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HomeMy WebLinkAbout0920A _ � """�"t"'"T`o"oE"A�AT�o" �`ro,°�"��3e' qppLiC/4TION FOR ELECTRICAL PERMIT n � f here'cy affirm tha+ I have a certificote of:onsent to �Eep�'y3r,- . . � - - I� insure,or cr cet��ficate.of Wo�kers'Compensation�nsvran�,- : - ' -_ �C)UNTY OF lp5 ANGELES - � DEPT.OP PUBLIC WORKS- � -- � � � �-or a ceriified copy the:reof(Sec.3800,Lab.G)�� � �.- � - - -:�- - � PoliCy No .. ..�Cnmpony.'..�. :".�-, .-.,`.` ' .... ... FOR APPUCANT TO�FILL IN .�_M � .:_-. 109 �-4�D��/�r�f. �Cerhf ed co is hereb fumished. � - � EACN NO FEE A.D3RESS f'�� , .. ��� . pY _ y � New Res�denhal Bldgs &Pools � � - � �Ce�tf�ed�mpy is filed with ihe�ountv bui�ding inspeo- 1 82-Famlly,5q.ff._ -. $ — 3 LOCALITY���Lj�(�/� . . -�- -.. Ilon depar+menL ... - � � �Mvlfi-family Sq.-FL � — NEaREST . ��� . - -��"' CRO55 5?. • - �Dote � ..'.A I cnrd . Residemial Swimming Pools ... . . DwNeR OR�.. `�,�. .. �p..: . �.:. _.:_ ,.,_._.... .. PP � .�� - - rIP.M NFME r�/�� /�yM�� �--- CERTIF�CATE OF EXEMPTION FRt7M WORKERS' Outlets:Rec�Light�5w.�� �� N"�'� f�r�� .- --- ' � - COMPENSA710N INSURANCE � - r �� aDD2E55 ��.�: :- -� - ,Q Firs1 20 (Tbis seclion.need not be complated if the work involved�6y Totol No.l� � -Additionof -� � � CI7Y Tel.No�i ��� � -ihe permit ts for one hundred�dokiars(S100Jor less.) - - p�pN,CHKK .� . � �� ��� - � I�cerhfy ihat.in ihe periormonce nf the work for wFich this - qppUCANi .. " � �--perm f s�ssued,I sholl not employ any person`in-Uny manner-- � ��9Ming fixtores Firsf 20 � ADDRE55 �so os io eco e sub�ecl to}he Workers'Com e at�on law . a - - - Add�honal - -- I ��' Toral No. � .. . .. . . � OTY , ,.__ . Tel.No. Dof? .-f� .. APPhco . ... - ,-.,.. . ._ -_ �—� Fized Applmntes Nof Over 1 HP � � PERM�T �/��� �--/� . NO CE TO APPIiCANT: If, after makir�g thls Cerfificate of ApPLiCATON r^Y`��' �A�.Tj�ev�i•.d"� .� Ekempt�on,-yov shvuld become �s�b�PU to ihe Workers'. Range--Heater—D.W. _ � . _ � -� � Compensanon provisions of the Lobb�Code,yo��mUSt forth- Oven -� y -_W.M._. A�DRESS� ��fl�� �Il�G�• .---Or er . wiih comply w th such provis�ons or this perm t shall 6e -Top — FAU —W.H.— -�� deemed revoked - .;,:_ .. .:--� ��' Hood ... ._ -��'� CITY U,�r� . Tel.No3,���r. ,— Fon Other—, . --�- LICENSE�CONTRACTORS pECLARATION � . � _� � - uCeNSE OR - - Disp.-�Room A r Cond. , '� � Class, -- I hereby aff rm ihot I am�icensed under provisions of Chppfer 9�- - . REG�.NJMBER .... � -�(commenang w th Sec�ion 7000)af D�vis on 3 of the Bvs�ness" � power Apporotus&Large Applionces DISTRICT NO� - - � PROfE�D BY Y and Professin�s Code,and my uc nse Is�n full force and effecL :. - - � -- - � � n' i �jy�j y� ,�/ Size&Type HP,KW,KVA,or KVAR- .