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HomeMy WebLinkAbout1592A ,..� � . . , __ ��� ws� :�.��+dra., ..wxm.�. ....r..,w , .,,....�.,: �-t :�,�. . � ,a��,*<.,.W.. '-' .. . . .. .., ..�_:.... _...- .. �, ; . M, ,�. ._ � WORKEFY$'COhiPEN$A710ND�C'L��ATT�N' �� 76A663 --��AppLICA�`1���WI ��� �LECTRI�QC�.PERMIT ��� , �E g�e��rz$a� ( fiereby affirm that [ ha�-e a cernt�ea.te os consent ro selt COUNTY OF LbS AN��LE$ � BUILDING AND$AfETY insure,or a cectificate�of W'orkets'Gompema[ion Insucance,o� � _ �,.y v , :1�s."'�* `•�'- a certified cop. thereo c.3800,Lab.C.) ... � � ...� ...` w ,•::� "� .�::��4 � .�.. �,...�.� .�.�� ����� ....„, . ,. .w ` � .. . �. � ._. -": �-7_�j,�ft��,�3 /,.[(/�([�Jt�M�N✓...ci .FO.FiAPPLICANYYO'�F1lLfN, ��, JOB / ,�i�c � ]'olicy No.� C�mPRny � _. MfhZI/�t.-- .. _... � � EACH NO. ... FEE �� ADDRESS �.e^G���.���„�`�:LEr:.., . -���� New Residential Bldgs.&Pools - � �����-� � +��Certifiedcopyisherebyfurmshel. , ,�.- 1&7,Family,Sq.�Fi. � �-� � —" $ LOCA�ITv ��j/����j/�,�'� ��f _ ,.,_,_ ����� � � � ' ' ������ ��' �- � Multi-family Sq.Ft. CFOSSST . � Certified cop}•is filed���ith the county building�inspection � ��--� ���� . ' �� .��Y ��a`'`�`/�� , Residential$wimming Pools. OWNEp�bH �� /� P" . . .. .. . � n FIRM NAIGIE' �Mil-LER. /'7'�/7�5 �-N"t„ .de artment.. , . Date�� ���- Applicant� � �� ��� Outiets:Rec�L Light�Sw.��� J j '��qDDRES5v7/����X ���� � . . .. - aw+.m ,� First 20 , . ....... _ CL.A'CiFIC:1TEOrEXF.�fPTf(JV'�`i�'O"�'�'V:s�'14z1t�'S ... TotaiNo �� � Addi[ional CITY /,��C.%���'. TeIN� ��sf9d3 ' _ .....w. .._. > . - cOriPCxsATi6V Th'S.U'Rw1V`�`�'•���,., .._. . � PLaN cHECK.._. .. . .. . . a . . � . .... .. ... .. . :' . . .�, APPLICANT � . �. .-. p (This section need not be completed if the work involved Lighting Fixtures �� Firsf�20 t�'� qODRESS by the peimit is for one Lundred dollazs (5100)or.lesa.) ; Additionai "'"'°�^""""" � � �� �� � . �_ � . . ., .. ... � Totai No.� _ ..... ... o 1 certiSv that iri the erformance of the�eork fot�tihich this� � � CITV T I No nwur ���� V P .... . Fixed Appliances Not Over 1 HP . . . ...-.- pertnit,�s issued,C shxll nut emD�oy any person'in any manner` f PERMIT ���� yd�� ��� •y so'eS��to 6ecome-sU6ject to the l4'orkets'Compensation L2yvs.� Renge�Heater�D,W._ APPL�CANT , ,. _.... .._�.._...�. ..-. _..... � - ��� . . . ... � . .�.: . .'� . . oven�_Drver_w.nn. �_ � aooRess �/�p 7S �i?�e'T.C'�y� ...,. � � �: . .._ .� 'A ....,.. , � _/..__�. . 1 � �_W.H.._ /! TCl-✓7/%?„T �No. (d �. / Da[e� Applicant ... Top _FAU -� C1TY Ah � 9D�� . . . �w�.��. ,x ..,:..- Hood—Fan ._Other_ . ., r .. .. ... ... > �_•.-+�^y� fi-�"` " ' t �LICENSE OR � NOTiCE'fO�A�I'�LCC:�`1T:Sf,atter making this Ce:tificate ot � pisp.