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1803A
\�'nR1:1:R5'C011!'I:VS.4710\�'[:CI,:\12:1TInV 7GAGG3 APPLICATION FOR ELECTRICAL PERMIT � CE�R05G 12�80) 1 I�rrrby affirm th�t [ have a ccrtificate of cnnsent to sclf COUNTY OF LOS ANGELES BUILDING AND SAFETY insure,ur a certificale uf 15'nrkers'Cumprnsotinn Insurancr,ar a certified mpr Iherrnf(4ec.SRDO,Iab.C.) FORl�PPLICANTTOfILLIN JOB rt�/ A ! 1'ol�c}'\�• Comp�nY EACH NO. FEE AODRESS �I / S/GE�L f=C���75� Np?r�Rqe�i;{�ential Bldgs.R Ponis � Cerlifitd cnpy is herrby fumishrd. 'S..L�Y�,�,m;iY,sQ.Fl. !i 7S s — s LOCALITY /)�/�v�a,i/p ,,g,q_R OP."ulti•f�mily Sq.Ft. — NEARE57 Crrtified rnpy is fiird���ith the county 6uilding inspection CROSS ST $�f{p C W d N ��� � Jr �rtmer.L ReSid^ntiol S•.vimmin�Pools OWnIER OR , � FIRMNAME nR. �—IR/� ���+�• ,�rn�+���� Out�ets:R�c.�'L�9ht�S�v.3 �� (T ADDRESS z7y) -STrY!'LE Lf�/�5/' F�rst 20 j — CIiRTII'IC:\Tli OP CXC11!'TIOV GRO)1 K'OftR4:R5' To:al Nn.� Addilionil CITY �IR-1h Q Kf tl (j.(fel Na. CU17PfN5:1TlO�i I\SURANCG PLAN CHECK a ,/,APPLICANT Q (This xec�ion r.eed not be completed if�l:^ wo�k insnleed " � �+'- U by the pe[mit i5 f0[ One hUndfCd do11u5 (SI00)a[ICSS.) , Liphting Fixtures First 20 ADDRESS A�iditional � Totnl�o. 1 certify Ihat in �he trfnrmance of the�aurk fnr�chich this CITY Tel No. Q �' Fixed A��liane�s�ot Ov^r 1 HP M— permit is Issued,1�.h711 nnt rmploy any prrsnn in any manncr PENM1".IT ✓ �� �r� G �— U 5�;IS 1��hect)me Suhjtti tr)the N'n�Atts�Co� �ensatin�Laws. Reng�_Hrater_D.6V._ APPI.ICANT � � ��'R �^ � W Oven _Or er_l"l.ft7._ 11D�RESS f ,/• � Y `l YI 2,���v�sr Dale3 !� 9Z 4 Iic�ni .. _ TaP —_FAU —W.H._ — . rr — cirv ��V� ��/A� Tal No. �3�'G�S I Hood_Fnn _Othrr 7 tipTfCli TO AI'PLIC:\1T:I(Ia(icr makin�thi5 Ccrtificalr uf T /!�j LICENSE OR v� Oisp. _Fnom Air Co�d._ REG.NUMBER�L J� 1 Ciass C �� Exemptinn, ynu xhould hecnme subject �o the \S��tArrS Cnrnpenca[inn procisions of thc l.:+hor Codr.)�nu r�uat forth• po�v=r Apparatus&L�rgr.APPlianees OISTRICT ND. PROCE5SE�8Y �cith comply �.�ith su<h pmvisiona nr this permit shall he Sim c4�Type HP,KW,KVA,or KVAR decmeJ re�•nkrd. l0 ,�,. Qll1:� U�to 1 Incl. FiNn� Ovrr 1 to 10lnel. oaT� � i�,� VAIIDATION I.ICIitiS1iD COVTI2:5CTOItS DICCLARATIOV Ovcr 10 to GO lnd. �C I hrreM1y affirm that 1 am licencr;l undrr prneisions of Chapter Ov^f 50 to 100 Ine, By A� 9 commencin ilh Scction;000 af Division 3 of[he Rusi- �� �,.. 1 ( F«� 1 Over 100 ,'��YL+— �_� � nccs.^.nd I'mtessinns Cndr,and my lirrnsr is in full force and . rffcrl. Scrvi[cs �� �7 S 2 C-/b 0-200 Amp.Under 600 V Licensc\umbrr�� I.ic.Cl�cs 207•f 000 Amp.Under 600 V j Conirat[nrG��N•rr�r� �c u;,� Over 10O0 Amp.or Ovcr 600 V ! 110.`.1Ii O\CVh:R�HUILDER DIiCL:112pTlOti Tcmp.Po:ver Pole&Appurtenanc^s � i hrreby a(firm [hat 1 am rKrmpt lrom Ihe (7ontntlor'S Sign rvilh One Brinch Cireui[ :c� C n J ft Licrnse t.�w for the fu1la�.inF rracon (Srctian T03LS,ilini- �1Aditional S�rn 6ranch Circuits "��� � � �L neca and I?nfr«ions Cade): A7isc.Conduii5&C��dUctorS I • •2�.7� � 1, ss man^r of the��o�r��r,���������r!e���ork�nd the Other.(S^e Compl?tc Fcr.Schedulcl— struclure is not intrnde;l nr nfferrd fnr xal�• (Gctinn � � 7 . �na.i,Bu<i�Ps4�nd 1'mkscinns Code). °!I. n u CONSTRL'CTION I.I�:NUING A(;IiNCY O,'`..� Q`S 2 1 herehy affirm �hat Ihrrr is a consiruclion IenJiny anrncy tor �he prrlorm�nce of the �enrk for ��'hith this permit ic pERMIT FEE (Sub-Total) � yb . issucd(Sec.?0�7.Ci�•.C.). I.enilcr'S N��iir PLAN CHECKING FEE (One-Fourth Pcrmit Fee) Lender's AJdress � pERPdIT ISSUING FEE _�G 1 cenify�Int 1 fuvr read this applica�ion an:l state that the TOTAL FEE �l �� ahnvc informalinn is corrctt.f oFrce ro comply�cith all CmmlY . nrdinoncca and Stalc laws rrgulafin3 Iiicctrical �cirinR� and hereby authori�e reprcsent�lirrs of this County to entrr upnn th �n�e�mcntinned p , � rty for inspectinn purpases. 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