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HomeMy WebLinkAbout1688A - - - _ _ .. __... __.. _ _ ._ ._ _ -----i -.;.. . .. _ ..___._....__ �tKERs�o„PENSAr�oNOE��AaAT,o�:.�� � �6A663 � APPLICATION FOR ELECTRICAL PERMIT � � �. . CE�BO6G(2�80) � ��afrtrm that I have a certificnte of consent to sett COUNTY OF LOS ANGELES BUILDING AND SAFETY -a certificate oF R'orkers'Compensation Insuronce,or �. . � 1 copy thereof(Sec.3800,Lab.CJ � � � . � -� FOR APPUCANT TO FILL IN JO8 Ql+OiS FALCON VIEW DR. � u. Company EACH NO. FEE ADORESS - New Residentiai Bldgs.&Poals COU38Y .rtified copy is hereby furnished. - 1&2•Family,Sq.FL S � — S LOCALITY 'ertified copy is filed with the county building inspection Multi-family Sq.Ft. CRpSS ST•I�I� C.�� � department. Residential Swimming Pools OWNER OP ��S WILLIAM TWEED � � ' FIRM NAME ,dte � Applicant Outlets:flec.25light Z�SW.1? ADpRE55'24Oi5 FALCON VIEW DR First 20 � CER71F[CAT6 OF£XEMPTION FROM WORKERS' Total No.57 .Additional CITY Tol No. � COMPPNSATION INSURANCE . C� � � � PLAN CHECK � d ��, - �(This section need not�be completed if the wo�k�involved � APPLICANT � 0. by the permit is [or one hundred dollars (SI00)or less.) Lighting Fixtures First 20 ADDRESS � � - � TotalNo.25 Add�tfonal �� I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP 'SC. •Z CITY Tel No. O permit is issued,I�sNall no[employ any person in any manner VERMIT L � � so as to become subject to the�i'orkers'Compensation Laws. Range_Heater�,W._, APPLICANT ' W � � � Oven _._.Dryer_W.M._ ADDRESS 13880 SMORE TREE ROAD N � Top _FAU _W.H., ? �ate 3 33 84 AP������� DON B. EROWN � _ _ � � Hood_Fan �Other_ . - CITY Tel No. � NOTICE TO APYLICAN'C:If,after making this Cerlificatc vf Disp. _Room Air Cond._ IICENSE OR na � Exemption, you should become subject to the R'orkers' � FEG.NUMBERC 10 23�Z.p�ms C 1� Compensation provisions ot the Labor Code,you must forth• ppwer Apparetus&Large Appliances DIS7RICT NO. � PROCESS D eY � ' �with compiy with such provisions or this permit shall be $ize&TYOe HP,KW,KVA,or KVA deemed revoked. � . ��� ,'�� . . llp to 1 Incl, FINAL � Ove�1 to 10 Ind. DATE c LfCENSGD CONTRACTORS DECLARATION Over 10 to 50 Incl. � p �O' g'� . VALI DATION I hereby atfirm that I am licensed onder provisions o[Chapter Over 50 to 100 Inc. F�WAL � . �R 9 (wmmencing with Section,7000)of Division�3 of the Busi• Over 700 ���P � . � ness and Professions.Code,und my license is in tull foroe and � . � effect. � ' Services � � . � License Number 230203 Uc.'Class C �0 OQ00 Amp.Under 600 V � . . � . _ YRCIWN SLECTBICb 3/23�84 201-1000 Amp.Under 600 V � Contranor ate Over 7000 Amp.or Over 600 V , .. � � HObtE OWNtiR-BUILDER DF.CLARATION � Temp.Power Poie&Appurtenances . �. � ' � I�hereby uffirm that 1 am exempt from the Contractor's � Sign with One Brench Circuit . � License Law.for Ihe foliowing reason(Section 1031.5, Busi� Additional Sign 8ranch Circuits � � ���6 8 8 A . ', ness nnd Protessions Code): � � � #�'� �'� �2 ' � Misc.Conduits&Conductors � . - � I, as owner of the property,will do Lhe work and the � Other(See Complete Fee Schedule)— � . � structua is nat intended vr offered for Sale�(Section � . . ��• •6 1.5 Q '� 7044,Business and Protessions Code)- � � � CONSTRUCTION LFiND[NG AOHNCY ' � ��•6 1,5 0 u � 1 here6y uffirm that [here is a construction lending agency ' � .Cor the performance of the work for which this permit is pERMIT FEE (Sub•T�tal) � � �.2 2 2�S 4 � issued(Sec 3097,Civ.CJ. - . '� LendePs Name � PLAN CHECKING FEE IOne-Fourth Permit Fee) - � � � �� Lender's Address PERMIT ISSUING FEE ' . - � I certify that I heve read this application and state that ihe TOTAL FEE 41 , above information is wrmc� i agree to comply with all Coimty � � . � ordinances d State regulnting Electrical wiring, and � - � � hereby onze t e t Hves of this County to enter upon . � - . the i ispection utpases. � SEE�REVERSE POR EXNLANATORY LANGUAGE � � � � . B 3/23/Y4 �. Signature of Permittee - Date � � �. -. % i .4 .� • . . .. . . . � ' .. . . �. . . � .. \�, � „ O{ti'l�IR-L'UILDF{ZD[CLAR.4T1U � � � � I hcrchp aiCam tl,at I am c�cmpt from thc C� . ..._.... . .. .. _ ._. _. . . . � :APPfiqVnLS '. ❑ATE iN'vECTUr��:' � . . � . Liccasc La��� Cor thc follo�cir.^_rcason�Secri .,_ �.i��i . SICNA7UnE - � -_ . -P,uciness an:l�N�ofe.r.siu��c"CodtJ:--qny rin�' .:1_..�. � . .. �.T,[Mr:,�pWF.R VOLE ' . .. .. - . '. ' .. ' �+'IrirJr rc.�uircr a pcnrrif (o tonstn�ct. p!ler. � -� -"� �� . UNDERSLA�VJORK.' .' � dcl`�alisft, or rcp7ir'crty stntcJvrr,prior to fis' . - � ,, also rcqxirct 1Gr cF>;>fi�•crri fur,audi pern:if n - -- -� �- aoUGH;Go�oUIT -. - � � � �� � '� - �si�r,ed�statemcrt dia! k: i� (icrnseG purrusnr ....��:i . . � protisior:r of Il.c Corr:ractor's l.icensc I.ma/Cha; �- - wtaiN� - .' .l; �. �`. � . . _ --_.(corrrn:er,cirt;; }•.rt1t Scctivn 7(OOJ�of Di��isiorr 3 0), .. . . • ' ... • � FIXTURES .- . . .. . . � Gusinese m'd A'ofcs.einrtt CodeJ or thet Lc is rxemr � � '�-=—_- � '` � �there rurn and d�e bas'i.z ' �'� _ �_ j for tlir ol'egrd exeitt,�7loii.:ln. • - .- . - . �owE�i aU7Nortize❑ � j�. � . rio;atiar of Scctior. 70315 b�•crti app�icartrfarapcnni, , . � UTILITY GO.NOTIFIED _ � - rubjects tl�e applicm�t to a cirr!peiie!!y of r7ot nmrCll:mt , _ . . . -. .. �- (� . � , firc h:uedrCd d'u(fars('$_SUOJ.: . . . . . _ FIn:AL. . . fi'�t�!2 'II+is �'�c�s�•� ��• � � ❑1,as incncr of ILc propcny�vill do lhe�cork,and • , - �� �� No7Es � .. ,.� . ` . . � , . `�� . �hc stcucturc ia not inicndcJ or oCtcrcJ tbr salc. . , . .. . . .. ,_,i�_, i:'r''.i;.'.. � � � � � /Scc. -7Dd», Fusirtcss acJ Yrofcssiw:s Codc: T7.c Corr , . � ' - . � � - . . � ., trcctor's�I_iccrc<r Inc doc.t uot annr}� ro aa oi�v�er of , 1. . .. .. .. : . .. . . . , .. _ ... . prnpertt ieha b:nl:l�or v�prmet themort.miA a�lto does . . . ,,,,, . ., ., . .,..- ,. , � �'' ' � ` � � . .j � suclt irorA f:in:scll.Frmided tltat s+eclt�un•upo�°meius ., ,_ _. . „ . _. .. ..... r.re �roi'I-vended nr nffercif lo•sr.!c'!L GniiPr�•r. r1�e �— -- - . � � . ' . . ' �� . buildin;.or impro��en:etrt is sold n�iddu one.vcar oI. _ . . , , con;pletior�, 11te oxaier-bui7dcr x�i!! h�re (he,burden . . _ `...'. - . . . . .. . oJ �+m�in,.^, 7f:n.t Ge did nnt build or irrtprnre�for 7he . � �� , , , � . � - . . , . , , , F'rrpn.s.o(tti�r.! � � � - .. � I am exempt tm:lcr Sec. � . , , , 13 f P.C.fur this reason' __ � U7itc _ � CH�T.r ���'. v: 1 ' . . . � _... . ... . , � � . . _ , ' ' . , ' ' .. . ' , . . _. ' .._.. ...... ..._... .._ . .. . ._ .__ . , .. � . . � . � . .. . �� .. .. .. . . .. . . .. � ... ,.. . . T \ ,` . . .ir. ,,...� . . . . ��._