�—' 6 �./ O license Number/'✓ .` - t c.Closs� Up fo 1 incl. FINAL . - . . � . ' �� . Over 1 to 7Q Ind . DATE �;,.'�;(. �� VALIDATION � . `�-Contract ,,,,.. •Da+e�—�-- Over 10 ro SO lncl. -. ; -� �-���� F- �Q � . .:__ . . FINAL )n . . I dm ezempt under Sec. - - -Over 5�to 100 Inc gy I/`� ��, ��'�y 2,r`A � � � � ��. Oyer 100 3f'"v ..m o c = s'� a � �� 6&P.C.for this reason -' �` � . . . . . . � - - � $eriires,Swbd.,1JiCC&Panelboards N . :�.:�Dote: z _ � 0-200 Amp.Under 600 V - . � ��.�a °G�''�-.7.�-�. . Signawre - 20t-1000 Amp Under 600-V� . � - � - � ... . �� : -Over 7000 Amp.or Over 600 V 5�,����^.�.. �❑ Exemptlon for Req.Ma�nt Ele<t _ � � -- - � . - � ._ .� SINGIE�FAM�LY . - . � 7emp.Power Pble 8 Appunenancas.. . U ,��_����R� . � HOME OWNER BUILDER-DECLARATION � Sign with pne Brancn Cvcui� � . I hereby affirm ihat:i am exempt fram ihe CoMroctor's License . � �� � . Lnw for ihe following reason(Section 7031.5,�8usinessand Additionol Sign Branch CircuHs . _ .. - ��Professions CodeJ: . � - . � Misa Conduits&Conductors � ❑I,as owner of the.propeny; w�ll do the work and ihe �� Other(See Comple�e Fee Schedule)_ - , ' - structLre�s nat iMended or offered for sale(Section 7044, - Business and Professio s Code). _ � � � ' � � � ��-CONSTRUCTION LENDING AGENCY . � - `""""� � -� �--" � 1 hereby affirm thot Ihere.is a construcrion lending agency for -�� -�he performance of the.work�for which�his permit is issued� PERMITFEE (Snb�otol) � . (Sec.3097,�Civ.C.). . ... . - . . . .. - - . � ��-�` . �. - � - � - � PLAN�CHECKING fEE- � . . . - - � - Lender's Nama . ��-'"` � . .. � � . - . � . ..�„ _ �.,. ... . � - . � ��- - . PERMIT ISSUUJG FEE Lender's Address , .4,:..-. '-` ...�-:�, -." : _._. . - ...,.. I cenlfy thot I have read this applicatron ond stare rhor rhe TOTAL FEE . , . `:: ,, .::... ' `.. �-:1�°� � . -- _. _.. _ . .. . . above information is correct.I agree�to comply with oll Counry � � - . -�- - - -- . . - � �� . - � , �� -� ��, �ordinances and 5!pte I regulating Electrical wiring�,qnd _. . .. � . �� . . . .. ... . . . .':.. .-.- . .�. � - . - hereby out ri r entatives of this County to eMer upon . -� � - � -� �-- � .� . �� � � the - ' n ty for inspection Lrposes .._.. � �.�... .. - �.'.� �. , �...- � - - SEE REVERSE FOR EXPLANATORY LANGUAGE - , -�.����� - �. . � . .... . . .-•. . . - , ._- -_ ,., . . ,.� , .,�.. , ;. : _._ Slgnatu-re ermiftee -.. . . Dpte .. :- . :- � ..-. � '� -� �, ,. - ' , _ .ais ;; - ; . � -: . .. '. �� . APPR(3VAL5 ... DA7'E �.. ��SPECiORS . .. . � i.1WN�fl•B�IILDEi�D�Ci.ARA-ffON . i, . . . S�GNP.7URE . _ . .. . ... : . - - . � TE41P POWEFI POLE� . �- . . � . . . . ;.