�_Roo�rt Air Cond._ ,.:... ��� v REG.NUMBEfi -�.'7����..3 Class EzempUon, you should become subjeM [o [he Workers' - . . . �� Compensation proaisions bP the Labor Code;you must forth� Power Apparatus&Large ApplianceS DISTRICT NO.' PROb��ED BY wi[h comply with such D�ovisions or [his permit shall be �- "�� �"� / deemed revoked. Size&TYpe HP,KW KVA",or KVAR. �C,t � �,ez.t� . . . . .. .� ......UPtot lncl. � .......... ......._,.. ..._._ FINAL �„ �.,;,;,�„ �,;r„. Oyer 1 to 10 InCI. DATE � �Q �+� VALIDATION . . I,ICEt�I5E'D�f5t5T�2'i'�'Ctl'ORS��'�'�'��-��RATIOl\ Ovar 10 to 50 Incl. I hereby affirm that I am licensed under provisions of Ch�pter� � Over 50 to TOU�Inc�. FINAL _ � ev'� � 9 (commencing with Sec[iun 7000)of�Division 3 of the Busi- Over 100 ness and Professions,Code,and my license is in full force and . xffect. � � .. . . , Services � � � � - ��� 0-200 Amp.Under 600 V� � � I,iceitse Numb,�her���.7�T�. Lic:Class pp7-7000 Amp.Under 600 V � ''fl�L.2K fY</i!�`�N�' ��. /2� � Over 1000 Anip.o�Over 600 V ��� Contrac[or ate . H00.7E�O�SKIfiR-BU7LDL.R DFCLAR.ATION, Temp.Power Pole&Appurtenances . . �`� rJ�,2� I hereb7•�affirm tha[ I-am esempt Trom the Contractor's Sign wiTh One Branch C rCUit .. ,,._, License Law For the following reason (Section 7031.5,-Busi- � �+dditional Sign Branch Qrcuits �;.c o . e G ness and Professions Code): � -- � ......_._.. __:.. .._....... � � � .._. -� �- �- � - �-� � � Misc.Conduits&CnnAuctors � ° °2�f� � [, as owner of the ro ert will,dn tlte work and [he ... ���� � P P Y� Other(See Cqmplete Fee�Sc6edul.el— sicuctuce-��is �nut intendzd�o�offe�ed fo[�sale (Sectlon� a e n�(j,]�s . . :.._�.:- 7044,Aus7ne§s and Professions Code). . ..........:�. CONS?RUCTION LCi7b'fNC';4G�ENCY`.-:.. .� . -.....".....".� .. . �2�� �'�r I hereby�nffirrti thae [here is a constructiqn lending agenc5'� �� ���--� �^ """ for �th�e performance�of ttie�work�for which,tiiis permrt �5 �� � pERMITFEE� (Sub-7o4a1) 1 .�jl . iss�ed(Sec.309�;�Cn'.C.).�� . , �. ,., � Len�ier's Nnme�� PLAN CHECKING�FEE �� {One-Fourth Permit Feel��� . .. . . .........:.. .,... .. .�.... . .... �-� .....,.......,.. �_......w..., �...:..,-.-. ; � Lender's AAdress PERMiT�ISSUIFIG�F`e� . . � �;,�.?� I certify that i fia�'e read th'ts application and state that the TOTAL FEE� � � . ..�. �,i-��� '?" �.w.-.,.,. ,...w, �.i- �.,. above information is correct.1 agree[o enmp(y with ail Coanry . �'�--' -� '� �� � � . _ . . � � � � - �� ordinances and Sxxte laws regulating Eledtrical wiring, attd . � � ' �� , , � -� hereby authorize reprrsentatives of this Couhty tQ enter upon . �-�. � �� � �- `"'�� � . .. . ... ..... .'d�✓+3fi"3..'��$""g,71.�tE`N. J.�Z,' ,..-?T�a. ..W�Mfia:>.:�.1°'�.�r�R:::yT.a..is�'_.e��:�._ _'" .-. ...,�.. theab �e-meniio�ed pruperty fo4i spec[ion purposes." SEE REVER$�E�F'ak'�G�.�A������ANGliAGf. e .�j ��"�f+�fLd ���/�����/'�"f✓ O� �/ 'j- � . . . . . . . Signature of Permittee Da ,,. ......_...p,«r�+,<�..:...m'w�x... . rt+�'�,'�w'r�»�.a+w�e,,.`.'w�'"�`,v+'��'�.^2, �k.�.. , . ..:>F'S m.'