�.SIHgZ-A�T3. - . �.Hood'_..,_Fen -.,_Other_,_ . r. NOTICE TO APPLICANT:1f,after making this CertiPica[e af � � j��sp.�,�Room Air Cond.��_ � � � �� � ' '��E%emptton,'you ahouid�become subject to.,8ie.Workers' � � , �� , REG.NUMBER 27$99$ � CI*ss . ��'Compensation provislans of the Lebor Code,you must forth- ppyyer AppBfetu3&Lefge ApplianCes � DISTRlCT NO.�.�. PROCpF�S SEp BY �,� �� �with.comply with such proxisions or this permit ahall be $ize&Type HR,KW,KVA,ar KVAR.�� � �Q - �/`��Ii.- . � ��� deemed-revoked, ' � � � , �� ' �Up to�fncl.- �� � r" � � .� ��..� �_,�. � . � � � �� Over 1 to iQ InCI. � DA E� p� " . ..�� ' LICENSEDCONTRACTORS�DECLARATlON �� ������ O o�Z �. ,�VALIDATION'.� ;�- �, � . - � � �� Over 10 to 601ncI. �� � � . . � �I hereby affirm that i am itcensed�under provialons of Chapter .[7ver 50 tR 100 ina � gY'44� <_ �,� � ; 9.(commenctng�with 3ectian 7000)ot Division.-3 of.the�Busi- � �q,�e�.�pp� �. . . ' . � � . ;��.nexs artd Rrofesaions.Code,�and my Itcense7s,ln futi force end . �.� � . � ., i . effect... . , , . . � $ervices _ . , � �.i � � .License Number 274998 •�Lta Clasa�'1�j . . .�p200 AmP..Undar 600 V. . . � , � 1�1004 AmP:Under 600 V ' � Conttactor Date ' ar 7000Amp.Or Wer600 V I� � AIR-KING II3C 1 28 82 _ , HOME�DWNER-BUILDER DECLARATION ' Semp.Power Pole&Appurtenances i, . ! T � � � �� ��' � � �� �� � ' � Sipn with One Brench Circuit. ' -� � -� [�hereby aff'am lbat 1-em-ezempt from the ContractoPe - � � � � . .���57,(��Q �; � . � License Gaw for the lotlowing reason (Section 7031.5,Huai• Additlonel_S19n BranchCircuit6 � �. nessandProfessiansCode): � . � - �` . �� ' � .' � � .. ' ' #����.� r��.;'� '..' . " : , . . . � . '� - . �� Misc.CondWts&Conductors � � . . '. � �; ' . .. � M�,��I,es owner nf�the property,w01 do the work and the , Oth¢r(See Complete Fee SChedule)..:.. , � � ' � ����.►Q}Q �; - r �atmcture is nnt intonded or offerod�for�iale (Sectiort � . ��� .� . �� � - � , ' �; � "� � � .��.9044,Businesa and ProPossions Code).�� � . . . � . �� , � � ��,,����g.�.0�� � .� � � CONSTAUQTION LENDINC A6ENCY � � . , . � � . � . . � • � � � ° �I hereby.afPirm that thare is a constructian lending egency � � � � � � '� O 2.'`�..g� �'� . j, for the per(ormence of the work for whlch thIs perm(t�ie�) . � - � _ ' .� . � �1 4� � , ��iasued(Sec.30B7.Civ:C.).. ,� . ,.. -. , . , PERM�TFEE ; . .. . . �.1Su6.TotelYi . . . . �{ . Lendets Name � . pLpN CHECKING FEE �(prte•Fourth Permit Fee1� ' � . � . � � � - � , . . . . , . . . . . . � . . � , �1 ,; � Lender'sAddress' � � PERMITIS5UINGF�E � �$� �, � ' � � - �. �i �I cestify that 3�have read this appHcation and state thet ttie�� �� - TOTAL FEE-��� � - � -�� Q . � � � . � � . above fnFormatiort is correct.1 agree to�camply with hll County , ��� � . , � � � � f ordinances and State lawa iegWating ElactNca[wlring,�and �, . . � . ' ` � �. . , � � � . � hereby authorize representattvea oP thls County to enter upon � . , . , � � . ' - .. � . a . � � ; the above-mentioned property�for Inspectlon purposea. ��' . � � SEE'REVERSE FOR EXPLANATORY LANGUAGH��� � � ' � �� �T �� �`��-a�- , �, �.. S ature FPermittee � _ - � --.Date . ' . . � . -, .. . , . ��. y- ,. . . . � - . . _ __ � ___. _ - _ _ --- --_.. __,_ ._ _ _ _ _ i �.'L� � �� .�l�'M"�RRI �I�� �T'�Fl �Vrf���, . . ��r �04i. � '�r'..