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HomeMy WebLinkAbout0940A � APPLiCATION FOR ELECTRICAL PERMIT � � R'ORRIiRS'CO!.Il'EtiS:1T70\DIiCI..�.RAT105 7GA66� � CE.90GG 12�601 t hereby aitirm �h:�t 1 h�re a ccnitic�te nt con�rnt m srlt COUNTY OF LOS ANGELES BUILDING AND SAFETV insurc,or a cenificate oi tVorkers'Compens�tion Insurance,or . � � a certifieA copy Ihercnf(Sec.3R00.I.sb.C.) FOR APALICANT TO FILL IN JOB � %(�C%_�I �� � � I �+�����•Vp. ('��mpan}' EACH NO. FEE AOOflESS '� ti� �'` fv^w Residential Bldgs.&Pools � Certifrd cnpy is hereby furnished. 1&2-F�mily,Sq.Ft. S -' Y LOCAUTY•,-_���• P.lulti•tamily Sq.Ft. - NEA EST � Crrtificd capl'ic fileA�rith ihe county buildinF inxpectinn CROSS ST department. Rrsidrntial 5�+4mming Pools OWNER OR �,{� � � i�_ FIRM NAME /�J✓�J�' L)xte ACPlicant Oinlcts:R�c�liqh7�$w.� � � ��1AIL +�Cl' ��-� o-t, ��.e.��`�- fi�st 2U �� � /1DDRE55 �' �� cLkrirrc:�T� orrxi:llrTiovrao�.�n•oieiu:ris� TO1�IN�.� A�'(1iti0n01 CITY-fj— Te�No.s�vyr,��� CO.`dPF:?S.aTfOV 1NSUR:\tiCT � PLAN CHECK G}. ! APPL�CANT � (This icction ntird not fie completeJ if Il!e a»rk inrolred Li,htinp Fixmrr First YO � nDORESS V by the permit is for onc hundred dnliars (SI00) or IessJ � Additional � TOt��N0. CITY Tel IJo. O 1 ccrtify thst in thc prrformxncc of�lie avork fur�ehich�his p�xp����nli�nccs Nat Ov^r 1 HP permit is issued,I shNl nnt emplol'�ny persnn in a p nanner PERMIT � ` V sn as to hrcome sublect to qi^N'nrArrs'Cor:�pens:i inn[aws. Rangc_Heater_D.VJ._ �PPLICANT =zt 1� C"' L%� a � Oven _Orycr_l'J.f.7._ AODRF55 -�'�(, 7�� y.� [n,,.,,�<<c��--`, � �. v. C' : Tnp FAU ...-l"LH._ 7/ IS z ua�e�o 5�� f :���r�,��.��-:?� `"�r-�_ ` CITY TeINo.ljY'�I ( O � Nood_Faa _OtMer_ NOTICf.TO AI'PI.IGS\T:IL after makir.G�his Crrtifiralc nf DiSP. _Room Air Cond.�_ LICENS[OR �7 t�(���/ I.�� licrmptinn, ynu shmdA M1ernmr suhjeci to Ihe V,'nrkers' REf;,NUMBER 7 Class Compenatinn procicions of�hz Lahor Cnde,you mu.�fnnh• Pownr ApparaWs&Large Appliances DISTRICT NO. PROCESSE�BY wilh cumpl,v «ith sudi pro�isions or ihis permi[ shall hc Si�e t4 TYP�HP,KVJ,KVA,or KVAR �� ,�Cl.�.t��� dccmed rrvnkrd. Up to 1 Inel, � FINAL O�Rf l i0101nC1. DATE / �� �� VALIDATIDN I,ICICNSI{D CO'JTR:\CTORS Di'CLA1t:1TfOV pvcr 10 te 501nd. OVPr JO Io 10D InC. FINAL _/� � 1 herehy;dfi:m thot 1 an lirensed un;ler prn��itinnc nf Chaptef BY J�� 0 (rnmmencing wiih crctinn 7000)�nf Diei�inn J ot�h^Ausi� Ovef 100 'Yv E nert anJ Pmfessin�t CnJe,and my ticrnce is in full fora an;I . effect. / S^rvires � 3�%y��� /7 0�200 Amp.Under 6D0 V I.icrncr 4umher � Lia Class Zp7.�ppp qmp.Under 600 V CoMractn�/��� ' �Datc��S' Ov^r 10C0'Am�.or Ovcr 600 V If(�1G O�CVF.R B1111iDF.R UF.CLAIt:�TION Temp.Powcr Pole&Appurtenance5 S�gn with One Ar?nch Circuit �r n h L.n 1 hrreby affirm that 1 am rermpt fmm 1h[ Ci�ntracfn�'.s Additianal Si�n Ar;�n[h Circuil5 . l.itense La�v for the lnllo�cing reason (Section 7071.5,fluci- nc�s anA Prnfes�ioni CmleJ: .'•r• � � � �G Misa Conduits&Cnnductars � I, a5 nw•ner n(Ihe pruperty,�sill do ihe u•ork snd Ihr Oth?r(See Comp�Mc F�c Schedulr.l— I • • � �,� (� xtructure is not intrnJrJ r>r afkrcA for ssic (Srctinn 70a4,ftucinrss and pmfes�ions CoJe). • • s � ?,� ����; CO\STRUCTION LI:NDINC.It;l'VCY p (± 1 htrehp affirm Iha1 Iherr is a consiruc[inn Ie0JI11G JRl•flq' . I Z Q J-�%� tor H+c pertormance e�T the +eork �x ��hicli this pe�mit is pERMIT FEE (Suh•Totai} .� �, iscurd(Scc.3097,Ci�•.C.). Lender's Namr��- /� PLAN CHECKiNG FEE (Onc-Fourlfi Permit Fee) ��� ! Lrndcr's:ldJrcax PERMIT ISSUING FEE �j / 1 I crrtify Ihat 1 harc re�d lhit applitatiun anA stile ihat thc TOTAL FEE �/ abnec infnrmslinn i<corrtct.1 agrec tn cnmply u�ith sll Cnnnty orJinsnces and St�te I�t+s regni�nin3 17ectrital o�iring. :md hrrrhy authorirr representssires nf this CuuntY to rntcr upnn . thr:�hnrr�mrntioned propr a1'(nr inspeclion purposes SIiE'RCVIiRSIi f�DR L•XPI.AYATOkY LANGUAGf•: " I) /s�-r� ,�l F /r�-�-- ��� /�� S iRna[ure n 'eri ttec �)ale \ � . . �. . _. �.. �,�� ..��:� � , �:. :. ,,,,; ;��, _ ;: \ -'. � • .�:: �. \�. ��.•' . . ` , '\ � f��\'%" �'�� ,\�� ,, - ��i. � \ \ '.`` �` � • �,' 7�, ��`, ,j .;`\,\`,.'t�~. \� �. \ , � �--. , � � � \ � ,.. t� �� ,�, i ` ; \ � ,�`` � .� '. 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