.�._r"� _z e�'+na.rs,*- ...-., -... :,, ' .-. " `", y , .,. , ,, .: . .: � ,: ;,_ �,:_� ,. , . � . � ��r�.u�-�=.�4e��.�n�e,,A�,�r«�v . ... . .. . ... . . � � .. '�t�:�.rL•y aifitn:tiai���l am.exem zr from ihe Contreceoc�s ...--'--._. -..._.. ... ., _ .... .___ . .... . . � �APPROVALS ��; . ❑ATE , INSPECTO�R'9 � ,. .�.� .. . . . .. . -: €Ee.ts a���aw �x ihe fu�to�5ing xeaaor �es�eon 70�7.5. . .- . . � . ....,.� .._ � siGr A.uae -. .... rsusr,fess onG t;..;�+s�,ors� �ode/. .�,i� rit! or _ounry � ..r . � ��' - . ..—. . , . _ . . .. . .. . .... . .. -TEM?.POWER POLE. . ,,.... .....�,—:' i ..._,. . . -�, . .. �. . . . }�ii1iCP[ �. , . `�. . . , . � .....,._ , .,- - �� � ' de r.el�:n elr�,�tn�:ures nnr-td«s s5.+ance, ... ..� � UNUcRSLAB WORK...... ...., �:. ....�. �� .. . � . a1507O !te Gppill�PtY fo:SdCh e:'rAt p j IP 6 C]k . .: ` '' .' . ' _'_ � . '' L4.: 6 ... . .. ...:.� . . �--�� - � '�Ou�H cououir ,: � -�� � . � ' � � ^� � � --� t nedestate eir 9at e s licevue .pu s.�anr te .re . ,�... '+ .:.j wlRinlG�.. .� �,. .f/'��-�-y�_'"—�—�. �. - � FeommerrttnX r.�.r Nc5ettono7�00Jcof DvasonC3IIof ePe . -----�� .Y..... . .--- � � ' �� '�� '� � ' � ; - � � n srness u+r: rrcfe.asaon- CodeJ o :�m[ n r exerttpt .. .... � �FIX UR�S. _ . .- . . . . �� � .--T.. -----j .. . . ,. .. tYz efrcir-�cnd tl�e ba.s:s fn.'the ftegel eserrnt7an_.�dny �� —`— ---. . . .. . .� .`., _ �. ...;POWE.RP.UTH6 izeU �. . ,�.: ��..�.. ..�... .�.�: . �olarortofSete-.N7c9�5�by��v �pFicantforepermi� . u�i�iry eo.rvo riFt�b � ��—. � _ . � . ^ub ecrs,h u�f�acar,z ro a civ:1 per a r�ef no rnere t�an .. . .. . . .... . � . .. ' lirenu;;ureddal�ars�(S3'On).:�� ': �� .. � . . . . ...,.... . _........ � .--...-� . . . . � .. � . ...�'ss�c2 G�t �r 204ti . .. � �,'�. ..�L�a+ow'nee u.`t?;e.Dro�crty w�i(1 do-4�,.,�wotk,a�id . . � FINAL . � x�. , .. _...... . . �- -�- � --���-�- - ;�e structurc *fot inie,qded or ofte:ed[or salc. : .. ... ... ._ . .. , .. . ., . ' �1DYFS � ...... . .... .... . . �. . . " ' ...."�.- .."."..:' " .`�' .l5ec.�7844, R=wxTness and Profesr,'e,r.s.Code: . ,TSe.�Cort- . . . . .. .. � . . . . : • � � . � � � � � ! . �. �traceork Liren.�e.7,¢:v dces�s:ann�r ro a,�nwr.er of ;, . � .... . � ,�rr.�rrty,wFsc�5uieds ar imprc,>es th�mos�,and�.vho docs . . -.._.._._..__ __._... ___.__.__. _ ,__ ... . .. .. ., ..�..,�. ...... .� � , �� .. . . . ......v,� ,_ ..:�.� . . '. . -:..... ,. . . . . . . . ..`.. . �. �r� � . nrch-�:�ork�;;,y}y¢:�nro:�ztie6 thvt such iinvravemenzs ._.. .-, - -- - � . -- '--_._._�.��___...__—.._—___. ...are rct inr�r,.�ed or-offe;�ed.�iti•sc:e. ?l,drnwecer, ;ne.� , . . . . ...._._. ��.�..._.. . - ... --___-' , .�. . . . :. . �_.,.. . .... . . . �,-. . , ... .. � ..__�:. ... . - . . ._ . . - � . . .. buitdirg� qr :inprove:rent Ls sola wirlri!� ore Y'ea.- of .�..., -- :. 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