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HomeMy WebLinkAbout1373A '"°"KERS-`°""�"S""°"°E"AR"T'°" ��'°'ei APPI,ICATION F4R ELECTRICAL PERMIT 1 hereby affirm tho�I have a certiFicote of consant fo self tnsure,or o cer��f�cate of Workeri Compensanon Insura�ce, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a ceriffie.�co/py/ih7e�raof+/�tG5�f5}.���3800,Lab.C.j � � � �Policy No.yRG{�Company-�.�.+j/.�-�� FOR APPLIGNi TO Flll IN AODRESS ��` �QA�+-4 wW @ Certitied mpy is hereby farnished. . _� New Resideniial Bldgs.,8 Pools EACM t�0. FEF _ ❑ LOCAtITY Carlified copy is filed with 1he coun building in c- 1&2-Fomily,$q.FL � S -- S �p�p e�y�, NEAREST . . tion epar� n1. Mulii-fomily Sq.Ft. � CR0555L � ���0 � Resideatiol5wimmingPools � pWNEROR � Date ApplitaN " � - FlRMNAME G � ERTI CATE OF EXEMPTION FROM WORKERS' Outlets:Rac_Lighf_Sw,_ �'�� � COMYENSATION INSURANCE � F,s �. ADORFSS (Thi�s�Hien m�d not M eempl�t�d if th�wark tmralv�d by 7otol No. q����a�o� CITY � Tel.No. fh�p�rmit 1s lor on�hundr�d dellan(f100)er I�ss.) I tertiiy ihat in Ihe performance of the work for which ihis APaIICANTK permil fs iuued,I sho�l not employ any parwn in ony monner � � . so as to become subjeU 10 the Worka�s'Compensption laws. Ll9hting FixNres Firs�20 ADDRE55 - � � �� � Totol No. Additionul � Do�e ApplimN � � CITY Tel.No. NOTICE TO APPIICAN7: If,after moking��his Certificote of Fixed Appliances No�Over 1 HP� pFRMir � . Eremption, you should bacome subject to 7he Workers' Range_Heoter_D.W._ A����'�T Compansotion provisions of the Labor Code,you must forth- Oven _Dryer�_W.M._ . ADORESS - - winc�omply with sv<h provisions or ihis permit shall be . Top _FqU —.W.H.— deemad revoked. ' . � � CITY � � Tel,No. . � � LICENSED CONTRACTORS�ECLARATION Hood _Pon _.Othar_ Disp.� �Room Air Cond. — ucENs�Oa . Cloas. � I heroby affirm ihot I am licansed unde�pravtsions of Chopter 9 REG.NUMBER� (commancing wi�h Saction 7000)of Oivision 3 of the 8usiness pa,,�er Apparatui 8 Lar9e Appliances DISTRICT NO. . PROCE D BY �, - ood Profeasions Code.ond my license in in full force and eff � � --� d 37/Od J Size 8 Type HP,KW,KVA,or KVAR LO.�] � � ticense Numbe� �O �ic.Class � � �' � � � � . _ V Up to 1 IncL FINAL . Cororoclo � ate�3%� Over l,to 101nc1. DATE !J . VAIIDATION O ova�,o ro so i�d. l'� +- . . a- . _ F�NA� _ . I om e.empt under Sec �Over 5010 100 Inc. BY . 6 . � B.BP.C.for lhis reasan Over 100 2 - �ate: Servites,Swbd.,MCC&Panelboords - ► � � ' 0-2W Amp.Under 600 V� , Signature 201-1000 Amp.�Under 600 V � - �, . .O ..Over 1000 AmP.ar Ovar 600 V �� ,. . . . _... Exempiion tor Re9.Maint.Elect. ' _ SINGtE FAMItY Tamp.Power Pole 8 Apportenancas ' A�3_7.3 A ��, ' HOME OWNER-BUiL�ER DECLARATION Sign wirh One Bronch Circuit � 1 00 � #•�' • • '2 � � I hereby effirm tha�I om ezemp�from the CoNroctor's Licanse Addiiional$ign 0mnch Circoiis� � " Law for ihe fallowing reason($ecrion 7031.5,Business and ' �,a •'2�5 Q - Pwfessions Code): � , , � . , ❑ 1.a%ownar of the propeny,will do ihe work ond ihe Misc.Conduits 6 Conductors - � � ,•,• a 2�J��� stroclure is nm intended or offered for sale(Sec�ion ��her(See Complete Fee Schedule)� ► . ,.O P.D�J-H 4. .. 