HomeMy WebLinkAbout0880A ��hereby`affi�mR��RShave'aPceS(cOe�DE�LARA'IOo self in5ure, �BA663 '0�8' qppLICATiON FOR ELECTRICAL PERMIT CE•806G � or a certificate ol Nbrkers'Cqmpensation Insurance,Or a Certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof�Sec.3800.Lab.C.) Polity N0. � ' � ' � ' Cpj�pa�y ' FOR APVLICANT TO FILL IN ' " JOB '*7 ` , !c,. ❑ ,Certifiedcopyisherebyfumished. , . . NewResidential8lags.BPods �� EACH'� NO. �E ADORESS�'1'�� /V ,�( YYlp�+4� �.wi1't �" Certified cop�is (iled with the�cwnty building inspection 7&2-Family,Sq.Ft. � — S LOCALITY'SJ•T��� � �'�'dCPBf�ff�2f11. � . '' . ' . . � Mulii•(amily Sq,Ft. � — NEMEST . .. , Cf70S5 ST. Residential Swimmi Pools �- � .�Date � � ppplicant � . � ��. ..� .. � � .. _. .. . � � avtdeq on . �� .CER'T�FICATE OF EXEMP710N FROM WORKERS �� � / � �� � � F�pM�� hS�OE� 'i S� ��.-j- � ��- � CAMPENSATION INSURANCE �:� � � , Ou1�etS=Rec� L'gh[—Sw.— , _ ^^a�� Irns�aeetbn need na ne eo F�rst zo � � ADDRES3 � S.'YiL•SC-pvo!K mpleted N the work Invdved by Ihe Total No.� Additional - CITY. ���N B . .. Tel.No.5�"j(�-p� permH Is for one hundred dollers(5100�w less.) - I certity ihat in the performance Of the work for which Ihis�1permit . P�o.ra CriECK is issued;1 shall not empby arry person in arry manrer to .... .._ AF'PIJCAM. ... � �become wbject to the Wakers'Canpen tion Lyhting F■tures First 20��� � - �AD�pESS ��- � � - �� � r;. � � Atldilional � Date ���� Total No. � CRY � � "�- �--- ...- . Tel.No. Applicant Fzed Apptiances Not Wer 1 HP pERMiT NOTICE TO APPLICANT:�II,�.after aking this Certificate ot �Exemption,you shouW become subject to the Worke 'Compensatqn _ Range_.Healer_D.W. ____ ,. A���NT ^ S provisbns d the Labor Code,you must tor�hwiih comdY��h such Oven_Dryer_W.M._ ADDRESS�� �— ����L�( provisions or[his permit shall be deemed ievokad. �,. .. . ToP..—FAU�_-W.H.�_ . . ._.._... . . _ �LICENSED CONTR4CTORS DECLARATION Hood_Fan _ Other_ qTY � �� [��j(%(���� ' �Tel.No9�''-06'3 �I hereby atfirm Ihat:l am licensed under provisions oi Chapter J . LICENSE OR (commencing with Seetion 7000)of Division 3 of the Business and �Disp. —Room Air Cond.� _ -- REG.NUMeER � � � �� C�aC �- Pfofes5ion5 COde,and my IICen50 IS Ifl fUll�Olce and elfeCf. . DISTI710E NO. PROCESSED BY � � Power�Appara[us&Large Appliances �-� . . . . .. .. _.. . . _ _ `l�l0p, Size&T e HP,K6N,KVA,or KVAR �� ' �'1 •r YP .. --_ __ _ LJcense Number ` Lic.Ciass �� � Up to 1 Incl. � � - �� �-- - - FlNAL U ^ � • - Over 1 to 70 Incl. �A� �i .....VAUDATION � Contractor � ♦ � � Date �- ��-�� � �- - 1 . -...-.-.- ... . . O i [ Over 10 to 50 Incl. pn CN14 -tEGlY7fL.(U�. FINAL F"' ❑..I am ffxempt un er Sec. � ��J - -�-- Ovei 50 to 100 Ine!. .. . . gy . . W . ...... ..._._. . . .B.BP.C.for this reason Ove�100 . N . . � ... . . __ . . ... � .. . _ ._ _... ....._ .. . _.___. ...... ._ Z . _ . . . . . . _ . .. ..