HomeMy WebLinkAboutNo Permit Number ��okKrRs•�ot�i�e�s�rio�nrc�:�x,�T�ov �6a�6� APPLICATION FOR ELECTRICAL PERMIT {� CE�806G 12�601 I hrrehy affirm that I ho�e a certificate ot concent to se�f COUNTY OF LOS ANGELES BUILDING AND SAFETY u inxnre,nr a certificate M�l'nrkers'Compensatinn Insunnce,nr s certified enpy thereof(Sec.3800,Lab.C.) �,�Qnn717� FOR APPLICANTTO FILL IN ,Ipg I Ynlicy No.=----mpan), IN� EACH NO. FEE ADDRESS IZQl ❑ �r,w Residential Bldgs.&Pools Cerlified copy is hereby furnishrJ. 7&2�Family,5q.Ft. S — g LOCALITY 425 � Multi•tamily Sr�.Ft. N ARE T � Certified copy is filed e�ilh the enunty huilding inspectinn CROSS ST Aepartment. Re5ldentinl Sn�imming Poo�s OWNER OR FIRMNAME �_'� I)ate1�9^84 :1pplican[ 11C�� �+�F.�,�Ctr�-C Outlets:R^c._Light_Sw._ MAIL F+�:�2o aooRess 4600' CIiKTIFICATG OP IiXGS1PT10Y i'ROS1 N'OKK1iIt5' To[a�No. AdAitionai CITY Tel No�14-540— COti11'i:tiSAT10V ItiSUR.�tiCf PLAN CHE K a (This sectiun need not i;e cnmpleteJ if the work involved APPLICANT V 6y lhc permit is fnr one IiunJred dqllars(5100)or icss.) Lighting Fixtures First 20 aDDRESS . Additionfll CC Total No, p 1 cenify that in Ihe erfnnnance nf Ihe work for�rhich this CITV Tel No. rnnit is issued,1 sha I nnt em Iny�ny Fixed Appl�anCes Not Over 1 HP � p p person in any m:mncr VERMIT V so as to bcrnme suhject ro Ihe 1A'orkers'CnciCensatinn La�rs. Ran9e_Heater D.W._ APPLICANT nC�� a � Oven _Dryer_W.M._ A�DRF.sS N t n:�i�� nvrnc�nc TOP _FAU _W.H._ ����._ ' Z � Hood_Fan _Otlier_ Ci7v Ta�N�.714-627-093 tiOTICf:TO��PI'I.IC:1\T:If,after m�kinF this Ccrtificate nf LICENSE OR ' h:xemptinn, ymi shnuld hecnme subject tn Ihe 4l'nrkea' Disp. _Room Air ConJ._ REG.NUMeER Class iG�mpensatinn prm�isinns of the Lahm CoJe,ynu muct fnrth� Power.4pparatus&Large Applianws ❑�STRICT NO. PROCESSLD 9Y a•ilh cnmply �sith 5�icl� pM�•isions or this permit shall Fa Sire&TYPe HP,KW,KVA,or KVAR � deemrd re��nkrJ. Q � �� Up 10 7 InCI. - FINAL Over 1 to 10 Incl, _ DATF �/� �� VALI�ATION LICfhSICU COtiTRACTORS D�CLARATIOV Ov^r 10 ro 50 Intl. � / � � 1 hcrchy affirm thal 1 am licensed under prm'isions�f Chaptcr Over 50 to 100 Inc. FINAL �/ - • 9(rommencing�vi�h Srction 7000)nf Division 7 nf the Rusi� Over 100 BY �� �Jn�� L✓✓�� ne55 anJ Ymfessinns Cnde,and my license is in full force and effcct. Services I.icenxe Numher 153378 �,��.Class_�.1� 0-200 Amp,Under 600 V �7� 201-1000 Amp.Under 600 V Contrac�or��C� �� +'+�netc 1-9""84 Over 1000 Amp•or Over 600 V IIOStIi O\1'YER•BUILDCR DCCL.4R.1TfOY Temn.P=:^�er Pole&Appur,Cnar.CCs 1 hereby af(irm Iha[ 1 am excmpt frnm the Contractor's Sign with On?e.���n c�.���f -s 0 9 4 7 A I.icente law for Ihe follox�ing reasnn(Settinn 70J1.5, Husi� A�diuon�l S�;n Bnn:h Cirtuits �:• • • • •� nece;i nd Pmfrssinns Cnde): . . � Misc.Conduits&Cnnductors � • •��5 O � 1, as oa•ner af the pmperty.�rill dn the u�ork�md the Other ISee Complote Fee Schedulel— — slructure is nM intended or offrrrd fnr salr (Srctinn �e�`� � _ • • •2�50� 7044,Rusinesa nnd Nmfexsi��ns Codt). ' , , CONSTRUCTIOV LL?ll)ItiG A(JL:KCY 1 herrby affirm that thrre is a cunstruction IenAing avency Q�.� ��$4 for tht prrformancc of�hc work tor�chich Ihix permi� ix pERMIT FEE (Sub-Total� � issued(Sec.3097,Civ.CJ. �-5 Lendrr's Name PLAN CHECKING FEE IOno-Fourth PPrmit Fee1 � � LenJtPs AJJrrss pER!.iIT ISSUING FEE 10 50 I � I ccrtify that 1 hare resd this applirntiun and state ihat the TOTAL FEE Zr) 50 ' i abo�•e infnrmatinn is correct.I acree tn cnmply w�ilh sll Cmm[y. � orJininres :mJ Stnfe lauc reR��latinh F.Irctric�i �cirinF. and ' hereby aulhori�e representnti��es of Ihis Cnunty lo entrr upnn the nl� mentin d property!nr inxpection purposes. 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