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY � � . ._ I hereby affirm ihat Ihere is a construtlion lending agenty for � . . fhe performance of the work for whkh this permit is Issued - PERMIT FEE � (Sub•Tolal) �5 pp ��� � .. . . .. . . �Set.3097.Civ.C.).� . . � � � � PVrN CHKKING FEE � � � � . . � lender's Name � Lender's Address � .. PERM(T ISSUING FEE . . �p � � 1 certify thot I hove read this applica�ion ond state thot the - TOTAI FEE 'ZS �j0 _ above inlormation is correct.1 agr comply with all County � ordinance�C nd State laws ra o�' g Eletlricol wiring,and � .� � ,. •6y�itF on reprezeM es ihis Caunly fo enfer upon � � . � � � . -� � -'—�mantio ed pro r1y r inspaction purposes. � . . \\ ' Z 3 � SEE REYERSE FOR EXPLANATORY IANGUAGE \ '�Perm� ee D e � � � � ✓ �, . . �.-- ... .. ....'. '��. � �. ',.. _ ... ._ LD D ���/. .. . .. .� APPRqVALS�. . DATE � . _ . , . . .._.. '- OWNER-BUI ER ECLARATION , SIGNATURE � � � _ . i ' � . ,,. � , , TEMp.Pq�NER POLE�� � �horeby affirm Ihol I am exemp�irom fhe Conlrocbr's ' � -� - - - -�� � - � Ucamo Law for tha following rcason (Secfion 7031.5, � • UNDERSIAB WORK ' . _. � _ ... .. . . . �.,. . ' 8usiness ond Professions Cado):Any city or county wh)ch, 1 - -�- - �� � re Wres a ormt/fo construct,ollcr,Improve,demallsh, _... �� ROUGH CONDUIT ---�-� - � � - � Q p . . _ , ,e... ,. �� ' �-�or repvfr ony sMudure,prlonto�!ls lssuanco, olso re- . � WIRING � . ., qulrvs}haapphconllorsuchparmttfoRleaslc�nedsfato- . � . � - � ��� - ment thot hc Js licensedpunuont fo rhe provislons ol the FIXTURES � --- � ' �,i Conf�acfor's lfcense low(Chapler 9(commoncing wUb �� '- ���- " � - POVYER AIfTHORIZED � --"'�- - � - �� SacUon 7000J o/Dlvlsion 3 0/fhe eusiness and Proles. ' ,�slont Code)or�ho�ho Is exempt thorelrom and the basls - �� - �� -� UTILITYCO.NOTIFIED` � ' . -lor fhe alleged,exempNon. Any Nofat(on o!Seci/on � . � --� ---� � � FINAL � P c-� � �,7031.5 6y any opp)itont foro permlf svbJods fho appli- , Lnfer an .y�nef . , . conf fo o clvU ponolty of noi morr fhon/7va hund�ed _ No�s- — doua��ssoo�.: . . � - , �� � .Q I,os owner of ihc properry�will do ihe work,ond �-�-�����- - � - -fhe structure is not intended or oFfered for sale. . � - � , -� � � � ' -� ���(Sec.�04t,8uslness ond Prolesslons Code: 7he Confrac- � � -� --� � � �- � � -' ' � 'for's Llcense Law doos nol apply fo an owner o�property ___._. _. ._ . . .. ._. . . � � � � . . � who 6ullds or Improves 1he�eon, end who does such � ' � ' work hlmaoff provlded fhat suth improvemenls are no) ,�- —� •-�--��. -- � ��- - � ��� ����� � -- . lMended or ollerod lor sale.N,however,Ihe bullding or - � � Improvamanf 7s so(d wlfhfn one year ol comple�/on.IFo - . .�,_� � �, ,-;,-� , �� , cwnorbulldorwillhavclhc6urdrnofprovfngthofhedid . - � '��-�-'� � � � � - ��not bul�d or fmprove lor the purposc olsalaJ I am axempt undcr.Sec. , . � B&P.C.fcr this reason - . _ ... ' � ' � Date-� . �- . � Ownor .. � . .. . . �:�t � � "t. . . , , . -. � ,- . . . . . . . . � . .� � . .. � .. . . . . . ., . �/ /-�'