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HomeMy WebLinkAbout1577A (9) N'ORKfRS'CO�tI'L\SATIO�1nF.CI.Al2AT1p\ ��A663 APPLICATION FOR ELECTRICAL PERMIT � CG-806G(2�80) � I herchy aftirm ihat 1 ha.e n certificate af consent to mlf COUNTY OF LOS ANGELES BUILDING AND SAFETY inxure,or a cer�ifit�te M Kbrkers'Compensa�ion lnsurancc,or ' � a ccrtifieJ rnpy ihereof(Sec.JA00,lab.C.) �KU6�68E588A81 The Travelers Ins. FORAPPLICANTTOFILLIN Jpg � I'r�licy�o. C�mp�n}• EACH NO. FEE A�DRE55 2341 5. Presado New Residantial Bidgs.&Pools � Certified cnpy ix hercby furnished. 1!9 2�Family,Sq.Ft. $ — g LOCALITY pl dif1011�� ❑ Multi�family Sq.Ft. — CRo55 ST Pathfi nder & Di amond Ba'r Bl v Certified topy is(ileJ n�ith the cnunty huilding Insprction de�artmrnt. Residential Swimming Pools oWNER OR FIRMNAME���f�d nit�fll(1f1(� {; Date�SZ 1pv�icant�llES.tf7Pld Oovelnrmant OuUc[s:Rpc.,.._Lir�ht_.S�v._ ADDRESS 17502 Sk Park C�rGle ` F�rst 20 �--.- CI�:RTIl�IC:\Tf:OI�1�:X1�:.`.1PTf0\�RD1111�'ORF:I:FiS' To[aI�o.�O_ 1tltJitional cirv IrVine, Cdl if. r°'"°g7g_3900 CO.`•IPLKS:1T10?i INSURAtiCE } I PLAN CMECK a � � (This section need not be completed if tlie a•ork invnlved APPLICANT 0 6y thc permit is for one hundred doilars (5100)or Icxs.) L�ghting Fixtures First 20 qDOAESS V A�lditional � Total No._� � I crrlify�that in the pednnn+nce of the u•ork for�vl�ich this Fixed Applianc=s Not Over 7 HP CITV Tei No. d . � �ennit is issued,1 shsll not rmploy any persnn in ony menner PERMIT V � so as tn become subject to the N'nrkers'Cnmpens:dinn I.mes. Range_Heatr.r_D.W._ PPLICANT w I a Oven _Drycf_W.M._ AD�RESS ' Top _FAU W.F{,, Z Unlc Anrlicant — � Hood_Fan �Other�_ CITv 7el No. XOTICIi TO APPI.ICAhT:If,eftcr makinc thix Crrtificafe of Disp. �Room Air Cond,_ 6 OO LICENSE OR F.xemptinn, you shnuld hrrome suM1jrct to the �1'orAers' AEG.NVMBER Class Compensalion prm�isinnx nf Ihe Lahor Code,ynu mus[forih• power Appare[us&Laror.AppliencP.s DISTRICT NO. PFOCESS BY �cith comply avith such prrn�isiuns or �his permit shall he Size&TypC HP,KW,KVA,or KVAR � � deemed re}•nkeJ. Up TO 1 InCI. FINAL over t�010 Incl. oArE I �Q VALIDATION LICF,YSI:f)CUtiTN:1CTORS DICCLARATIO'd Ovcr 10 to 50 Incl. // �� "/ I hereby sffirm thot 1 am IiccnseA unAcr rnvisions of Cha �er Over 50 to 100 Ina FiNAL r r B�. 9(cnmmencinG w'ith Sectinn 7000)of Divisinn]of fhe Rusi- OvCf 100 ._.-.J nr5t and Itnfrssians Cod0.��d my litense is in tull force nnd etfect. Services �� 5�,�f f� Licrnu NumM1cr 2�44�� Lia Class 0-200 Amp.Under 600 V 5 201•1000 Amp,Untier 600 V i+• • � • •2 Contnc�or Datc Ovcr 7000 Amp.or Over 600 V � • •7 6 9 0 ' 11C7\1f:0�1'4k;R-RUILI)i:lt DGCLARATIOV � Temp.Power Po'c&Appurtr.nances • • •7�p Q� I hcreby a(firm thnl 1 am rxempt from the Cnnlractor's Sin�with One Bran[h Cir[Ui[ � l.icer.se La�v for the foilo�vine renson (Srctinn 7n31.g, pu�f. AdditinnxlSlpn Branch Cireuits �2� �]+82 . ness and I�mfessinns Code): hlist.ConAuits&Cnnducrors � 1, as o�vner af the proprrtY.�s'ill do the���ork and thc Other(Ser,Campletc Fee Sthedulel— structure is not intended or affercA for sale (irclinn _ 707A,Ausiness and ProRssions Codc). COVSTRUCTION I.li\Diti(:AQF.tiCY I hereby affirm that there is a consiructinn IenAing acency for [he prrformnncc of ihc �vnrk fnr �chirh Ihis permit ix pERMIT FEE (SUb-To[al) 8 50 �5s���a�sr�.�a9 Fi r's�t�� n I.enJcr's Name____�PL"St�t�B.a�1IC pLAN'CHECKING FEE (One-Fourth Permit Fr.=) � . Lender's AdJress 4667 hidcArthur, NeSY�OL^�G}1, pERMIT ISSUING FEE I I 1 certify that I have read �his opplicatinn and sta�e�hat the TOTAL FEE 76 90 � . ahaee infonnulinn is cqrrec6 1 aFree tr�comply«i11�ail County ' or ' oneee nnA Sta�e la�es rraulating flrctric,rl �eirina, ond ' r� iy authorise representati��es nt thix Coun[y fo enter upon tl e rmioned proprfrty for inspection purposrs. 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