HomeMy WebLinkAbout0940A (5) � APPLiCATION FOR ELECTRICAL PERMIT � � R'ORKIiRS'CO!.II'EtiS:1T70`DIiCI..�.R.\T105 7GA663 � CE.90GG 12�601 � herebl' aitirm �h:�t � h�re a ccnitic�te nt con�rnt m srit COUNTY OF LOS ANGELES BUILDING AND SAfETY insurc,or a cenificate oi tVorkers'Compens�tion Insurance,or . � � a certifieA copy Ihereof(Sec.3R00.I.sb.C.) FOR APALICANT TO FILL IN JOB � %(�C%_�I �� � � I �+��iz�•Vp_ ���mpan}' EACH NO. FEE AOOHESS J ti� �" fv^w Residential Bldgs.&Pools � Certifrd cnpy is hereby furnished. 1&2-Fcmily,Sq.Ft. S �' Y LOCAUTY•,-_���. P.lulti•tamily Sq.Ft. — NEA EST � Crrtificd capl'ic fileA�rith ihe county buildinF inxpectinn CROSS ST dep:irtment. Rrsidrntial 5�+4mming Pools OKNER OR �,{� � � i�_ FIRM NAME /�J✓�J�' L)atr :�CI!licant OuUcts:R�c�'light�S�v.� � � ��1AIL +�Cl' ��-� o-t, �±.c.��`�- fi�st 2U �� � /1DDRE55 �' �� cLknrrc:�n orrxi:tirnovraoun•oieiu:ris� TO1�IN0.� A�'lliti0n01 CITY-fj— Te�No.s�vyr,�a CO.`dPF:?S.aTfOV 1�SUR:\tiCT � PLAN CHECK G}. ! APPL�CANT � (This icction ntird not be 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 p�rformxncc of die avork fur�ehich�his p�xp����nli�nccs Nat Ov^r 1 HP permit is issu2d.I shall nnt employ�ny persnn in a }'nanner PERMIT � ` U sn as ro hrcome sublect to qi^N'nrArrs'Compens:i inn[aws. Rangc_Heater_D.VJ._ �PPLICANT =zt 1� C"' L%� a �} Oven _Orycr_l'J.f.1._ AODRF55 �(, 7�� L.� [t:,.-.,�<<c��--�, z /- S� f i•' /> C' : Tnp �FAU _l":.Fi._ Tel No.jr i 7/ IS > — e. I - � / ( G Uate � � :1pplicaN„cr���" `5-�-�_ CITY i J � Noocf_Fan _OtMer_ NOTICf.TO AI'PI.IGS\T:IL after makir.G�his Crrtific�alc nf DiSP. _Room Air Cond.__ LICENS[OR �7 t�(���/ I.�� I:crmptinn, you shnulA M1ernmr suhjeci to Ihe V,'nrkers' REf;,NUMBER 7 Class Compenvatinn procicions of�hz Lahor Cnde,you mu+�fnnh• Pownr Appara[us&Large Appliances DISTRICT NO. PROCESSEB BY wilh cumpl,v «ith sudi pro�isions or ihis permi[ shall hc Si�e tF TYP�HP,KVJ,KVA,or KVAR �� ,�Q.�.t��� dccmed rn•okrd. Up to 1 Inel, � FINAL 0�2f t tOt01nc1. DATE � �� �� VALIDATIDN I,ICICNSI{D CO'JTR:\CTORS DiCCLA1t:1TfOV pver 10 te 501nd. OVer JO IO 10D InC. PINAL �n � 1 herehy:dfi:m thot 1 an tirensed un;ler prn��itinnc nf Chaptef BY J`�' / 0 (rnmmencing wiih crctinn 7000)�nf Diei�inn J ot�h^Ausi� Ovef 100 'Y` E nert anJ Pmfessin�t CnJe,and my licrnce is in full fora an;I . effcct. S^rvires � 3�%���� /� 0�200 Amp.Under 6D0 V I.icrncr.":umher � Lia Class Zp7.�ppp qmp.Under 600 V CoMractn�/��� ' �Datc��S' Ov^r 10C0'Am�.or Ovcr 600 V li(�1G O�CVF.R B11IIiDF.R UF.CLAIt:�TION Temp.Powcr Pole&Appurtenances S�gn with One Ar?nch Circuit �r n h L.n 1 hrreby aifirm that 1 am rermpt (mm 1h[ Ci�ntracin�'.s Additian�l Si�n Ar;�n[h CirCuilS , l.itense La�v for the lnllo�cing reason (Section 7031.5,fluci- nc�s anA Pmfes�ioni Co:leJ: �r• � � � �G Misa.Conduits&Cnnductars � I, a5 nw•ner af Ihe pruperty,�sill do ihe u•ork snd Ihr Oth?r(See Comp�Mc F�c Schedule)— � • • � �,� {� xtructurc is not intenJrJ or afkrcA for ssic (Srctinn 70a4,ftucinrss and pmfes�ions CoJe). • • s � ?,� ����; CO\STIiUCT10N LI:NDINC.\t;l'NCY 1 htrehp affirm Iha1 Iherr is a consiruc[inn IrnJing afcnq' . I Z Q�—�`� tor H+c prrtormance ot the �e�>rk ��r ��hicli this pe�mit is pERMIT FEE (Suh•Totalj .� �, iscurd(Sec.3097,Ci�•.C.). 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