� �- . . t her2hy�ttirm ihat 1 am axx�rpi tram 9he Contracfar's -- � - UNDERSIABVdORK. � - - -� � - - � . - _ - � �LicenseLawfociA�f61lowing�easonj5action7031.5,Buslness - - - . . ROIfGH.�6NaUiT.�� � , � ... .r' ..� . . andProfessrarWG�eJ:Aryciryarcountywnichrequiresapermlr • . . . � �. -, ���`° � � - � rc.corrstrucz;alter,"rmprova,�.dzmW;sh.or reyair any st�ooiure, - - � � " '1�IRING` -'� � . - - �"�� � - priortolrsissuence,alsorequires*heapplicar,t./flrsuchpe�mitto . .. .i� .. . . �- � " --��-� � ��� � �- file a srgneC statemenr tha7 he(s lrcansed�ursuant tc tlre�rovF - - . FIXTURES " - �� � - �_ �� - .� � �,ions ot tfie ContractgJ's License La;v(Chap�er.9.(ca^+mexrng :i}•; µ:`""._ . . x `.. . , . . . ... _ � . POW EA AUTHORIZED�" � . � .�- �_� ���-� ���`'� � � wifh Sectron 7bOp)ai Biv�sior 9 ot thz Busi�es3 ai�d Professiuns -� . . . Code)orfhath&isex¢mp[iharefrOm3ndMebasistOr1he2118g8tl . .. _ .. . U7ILITYCO.iVOSlFI'eD�� � - • � � . - � _ - e;cemAironAiyrrof&t+onofSection7031.54y.anyalsplicantfora . ... .. FihiAi. -:-...�' �.-,. ..�. � ... � .-. . . . ,oermit snDjects 16e applrcan(ro-�a arvit�rralty ot�nat mcr�rian . . .. nter on e»nE- : ..,, t vE hur�dred da ars;"35QD}:. - � `3 : �. . _ . +�lOYE& �-.. . . ._ _ _ . . --.�.._ . . ��, -" . . .;�•, .:n t.� . . . . . _.. . :.^_ _1�_,;,-. .4_ _ -� :. � . , . _. . � . ..,.. ..�. �_.;.� y...,>. . ,.� ", s... .. . . .. . - . ..-- �t,as owe��r o#tn�pra�s�eY wit,Uc iNa waek,2rkt — . -_ . �� i#��sira�ture is�+wt±ntended or offerea fof eaie. � �.�;.. : .�•'%.. .. , . --',...,,,� ..�..:-..:. . _ -. ... -_ _. �.- ' ' ._`�iSec.70A4..Business and Proiessiors CaCer..Tfie Con[racYOYs _ � - - . a .. . ���CicenseLawticesnata��.�y�tasnownetoipiopertywhobuirtlsoi�. _ � .''�..�`" � _ � . �� . ... �mp�oves thereon;anC v�ho�oes svch work him,e7/prov'r0ed thaf� . �^.. � , '.� ...-.. . .. - — _ - _,��_„_,. such%mprovems-ols-2re�noF�intended or'oflered;w sa�e. Jf. . �� � �`-� ' ' - . .....__..-. �. .. .. .. � . . .'. - however.the burfd;ng or.improverrant;s sold within one-year 3l � . . . . ....._._. . .. .... � ...�: -� .—_ -�-compietran,fhe ownerbuilder wif�nave the burden ci proving that� - . � ��.� ' - . . - - - _ � � ' . . ... .._.. . �. ._ne did�ot oulitl ci improve for 1ne,Purpose of sale.l � . . .. � . � _.. . __. - .._ . .. M -. �-�.. �':. ,_: l�;ex'�`�t�t ur,4�sa�, ; • �� - — � _ __: : , . ": . . .. . .. -. �.:. ,._,:- ,...�_. � .��&�'.C.fbt YFYIS id�5@R :;,. - ..... �e� �1Rt@_... _ : , -- — .�-,�-.�,.�.m.. . �wner . - : _. ,. : , . ,. ---- - z ,-�- .� - ,sj .„�=,� -