___. . Services.Swbd..MCC&Panelboards � � - _ Date: 0-200 Amp.Urx)er 600 V Signature � 201-1000 Amp.Under 600 V- � - -��-- � � ---�"� � - �- �--�'� - - - � � � � �� Over 1000 Amp.or Over 600 V ❑ Exemption for Reg.MainL Eled. -- � - - ��� � � � �-�� -� �- � . - ��8.8.�a � SINGLE FAMILY ��� � . Temp.Power.Polc 6 Appurtenances . #• • • • •2 HOME OWNER-BUILpER DECLARATION � - - � � ' � -� I hereby affirm that I am ezempt trom the Contracror's License Law Sign with One Br2nch Cireuit . for thn following re�son(•�cfion 7031.5.Rusinoss and Pmfaecinng Additbnal Sgn Branch CirCuits . . .. -...- . .. . ... __. . . � . _ ..� • ' � �5� CO(k): • •..' �.J O.U. ❑ I,as owner ot ihe ro r will do ihe vrork anA the structure �"��sd Conduits�&Conductors� ��-�--� - ' " � - " � � � - - --��� � -� - - p �ry' Other See Com tete Fee Schetluie , 0 8 1 5—8 8 is rwt intended or oflered 1or sale(Section 7044,Business . � P _ 1_ � and Pmfessions Code). � �� �" � � " � " - -- - CONSTRUCTION LENDING AGENCY � --- � •� -- - � � � I hereby affirm that there is a construction lerdirg a9ency for the - - performance ol ihe work(or which this permit is issued(SeC.3097, . pERMfT FEE �� � �� (Sub-Totai)' �- -� � � - � - -- --- -�- � �--- Civ.C.). PLAN CHECKING FEE- �� � - � --�- - � --� �� - � . . ___ _ . ... . . _ . ...... Lender's Name � �PERMITISSUINGFEE ---�-- - � � � . _/�J. _. . .. . ... ..._ . _ ...__.. Lender's Address � � . � /�� I Certity th2t I have read ihis xpplication and state that the a6ove� -TOTAL FEE . .. _ ._ . ... ..__ . . ._. InformaYqn is correct I agree to comply with ali County ordinances � � � and State taws reguiating Electrical winng,and here6y authorize . . . . _ . _. . . . . _. _.. ...._. representatives of this CouMy to enter upon the above•mentioned � - erty for in c[ipn oPs: ^ .. .. . - -SEE REVERSE FOR E7fPLANATORY LANGUAGE • . . ... . .. _. . . . -��'Cg� nature of Per ittes Date � [_"'_"�. . . . � ��..1 r � �^..-.� �� l_.._.. � . I;;...-- ..._ •.. _._.. . �. ,.., ; - -i-- ;;- � - ; ---;.;---�-.; --�.4;-�; �::-: � �� . � ;,� ; Y ; ; �� � i r., . � , i•_ 1 i I i I . • i ! � ��; i ' � I �Y' i • I j�` I' ��/ � I I I��' I� ,- � i i,^� � - i � .. � � , �, i I � j� � i . � I : I i � � �' i�� � i i � i ',. � �' I� i i � i - I � j , �� � j 4 1 -t + I i`� `/ 1 � I � �;�.. i ���, I � �.� ,.. S i ,� � i-' � � i � if„ !r � ' i+.. � ,i . -- -- -- � i �. - � � ' � � �` i_j � — ,.�1 y i:� . � I �� I 1�� �� I T I � �. _ �7J� C --1' - � C.� ..� ' ,. i �i( �`;" "i i° � C o � � o o � � ' i m C �.` ., � � • 1� -i m � z G) m v i'� .._ . i � r� � ' � IN � � � :�o � �= a � ; ! � - � ��i i � c� D u`�'i' i c�, N o � I - : . 1 i__ " i � I O � o' � . ; t:� � � - , i �� ' z �a 'R, � ; �_ : . �. � i ,�� ��' — � � _ '� � � _°� � " � . ,�. � o '� -c' p � �� ' `- � ' j i `j. '"" i` - . � O o. � T�. � m i .. .' � . - -� -- � ` , = y7 I •� 1 .. . . • , , . , -. : .. : .. : . "�- - 7. .. . .. ...._. . . __.. _... .