HomeMy WebLinkAbout1348A (7) R':�':Kl:liS'COSfI'rtiSATIO,:DFCLAI2AT10V 76A663 APPLICATION FOR ELECTRICAL PERMIT �
CE�SO6G f2�801
I hereby atfirm thnt I hsce a certificare of cnncrn� to sclf COUNTY OF LOS ANGELES BUILDING AND SAFETV
insure,or a cenificale ot R'orkers'Comprnsalion Insurancc,or
a rr[ified copy ihereof(Src.3604 Lab.C.) �
�ft L�CL��/C-��J��� �1 FOR APPL�CANT TO FILL IN JOe �Zp (1
I PolicY No. C�>mpan)�N� a'Z EACH NO. FEE ADORESS �o ��(,4�i ►a. rJn
New Residential Bldgs.&Pools ��
� Certified copy is herel�y furnished. 1&2�Family,5q.Ft. $ � — 5 LOCALITv
Multi�farf�ily$q.F�, — NEAREST
� Certified cnpy is filed w�ith the cnunty building insprctinn CROSS ST
Res+d_e7 lial wimming Pnols !"t
dep:inment. 5�i1� �. �IRM NAME�1..�
Date_L—�.5.��nN����� �' S• '� o�uou RCa�Licht_S�v._ � MAIL / �^
FirSt 20 ADDRESS b
CI�:KTII'IC:1TI:OI'G�F'�II'TION I'ROt1'.�'OKI:1:R5' Tot�':I Nn. llrlciitionzl clTv ' Tel No.
CO}1pGN5:1TfON IVSIIRAKCIi PLAN CHECK � }
APPLICANT a
(This section need nnt Iw cnmpleted if ILe u•ork im•olved �
I�y the permit�is for one IiunJred dollars (5100) nr Ics�.) Li9hting Fixtures First 20 ,4DDRE55 V
Aciditional �
Total No. CITY � Tel No. D
1 crrtify ihsl in Ihe perfnrmance of the�cnrk fur�chich this Fixed Appliances No[Over 1 HP �
�!CffI11I IS ISSUPC,I SIIpII not employ�ny persnn in any r:ianncr PERMIT '�� („)
SfI�5 tn Lecume subjrct to Ihe A'orkers'Com�ensatinn I.awt. Range_Hr.ater D.W.� APPLICANT W�
Oven __DryCC—W.M.— ADOP.F�S� i ���� 4)
Uate ,aoruc�m Top _FAU _W.H,_ � Z
HOOd—FA� _OthCf_ CITY I���,4, �� Tei No. _d
YlL
NOTICIC 70.API'LfCAVT:If,afler makinc this Certificalc nf Disp. _Room Air Cond,_ LICENSE OR
ICxemption, you shnuW hecome suhject tu the A'orkrrs' . F7EG.NUMBER Glase �
Compensatinn Frm•isions of Ihe I.aNnt Codc,you m�ist�orth- Power Apparetus&Large Appliances . OISTRICT NO. PR`�SSED BY
u�ith compl5' H'��h xuch prm'itinn5 or Ihis permil Shsll he Sire ffi Type HP,KW,KVA,of KVAR �L' �
deemed revokrd. L,/ , �'���r�Y�
Up to 1 Inel, FINAL ii
Ovr.i 1 to 10 Incl. pATE Z VkLIDATION
LICI:�SI;U COVTRACTORS pF:CLARATfOY Over 10�0 50 Incl. �� �J�
I hrreby offirm that I am licensed undcr provixiuns nf Chapter d�er 50 to 100 InC. FINAL � � d� �`�
7 (cnmmencing w�ilh Section 7000)nf Divisinn 7 nf ihe Rusi- OvBr 100 BY
ncxs and Yrnfestions Code,and my license is in fuil force and � . .
effect. Services
Licrnse NumberG�_C_:11//D Lic.Clasx_`�–�ZLI� �'Z�'°�mp,Under 600 V
'–'/ 207•1000 Amp.UnAer 600 V
Contractor�s� Oete�=gZ Over 1000 Amp.o�Over 600 V
!f0\iG 01l'NER�AlJ1l.UER DF.CL:IRATION Trmp.Powr.r Pnle&Appurtenances
1 herehy aflirm that ! om exemp[ fmm ihe Con�nctor'S Si9n with One Branch Circuit
License[aw for Ihe follnu•inR reason (Secfinn 7031.5,Rusi- n��i[ional Sign Bronch Circuits
nesa and 1'rofes�ions Code):
h",isc.Conduits&Conductors
� I,�x nwner M the Property,x�ill An the u�ork and the p�her(See Comp!ete Fee Schedulel—
structure is not imendeJ or offered for sal� (Se[tion F� 3 4,$n
' 7034,H�isinrss�nd Profeasions Code).
