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HomeMy WebLinkAboutNo Permit Number _:, , ...,. . , .. :.: . .,.._ . . :.. .. ��WORKERS',LO/v1PEN5AT16NbECL'ARYaTION ���` "" 76A663 10!87 APPLI�ATION�FO�R��E����°��CALM`���'I�A���"".� ��w��z~�^�µµ _ _ .. I hereby offirm that I have a certifimte of consent to seli �EBOfiG '� � . � � insure,-or a-cen f care of Workers'Compensa�ion Insurance, COUNTY OF LOS AIV�GE�CES�� � � BUILDING AND SAFETY�� � � � or a tertified copy thereof(Sec.3800,Lab C.) � � P�oI�CYCe�ifedaOp7.23eeby�urnishedA ., . _. ' .. . � 9 FORAPPUCANTTO.FILFACH� � NO .. F�:.: �.:.....� ...��'� •,..:,•� 'i6�. . . '„. • •�,.R � . .. �, .., . ..ew:�:.; ,C� �� EE ADORESS.Lpt .#3G — ZQs�j . .. . , . . New ReSidential Bld s &Pools � �,� Certified copy is filed with�the munty building inspeo- 1 8 2-family,Sq.Ft. 27O(1� § — S - LOCALIT4*iR.#35�42-3OOS D1 ' ��-tion department. - Multi-family Sq.Ft � — -NeaREST� � � � Date � A A �� �� �t �� � � Residential5wimmingPools � CROSSST. �� ., � .� Appl¢ont f' M ree Elec��-ic OWNER OR M.f� B��ck & Sons � ., � FIRM NAME .. _..._....,.... �,� . CERTIFICATE�F�EXEMPTION�F1£'Oh7(WORKERS' �� Outle�s`.Rec_Light_Sw._ '��� � � '� '� COMPEN$ATION�I�ISURANCE'"�� �� � ADDRESS��.69$ Greenkiriar -224 . (This section need nof be complefed if the work lnvolved 6y First 20 2 Total No. ��� qdditional CITY $Tea. Tel.N � � fhe permit is for one hundred dollars(5700)-ur less.)� Pjz9-$ . ........... ....... . .... . . PLAN CHECK . I�ce�tfy thdt�n the performonce o4 ihe work�fo 'which thls qppuCaNT . ��pe mit is issued,I shall not employ any person in any mdnner � �-- � --�---��--� � so as fo hemme su6jetl fo ihe Workers'Compensation Lows. Lighfing Fixtures Pirst 20 ADDRESS - � -�� - � TotalNo. . 1 ,Addilional � � � . - -.-. . . . .`-. . . . CIN TeL No. Date Appl caN �� Fixed Applionces Not Over 1 HP �� PERMIi - � � ������ �TICE TO�APPLICANTC��li, after mak ng il�is�Ce t f wte'"oT��� APPLICAN��C° McGee Electric� Inc pt on,�yo shauld�become sob�ect to ihe Workers' Ronge_Heater_D.W. _ . �_.npensation proJisions of the Labor Code,you must forfh- � Oven _Dryer� _W.M.� ADDRESS,�390 S. Reservoir � �wiih. comply with such provisions or this permit sholl be � � � ..__._...._._.. . Top _FAU _L W.H.— � - � ,deemed rev.oked � Hood _Fan _Other— C�TY POIROYI3� Tel.N . � . � r, LICENSED:GONTRACTbIT5�DECL!{R7iTICSN ��'�����-��� — � Disp. �Room Air Cand.��— �I OO �ICENSE OR 153378 � -aau. �I hereby affirm that I a licensed unde provisions of Chapher 9 - REG.NUMBER . . �C��.D (comme c ng with Sect�on 700p)of Div s on 3 of the Business power Apparatus 8 Large Applionces DISTRICT NO. ^� � PRO SSED BY � �ond P ofess qns Code and my license is f II force and effecL ,a/ � �� � �� Size B,Type HP;KW,�KVA,�or KV�AR- «S Q' L i c e n s e N u m b e r �-533'�$ L c C l o s s ����'—1�n Up to 1 Ind. � FINAL . � . . ... ,....' ' . '. .. Over 1 ta iD�ind. DATE , . � �. co�o-ac+o� Electrical Date 8/8�83 I(—� 7— -�S",j VALIDATION p ...