HomeMy WebLinkAbout1796A (10) � n•oHxews•co�arrns,v�ovn�:ci.:�ia�.r�ov 7�qGG3 APPUCATION FOR ELECTRICAL PERMIT �
ce aocc tz�eoi �
� uereby atGrm �hat 1 ha+e a crrtific�te ot cnnsrnt �o srlt COUNTY OF LOS ANGELES BUILDING AND SAFETY
insure,ur a cer�i(inte ol R'nrkcrs'Cnmprns�tion Insurance,or .
a carlified cnpy therenf(Sec.7A00.Lab.C.) �
�OR APPLICAN7T0 fILL IN Jpg �l/, S�
I Pnlicy Vo. C�mp�ny� EACH NO. FEE A�DRESS �C//�`K-
New Resirl�ntial BIc19s.&Poois
� Certified cnpy is hereny fivnished. 1&2-Family,5q.Ft. S — S LOCALITY ��ln rR,Q�
NEAREST ' ��—Y���
❑ �",ulti-fnmily Sq.Ft. cRoss sT
Cer[ifie;l cnpy ic filyd u•i[h the cnunty huilding inspection Resi[1cmi;!I S�vimmin�Poo!s /,////tt''
t1e��rfmPn[. � O RM NA E � •�{��((J
nazz .���uc:��� o�ue�s:��,�.���i,�s�v._� aooR � v iT
F�rst 2U � . r►l��-
CERTIFICATIi OP C.XF.�iPTIOY PRO!d tt'OItKf[ItS' 7oc,I Nn. � � Addltional CI7v t nlo.
CO.`.1PGXS:\TIOV ItiS1:RA\CF 7! t� � }
PLAN CHECK p_
(Tl�is uctinn need nat he eomplCted if Ihe w�ork im'nlved APPLICAYT Q
Li,htin9 Fiztures First 20 �1DDR[55 V
hy ihe permi[ i.c for one Imndral dollars �SI00)or less.) Additional �
Total No.� CITY Tn�No. O
1 cer[ify that in the �rrfnrrn:�nce nf the work fnr�+iiich tl�is pixcd Appli�nC�s Not Over 1 HP �
rrrmil is i5511td,1 s!ull nnt cr:iC���Y��I•D�'rsnn in anV rt1:�nnPr ( PERMI� (J
so:14 tD hecome subjec!to Ihr 14'nrkrrx' � pens�tinn I.a�es. Ranae_L_HC_TCr�D.Nl._ APPLICANT � � t W
�{,1///� -L/� �i Ovcn �Drycr_W.".L_ ADDRESS (� � �, �
l '7�//,.;/�,� �(// ,�'� TeP _FAU _W.H._/_ �y�F ^��C�'K z
natr� APrlicant .m L.�u+a d� „�f.�:�3_y ci7 Q L(.T �_.,;oi 7 L <' —
� Honcl_F�n _Olhcr_ yy(�j�_� ��
V O C�T O:\f'P I.I CA'v T�f f,�f ler r i�ki ng t l i i s Cr r�i f i ca t=��f Disp. _Roam Air Can d._ Q 3 LI C [OR
I:xrrtf�li�n, ynu shnuld hecome sul�jec[ In Ilie li'ntAers� R F f i.N U M O F R Cl as s
Compenc�tinn prnvisionx nt the I,ahnr Cnde,y�ou must fonh� Pow=r Apparatus&Large Appliances DISTRICT NO. PROCESSED 8Y
�cith enmply �cith xuch prosisinn5 nr this prrmit sh�ll he S�ze&Type HP,KW,KVA,or KVAR ,
dcemeA re��r�ked. Up to i Incl. `� '� �- �
FINAL
ovcr t co 7D Inci. oATF 3 �� � VALIDATION
I,ICGNSI;D CO'vTR:lCTO1i5 DfC1.ARATIOV Ovcr 10 to 50 Incl, �
1 herchy affirm thot 1 am licensed under provisinns nf Cheptrr Ov^r�O t0 lOO InC. dy A�
) 9 (rnmmenciog«�i�h Srctinn 7Q00)of Di��isinn d nf Ihe Husi- Over 100 �
1 ne�c and Prnfe�•in�s Cm.k,5nd my license is in fu!I force and
� effrct. S^rvices
'�irense Xu er I.ic.Clias � 0�290 Amp.Vnc!er 600 V
/J ?���� 201•7000 Amp.Unrh+r 600 V
Cnntracin yL{rK�?1��' � ale.� Over t00D Mip.or Ovcr f00 V
IIU`dF 015'YF:ILBUILDF.It pl?CI.AIt:1T10V Temp.Po�a•er Poic&Appurt^nancrs
1 hrrehy affirm Ihat 1 sm errmpl from the Cnniraclor's S'��w�th One Rranch Circuit
l,i:en5r I.aw for Ihe fnilm�•ing re�cnn (Sectinn ;03�.5, Iluci- n��iitionnl Sfgn Braneh C�rcuits �' 7 Q.6�
necs and Prn(esaions Cnde): . �
�disc.Conduits&Cnnductnrs �:.• � •.. .7
� I,'us owne� uf�he property,w�ill Jn�he�eork anA thr p�h�r ISe^Complete Fee Schedulcl—
structure is nnt in�rnJed or nffereA fnr s�le (Sectinn �'� �2�5 O
;Oid,Buiiness and Pmfeasinnx C��dr).
COVSTKUCTION L1�:�171�(;A(11:\CY � • `�6 J��
I hrrrby ;�ffinn ihat Ihere is a con<�ruction Irndinp,:ieency • .
for the perfnrmsnce nf Ilm uork for which this prrmit is PER�dIT FE[ (Sub-Totall �3.C 9�c4�
issurd(Src.3097,Cie.C.).
I.rnJer's Name PLAN CHECKING FEE IOne-Fourth Permit Fe�)
Lendcr's AdJrcss pEfl�.11T ISSUING FEE
1 certiry thot�1 h�ce read thic appiicalion anA state th�t the TOTAL FEE a
nhove infmmation Ic corrteL I a¢rte tn enmply��ith ail C����nty .
ordininccs anA Sts�e �a�cs rcFulating I!Irclrical �cirinF, and
hereby authori�c r presrnlaticrs of Ihis Cnunty to entcr upnn � �
Ihe a nvr�menl'i d Croprrty for Qs ectinn purpnsex. ,
� r SLili�NfiV�NSG POR IiXYLANATORY I.ANCUAGG
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