HomeMy WebLinkAbout0602A (4) u�oRhrRs��a,.,�'FVSATfO\1)fC1..1fiAT10V 7GA663 APPIICATION FOR EIECTRICAI PERMIT �
C[�806G(2�D01
I herebY affirm that I hsee�s rertificstr of ennsent �o se�� COUNTY OF LOS ANGELES BUILDING AND SAFETY
insurr,or a crrtific:�te uf 1�t'nrkers'Cnmpensatinn In�urance,or
a certifird mpy�[hrrenf(Sea J900.I.�b.C.)
i Policy Nn. Cnmp:my FOR APPIICANT TO FILL IN D�RESS ��` n -��L�� �1.
�ew R^siciential Bldrs.Fi Poo� EAC�+ NO. FEE
� Certified c�py is herrli5'furnisl�eA. 7&2-Family,5q.Ft. ���� S — S ��'� LOCALITY�, ,�` ..��� �j�_�
❑ P.lulli�family Sq.Ft. — NEAREST
Certified copy ie fileJ with Ihr countr huilding inspretinn CROSS ST �� nY��.�n.11'�
departmrnL Residr.nti�l Sivimmin�Pnols owNER OR `�
FIRM NAWIE v��� O_
bate Applirant Ou71et5:R^C._Linht_5•.v._ MAIL N 1--� C' [
First 20 ADDRESS �J I �����`C
C1:NTIfIG�TIS OI'ICXG�IPTIOV CR0�1 WORRLRS' Total M1o. Addition�l CI7V �'� Tal No.
C0111'k\S:\TIOY IVSIIR:1RCii . PLAN CHECK }
a
(T6is section neeJ not lie completed if ihe work IIIVfAYCti � APPL�C!+NT p
Uy thc permit is for onc h:mJred dollars (5100)or Icsa.) Li9hting Fixtures First 20 qooRess V
Additinnal �
Tot.=.1 No.
1 certi(y thzt i�thr prrfnrr�once nf the�enrk for n�hich this CITY Tel No. 0
ermit�icsued,I shall nnt rm In an Fixed Appt�ances Not Over 1 HP
r r• Y 3'PtfSnn In 9n)'m]nnef PER.V.IT M �
so at In hecomr.subjrct tn the\1'nrArrs'Compenx�linn Lrncs. RanqC_Heater_D.W,_ APPUCANT l 1•�C C1 W
Oven _Dryrr_LN.M._ ADOREsS l ll- " N
1 �3 'Mc�m z
1)ate'�� Appli� — � — —�.H.— CITv (�hUV,N Tcl Na.o1�
Hood—F2n _Othcr_ � R�_ \l7�-31�,�
�071Cf TO AI'PL1C:\tiT:It,aftcr makin�Ihis Ccrtific�te af L�CENSG OF
Disp. _RoomAirCond._ REG.NUM9ER .� C'��Clacs -
l;armption, }�ou should becnme cuLJecl to Ihr N'nrkers'
Compensatinn prm�isionc of Ihe[aFot CnAe,you mus�fnrth- pp�vnr App.ra[us&Larne Applia�ees ��STRiCT NO. PROCESSED BY
�cilh comply �cilh s�.ich procisions or this prrmit clull hr `\
dremeJ re.�okrA., Size&TYp^HP,KW,KVl1,or KVAfi y � ��
Up to 1 Intl. ���
— FINAL
Ovcr t to 701nc1. oATE %/ 3 VALIDATION
�.rcrvsru co�Tx:�crotes nrc�.,�n:�rro� pvcr 10 ro 50 Inel. � ��
I herrby af(irm Ihol 1:+m licrncrd�mJrr proeicions nf Chap(er Over 50 to 100 InC. f-INqL
AY /J
� 9(commencing w�ith Ser[inn 7000)of Uivision 3 of the Ausi� Over 100 �l,/1�[�
nrss and 14nfe�sinnc Cude,nnd my licrnse ix in(ull fnrcr and
effect. Serviees
�$��� �j-� 0�200 Amp.UnAer G00 V
License Numhrr--- I.ic.Cisss
2U7-1000 11mp.Undcr 600 V
Cnntract���.�__ Datc � 3 Ov^r 7000 Amp.or Over G00 V �
J
IfOVi:O'�\'Ylfli-AUII.DfIt DECI.AIEATIOti Temp.Pm•:er Pnlc R APPunenanc^s .
1 hrreby sffinn lhat 1 em c.empt from Ihr Contrartor'S Siqn With One(irenr,h C�reuit
Licenae I.aw fnr the fnilow�ing rrac��n (Sectinn 70J1.5, Ilusi� ����itional S�9n BronC!i Cireuit5
nrss anJ 1'rofracinnc Cnde):
� 11isc.Con;lu�ts Fk Cnnducrors
� I, as o�+•nrr nf thr proper[y,a�ill dn thc�curk and thc Other ISe^ComplMe F�e Schedulel—
shucturc i5 nqt intcnJrd or nf(rred far silt (SaUion
7034,Ru.inrac and Pmfessions Cnde).
CONSTRUC'f10V LI?VDI�G:101itiCY
1 herrM1y� affinn tl�at Ihrrc is a cunstrucliun Irnding aeency �
fnr thc per(ormancc nf Ihr �curA for �chich this permit is pERA91T FFE (Sub-Total) �r -? :�G Q G�i
iswed(ti:c.)09'..Ci��.C.)• av ,
Lcnder's ti�inr PLAN CIIECKING FEE (One•Fourth Pcrmit Fee) 1!� • ' ' '�
LenJer's:\ddress PERP.71T ISSUING FEE � '� • 1 6�2 1 6
1 certify�hat 1 haa•e r^�d this ap�licatinn and st:+te that tlie TOTAL FEE a Ib • • � 6��T �u
:�hnvr information is correcL I aFree fo compl5'��'ith all Connty
nrdinanres and Stalc la«•s rr�ulatinN 1':Icctrical «�irinR, anJ I �,� J-a�
hercby auUiorire rrpresen�ali��es nf this Connty to enter upnn
thr nhnve-mentionrd praperty fnr inspectinn purpnces. SI{It'It1tVI;RSit 1'OR ICXI'LA'JATORl'LAtiGUAGL
" nature I'rrmittre atc �
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