�"�• �,i::1M�' . . ' . . ... �.r... i .:f,� . . , '- :_.��-i�'fa_ ��f� �r �A . , f.., . :r..� . r � t . .. . , .. �'r.. �,_ . �_� '1... . . . . ti . � , ''aiYltW , . . � . , • � . .. .. . � . . . . � � ��A'ICDy81�17R:�tlYLL�Y�'B��ni�+-.L�,�91�i�b .. .._._ , ._.... .� i , ,,... �.. .. I,icGuac�.87r�.Ax the Poi .(Satie�n 7031.5. � . � . APPROVA�S � DATE . SI .IYAT R . . . ....� � � � , �•.. Ba.etnrts ardt.��tofersoa�a.�'�l'+ty�.chy..vr''eowtty . . ,... . . .�. .�.:.->--• - . . .._ . . . . � ,-�. ..��; TEMP.:POWkPR POLE � .. . '- ... �� � � . � . .r� demaliahQor re��yir�to construcl, nlrer. impreve. ....- ... • . .� �tlNDERSL�AB WOWiF. . .. . . � . ' . . � . � . A EfeeKhe92,pYier�ro its�iasu6rece� . � . _ . � � � olso requires.�he aAPt�cpnt Jor,auch-permir m.jik�a � � .. ..� --:.. '...-.:..-RouGttcow��v�i�' '� ��-� .�. ; .- _.,� : _..�_., ! .. ... -, ;. : � ' sigreed��siotemer,t�-that he is�lfc�emred pursuant to the � � , . . .... . . . . - �' w�MNe�, ,� .� � .. . .� .. -� , " j provlsions O,i,ihe Cott(t�rctor$Litenae 1aw/Chopter 9 � .... .. ... .... . , . .,.. �,, . � ,.(commencins wteh'z3letEo�y JQ00/of Divisiore..3..of the ' � FIXTUGlB � .�... ..,_" . .e_ � `''. . .. . . . . .. ' ... Busiqesa an[�Projesa�ions CodeJ or Jhat he is exempf . `j . , . .. � _ ... . .. .. . _ . . . . . . � ehersfrom errd�"the bairis.hX'rice al(e�exemptitin.Any . . POW�:Ft AUTHORIZE4 . , � . . violati0n�bf SMfi6ri�7'031.5 by�iiny 9ppi+cant forn permri � g� � uriLirv co No7iFiEo �j' �� � ' � ' �. ' subjecrr rhe applicanr ro a civi!penatty ojnar more rhan �..�� ���. . NOTeS. � ' .... . . .� '� ::� (Sec�7044,oBuser�o��tQ���petty will do the wo�k,and _ .� ti�lE brs f40ff� •' P �- . . r ofPered for sate. ' " � �� . ' . � �� � � ofe.ssions Code: The Can� • .;:_-. . -..-.. .. . .�, �. , . . . . . ,..:�. . . �.. . ��� . . . .dactor's.license 1aw,Joes�not�..qpply to an awner.nf � ., � .. ,.,. , . . ._ . . ,� . . ,. ., . . . . . f �_ . ', , �. property�w6o 6uilds or improves rhereon,and w@o-does � j � _ �- -. . � �� . � . . . . � such wark himself provided thut sucN improvements. ,.,. ,��,'..-.' �� .��y` '.,- ' '� 'A ;�.-.�. , . � . . are��noa..i��tended o�offered��for safe..ff,however, ihe � . :. .t,. _, �` ::,. ', .. . .. ., , � � '�. . . ..... . ��, . � ��. ;. __ _.. . . .. ... . : �� � -� . buiiding ar improvement ts soJd withb� one.year of . - � , , � completion,�rhe-ownerbuildeJ,wilY huve�rhe burden ' �• � � i . - , � .- of,proving thar..he�did not,build.or.improve jor tfie � ,.I, . . . . � �. , .,. . � ��Purpose of saie.j,� . � , � . . . .. - '_ ..... . . � - ' � '� . . . �.�., . � . � - I am exempt under Sec. , .... . ,. ,r _ _ � , _ B�&P.C.for this reason.. , , , Date , _.., ,. � _ _ _ . ����.. � , � � . .,. � � . _ , „ n � � � ' S• ! O��I.4� . . . ' . . . .... . ' ' . . � . . . . � . .. . . .. -- __ - . � � � . ' ' �. .. i � . � . .�� . ..: .. ... . . .. . . ... �i.. �. .-� . . ,. .�.�,� ..�, . . .. ... � . . . . . . . .. . . .. .. .._. .. . .' . . . y��i.. . . . . -� �.� . . �. . ;', ,.,.�s ,.;.'� ��., . : . �, . . .-. �. . . .. , . ._.. . _ .. � . i_ _. . . . ,. .- ._ . �.: ,. .. . . ' ' `�g'1.� �" . . .. . _ . ' . . .. ,. . . � , �.� . . . . '. I ','�.:I � ,. .. ...- . .. . ._... ., �... .... . �.�, .. :�� . �. . ' . . �ti:' . � . . . . .