❑ ..... .:..:. . . .. .- -.- .....-. . OverlOto50�IncL FINAL � . I om exempt�nder Sec � .. Over 50-to 100�inc. BY � 8.8h.C.for this�reoson � . .� Over 100 � � - �� . - � � � � Services,Swbd.,MCC&Panelboards , � � �Dotei� . 0-20D Amp.Under 600 V Signoture � � ..._ 201-1000 Amp.l)nder 6b0 V � � � ❑ � � �� � �, Over 1000 Amp.oi Over 600 V Exemption for Reg.Mainf.EIeU � ��� .SINGLE FAMILY � �� ��� Tem Power Pole&A��� ..�. .... ..... p. ppurfenqnces HOME OWNER-BUIlDER DECLARATION� Sign wi�h One Bronch Cirtuit f"'.=re6y affirm ihot l am exempt from ihe Canirpctor's License qdditionpl Sign-Branch Circuits .v for ihe following reasbn ($ection 7031.5, Business and � Vrofessions Code): � ,..,��� �� ❑ I,as owne of the p operty II da the work and ihe Misc.Conduits 8 Conduclovs . O�her See Gom le!e Fee Schedule)_ , _�� struciure s not ntended o offered for�sole (Section � P �-� � . 7044,�8usi ess and P ofess o s Code) , ' .- F J � CONSTRUC7IUN.LENDMGAG�NCV'�� ��������������-��� ' I here6y affirm ihot Ihe�e�is a conahoct on lending agency for ;� _,- _ � ;:.;., Ihe performonce of fhe wo•k for which this permit is issued PERMIT�FEE (Sub-Total} ., , . -'(Sec.3o97,-Civ C J ...._ _._._... ..: . - � 94. . . _. , . ,. �:. 3 / ., . . . . . � � - � � PLAN CHECKING FEE �Lender's Nome � � � .....� . � .. . , , . . . .�_ ._. PERMIT ISSUING�FEE_. .. _ .. _...... . .. . _... �.O O Lender's Address � � � �� ���� � � 1 certify that I hove read ihis applimilon ond;tare tha�the� TOiAI FEE � 104.$0 . above information is correct.I ogree ro comply with all County - . ordinon<es pnd$tale laws regulating Electricol wring,ond � i ��ul�arize representptives of ihis Coonfy fo�enter upon � � � ��-��- � � - � � . msln ioned proper�y for inspecrion purposes. SEE REVERSE FOR EkPLANATORY 1ANGUAGE ������ � � ��" �� � � � � � � � �� � ere y a ihe ov r , `'�� _ 8/s�R� no�me of ermiitee Daie � � . � - ' , me+ . . . ..... .......... . .. ........ . . .,.,..,��: ,q,.,.,., .my 5.�,:2 ...U..w �_ • ., ...���.. . ... .� . . �..,.. �;�:.Y' . _, '::;i . ...::. ...:.:. .. . ....�, ....:...�.s.r.u.w .�'-'�. ... .- _ _ . - � �' �... � y��r�� � ��� � OWhlERBUILpER DE£L'ARATION.� � � .,.•. . , .. . .. �.. APPROVALS DATe. . .._ . . . . SIGI�lATURE � � � � � TEMP.�POWER PCLE � � - � � . �-,-_�.