__ ....._ ..__ ...__. ___ ___ _--. ,..... _.,._ .._. _ - - - --- - -- - - - � i ° M .. I ; ; ' z ; , � ' � . ' i . ' 1 � � � � 4: � �. . � � : . ! ... I � I : . � . ` � � . � .. � �..! t ' � � ' � _ _ "_ � . I � � I � � _ . . .__. .L..� "'__ I I . _.. � .. ._._ . ._. . . : _-_ _.__ . _.' .. � _' _ . I i. i � � Ji O , i -.' _ , ' ! ; i ; i � h m i .. i ... - - . . - -- - - -- - --- - . - ; - i- - i -i - , ' ' ; ! 1 I . I - � i -� - • --� -I -- - ;--- ' - -� -� -, -- - - -- --; i. j zm � i � ; , , , � : I � ' • • � . . , • ' , , � ; _ , , ! � ' � • -�+� � � ; � . , ; ` ; , , i ' -I ' ' � ' � - -- --- - -- -i `I_ � m0 ! . . , _ . - - - - - -- --... .. : - c; ` _ - � ` j ` ' � � ., f ! , � � .t! !• � � - - - i..' . � i I (: � ' , � , .. .. � � ' ... I- � ! .`�.. i � - . � � � i=i � � . _ _ - . � . .: ' �__ .� � � l: ' � .. _ - .. _ i �: : � � - . _. . : '. . r �- .. .. lL 1 � : _ � - �� i, i I'� ' � . ' � . � ' � : i � - i � ' ' � . . 1� ' i ' i � � � . .. _. _ _ � - _ ' . . . . _ � . � - 7 i ; ` � i i . ._ l. •_ .. .._ �- +, ' ! � " .. . . ... . � i � � ��'\ ' . - _ ' . . _ . C�• . I - ' " O � I I �• — � J � ci a g � r y w�=✓.o,� � �� Q m o o � � � ' _ 'C7 � Q 0 ti n ' N i �"... ' ..- � � . .. _ � ; ' R°. �;� ! �.! �'¢ � � -S2 ,c�'S � a � ` �'s va �:, o c'o $ � ' `D j � � '"x _.�� � � `�° "c, �3 � 4 � na � � �ov . . , � rl� .. , ; '_ ' . _ .. - ._ . -n� :� I .o � �S� 4.0 N—� ' o Q O � �� � � � � � i . . - � ' � ' Q't� C G - n � " � - � I 1 � '��^ � � 0� �4 A .4.'p c>� � Ot�''i � S"i r� n'o 3 '0 - o � �� � � � _ .�,,� .. - � .. � :. . • � : � � i N , Q .� Q � Q � co � ���� � � n Q y � L; ^ .q.,.� � � .. ., i _'`.• ; .. - . . - ' ��,:..� � � 3 � � �.`-°_�:� n y p r o .� _ m ; � '� �, � � n j:� ' ._ � � • _.- • _ �� � �;,, Cn :..a aQ � ypm +�n'o'� rnt k `� 25' ��c �g '� m 3� �7 .. , �. , I _ � " I : �• _c� `m �' S Y �� � g,� < � Q � c� �3 �..N � C .. � , , 1� `��' � �bTo' o °� �y Q'o iart � 4�c? �_ r= � � - . - i ,' ; � ',�'Fg Q �n� Q $ � �'� � � � � Q'�� � ' ' � � :_ I _ _ ; � _ ' � - ` ' ` _g � � ' � � `�.� � �° o � �?���-���, � o . _ __ - . � ``,_ � , .�._, ¢ � � � o' � �$v �', 3 .� � $<'� m , ` _ . _ . i -_ _ . , .._. i � : I � ���ry(.j f�n y S � (")�_ � 'p O y � �� � ?-�1 ry � , �. -�. � ' . .. , - - ' ' ' ' _' I ''y� �Q �,O � 'f.O O � � 4 � (O S Q b. ?;:w� '� , -.�--�-; _ — - _ i : .. _ , _ : : cy, � g °�, -� ,�� s_ .i � � � � ��' ,cn= �� � .. - : , . : . �,:_ _�-4.� �� � ��� . .�, W n � � ? �, �.� � Z _ . �a R �S � m e � � -i`- . . i . . . - _ ... =' .., _ _ y� �' � �� '" =�'� � _ � "�.� � ' � � (,:• o c� � m � " - - � -,�' � - ' � � - - - � o r � c � � � m . �o �g c c�' a :�'� � �o a � --,- �.� . . = :_... :. . �1 ; '.. :_} _. _ _ �� � ; � Q � E $. � � � � `� ` . . _ _�_ ' _.. n h v; �� � `��c g � � � � ��Q ����o -. � --