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HomeMy WebLinkAbout1323A ,�� ,.. ss '-!'�v W�aK,.: ����.: ,,�����„�.:�L.qkA���, 76A663 APPLICATION FOR ELECTRICAL PERMIT � CE-806G(2-80) � I heruby affirm that I have a certific:ate of consent tn setf COUNTY OF LOS ANGELES BUILDING AND$14FETV insure.or s certificate ot W�rkers'Cnmpensation lnsurance,or �cer[ified co�f(Sea 3800�Lab.C.) � ,f/� FOR APPLICANTTO FILL IN Jpg � Yolicy o. Company �«r[' aooaess � � W i rl�✓ p� New Residential Bldgs.&Pools EACH NO. FEE (�''' � CertifieJ cupY��hercby furni�heJ. 7&2-Family,Sq.Ft. _ $ - $ LOCALITY ' yr,r„y ,L f' rwa �C��-a � Multi-family Sq.Ft. - NEAREST �Certified copy is filed with the coun[y h ilding inspection CRO55 ST U l�1 �V rY�t departinent. !/Reside lial Swimming Pools OWNER OR ` ���.�y�� .>2-� �7 ��� FIRM NAME �e� uQ,f Y��✓ Datz1=(r�`_Applic�n[ — Outlets:Rec.,_Li9ht F S i 20 AODRESS ,-1,?j la�IU WCQ�p CEATIFICA'TF'.QP F.XF?.iPT10N N'ItOM WORKF.kS' �'fotal No. Addiuonal CITv �4A„��� �K Tel No. Sqg-Z(-�� COMPENSATION INSURANCE a PLAN CHECKn�4 P APPLICANT [� 0 (This section need �of be completed if the wark involved LightingFixtures Firs220 qo�rtE55 ' Qq �"� � 6y tLe permit is for one hundrecl doltan (8100)or IessJ Additional � � �- � � Total No. - -" I certify that in iYir. perfunnnnce uf tLe work for wiiich this CITV�, �� Tel No. {'{ Zn^,J,..� � permi[is issued,i shall nut empi�ry any person in any rt�anner Fixed ApPliances Not Over 7 HP pERMIT � � C U so es to become subject to the Workers'Compensafion Laws. Range_Heater_D.W._ APPLIGANT(�,�.(„___�(� LdJ Oven _Dryer_W.M._ ADDRESS N I�ute__Applicunt_._.__. Too ___FAU _W.H.,__ B�� �• L•� �V^�� � Hood_Fan _Other__ CITY��^ �a}�y�,C, � Tel No. �r.�z,(e) VOI�ICt;'f0 APPI.ICANI': If',after making[his Certificate of Disp. _Room Air Cond._ LICE SE OR Sl� Class C�`�� Exemption, pou should become subject to [he Norkers' REG.NUMBER CompensaNun pro�isio�is of the Lahor Code,you must furth- power Apparams&Large Appliances DISTRICT NO. PROCESSED BV �pith comply with such pmvisionc or this permit shall be Size&Type HP,KW,KVA,or KVA '�;i �{eemed revoked. Up t0 1 Incl. � "~ ����L� � FINAL /// • { _ Over 7 to 701nc1. ____ _._ _ DATE �' �'�`� �� LICF:N54:U CUNTRACTUNS Dl•:C1.ARATION Over 70 to 50 Incl. � l � VALIDATION I heroby affirm tha[1�m licensed under provisiu�ts of ChuV[er Over 50 to 500 Inc. FINAL f\ � 9 (commencing wiih Secliun 7006)uf Division 3 of U�e Ausi- Over 100 Bv � 1���4 +-r'" ness and!'rofessions Code,and my license is in full force and �'�l�r� effecl. C ServiCes ' Lic�nse Numher��J 1�4'I..ic.Claxc��7� 0-200 Amp.Under 600 V n^ �p 207-7 D00 Amp.Under 600 V Contract<1e�L lAo� llate�pZZ.-g�___ Over 1000 Amp.or Over 600 V HOME 01VNER-BUILDER DECLARATION Temp.Power Pole&Appurtenances � ! heecby af'firm chat 1 nm exempi from the Contrnetor's •Sign with One Branch Circuit - - License Law for the foliowing reason (Section 7031.5.Ausi- A��itional Sign Branch Circuits r�,� ���,� ness and Professions Code): ' Misr..Conduits&Conductors t`o s a • n i � 1,as owner of the property,ia-ill do [he work and the Other(See Complete Fee Schedule)— structure iti not intended or offered for sale (iection , " n t�i,5 Q 7U44,Business.md Yrofessions Code). CON9"I�NUCTfUN C.I�;NUING AL'1•:NCY o s e��=, �j O�=. I hereby nffirm Ihat there is a cons[ructiort lending agency for the perfnrmance of the work for which this permit is pERMIT FEE (Sub-Totaq jLl� � i,L C`��C. issuecl(Sec.3097.Ci��.C.). - . . Lender's Name -- pLAN CHECKWG FEE IOne-Fourth Permit Feel - _f�. LenJer's Address _- PERMIT ISSUING FEE � � i certify ihat I have read this application anU sta[e [hnT the TOTAL FEE ��,.�L: abo�e intbrmation ix currect.1 agroe to comply witl�all County ordinanc s and State la�va regiilating F,lectrical wiring, xnd hereby thorize repres i es of this County to enter upon the ab c-mentioned r For inspection purpuses. 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