- � 6 hereby affum±her i om exemot from rhe Caniroc:cr's - � ��( ^ �--�� � � � iicsnsz Law for�tha following reason ISec•'or, 7031.5. � UNDERSLA6 WORK � . � Business and Professions Code):Any city or counry v�iiich - � -.ROl1GHCONDUIT � , reryufres a permit,}o,fonsPrucl,olter,imRror,e,demoiish, ; ,,,... � . �__-. . . � '� - ���--• • �• ' �-�-�-- `or rep¢ir any s!rutfvre,pricr to 'rts 'ssuance, also re- � _ WIRING. . . � qWres Pbe appfioanf for such aerr,'rt to ii16 a stgncdstate- ... �� � � � FI?CTURES�: .� � rnent that he is licensedpursuant to tbe provisions af the -.-.. ... � " � �� Contractor's L(cense Law(C'hapter 9(commenc�r,g•,vi;h � ' T ��" ---'���'�-��-��` ��� Section 7000 of Divislon 3 of q6e Rusiness and Profes- -���� �� �� � � POWERAUTHORIZED J � � � s'rcns Code)or that Ae is exrmpt;herefrom and the basis : �������- � ���� �� -� UTILITYCO.NOTIFIED � � fo� the atleged exzmpflen. Any vrolation of Seceian � "�' "" �----��- 7C3i.5 by any appl7cont 4or a permit sub(e<ts the appli- . .. . . .. .. ... ... FINAL �nfa�om �roaE - . . . _ � oont to a c(vll penaffy of not more 4hon five nundrad ... . . . . .. . NOTES .. .....:.. .... .. .. . . _ , ... .,,... , . .,,,,_ _. ..,,_. .......,. � �•dollars(5500).: -- . �._.:., - � � �� ::-•;: � � �. � � �i�,os owner of the property will do�ha work,and ' � - � � �-� - ������ � � ihe structure is not intended or offered for sa!e. - . - • � .__.. ,. .,.-: .c...s,....., �.,��,............ ..,.s.:: ,...,.F�». ,,...1_:...,.:.rcr..::;.;..:.:a. ...��.:��...+ f. 1,:.:�,...;.(See."YD4$.�u'sTries's"SridProfesslonsCode: PheCom. , � ..�.�.� . _� . . . . � ��� � � - -� - � - � �� . � � .. . tor's License Lqw does not apply to pn owner of property .. _.-..: ._ . .,.___ --......,.:_..�..,�. a.�,........_�.... � ,:.....,.,»;.� .,.� .. . . ws-.--,.._..,, : -.�. _ . ..`:':' - ..••..�- H.•.-,r-�.'�.��..� -.:�:........ .... ....._who bWlds or improves the�eon, and who dces such � - � � �� wark himseli providnd Yhat sacb improvamen9s arz not . • . . ....� �. ...'"'A"`.J "`.` _.. '�.-^� . .^ „ �"'.. ."`::`" ..�.'"�' :�"".'�!M§'.°intendedor�oifercd€orsole.lf,hawever,thebuildingor . . ._ . .... . .. ,. ._ .. ..__. � � �� � � ' � � � � improvement!s sold within ons year of compfation,thc , :.,.. _ .............. .. ...:,._�._,.... .,..,...-,..w�� _.........,-:ww-.,...�,�.::-.«.::.. . ..�;�;, *4^.. .-.» .�y».�,;,..�.,�,r.��,�>�.�rw��,,..�s � .. . � . : � ,�•�-�," ��.•"-»�- - �.+---� -.�-.„.�'.•...;......,b�lti�7-bu�lder will hoie ihe burden of proving iha7 he did ��� � -- -- - - - - � noYbuild or improve for lfiepurpose of safe.) , ..._. ._...,..,,.� ..........:.. ...w..>=p: r.»�„>�:�_ .. ,. .,...,., . � a.�. - ... . ." . .ix..v.-e:uewwe.-a.P......-�.-�.tw.:au.�...cS�ww"«Y`i.x"�i..rr,. '�,..,.�-�.-+..+,�— +rry �.::..»..�.y�a.nn„wunw+ � .'. , � •.�... .�ufr.rw.+; .n.rs'x.�n��w. . ��. . � .. ......�. 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