CONSTRLJCTIOV I.IiNDI\G AO16NCY �t� � • • •'�
1 herrby nffirm lhat [hrre i5 a c�nsiruction Iendinc ae^nty
fnr the prrfnrmonce�>f Ihe���nrk for «�hich ehis permil is pERbq1T FEE ISub-Total) � • • •0��
issurd(tiec.3097,Civ.C.). �
I.rnJcr'S1amr PLAN CHECKING FEE IOne•Fourth Permit Fee1 • � • •0� Q�
I Lendcr's Ad�irrss PERq71T ISSUING FEE � � O�.Z 7��2
� I ccrtity thst I harr re�d this application and sta�r that thr TOTAL FEE
above inturmetion i:correct.1 aeree�o cnmply�sith sIi Cnunty
mdin�ncec and State la���s reFulatin6 ���ectrical �ci�inG, and .
It^fehy authorire reprrsentati��rs nf this Counly fo enter upmt
the abm�e�m ntinned prop ty for inspectinn purpnsrs. SF.Ii RESV F,RS[i 1'OR GXPLAV.\TORY I,ANCUACIi
�l.Y�•
i¢nature erminee Uate
Il , , ,J 'J ' ' . . ... .
�. • .
`' •
, s • . ..
�. . : s � � .
I `' . ' '
I ' ' I .
� � � � � � - = I- , =�±�f ��:
� I ' 1" f"_ �C _ ,I ` I r� I� : _
I c: � r I i':: � ' �^� ' �r
� I � { .. ' . ; ;; I ; �:: � I �� i ? �
� .I � �..
� � I I � � _ I_ ! _ i � i� l; 1 .I I �
I I I I I � � . .J , ! � �� Iw I� '
I • . ' �� ; � r. I
' I I I I' I �,L',"-• ! � - � ' !-- � -
I I i` ' . ' � I
I � I I ; . , -�. _.'. .' .i.-
� � I C .1 I � i i � 1
I � j I -d
I I . . I^i I I i I r.
� I ! � �� ' I I !
� I � � ._ � ; � � . I . i
� f � i _i; i .�- -- -:- -_�
� � � i � I � � � I ' � I - ' I I �=�
� � � � � �
, I � i ; I , _�.
� i I � I � � � ; I�:�;;
' � I i _ _
,�..
. I I I ' I I , �=:..
� � ; i � � i i � I ► _i� I i����;
� ; � � j � I i ( � , -- -
� � I ; � I � i
; � ' ; i � , i .
� � i � ' ; I
� , � . ; � � i
� � � � i I � � I
� I � il � � .� � � � � i
, �
� � � ' I I � : i .
I � I � If � I � ,
I � I � I I I � � I . i I
ii � � � � , fl ! ; il � illl
- - - �. _ _ _ _
• — „_ — ' c ! � _ C - = r " - \ " , - -
,' r ^ ' , - - .' _ ' � _c..~ - r,`, ` - ' _ -- -
It = `- • �, . _ � ' _ _ ..._
7 I - _ , , : _� .'i�, � = ' � ._ , ' _ � i., - - - ._
�: r.
_ _ y � _ _ - _ � � �
- � _ _ C'' L. - _ �' -,C.�. ' �' , ( � �
. I • ' ' � �. ` _ " ' _ _ l _ - i.
' . ; I , "_ C� `! (�_,_ ` , `1 .. - ` y % .
• ' � �: ..;' C � ^ .. ` � �, ' ` ` _ _ _ %
, ` _ ' �C `[� � _ - ^[� - lC..`,. C�N y,C `t- � �
' I , ` � , ' T' .` - � � � �_ _ C
` } [ _ _
� ` � �^. �.. .. �` � ... � � �. . \ 'C'. . .. . .r.