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HomeMy Public PortalAbout10662 FREER ST_Electrical__ (3) 76A663 DBS SA 25M SETS 11.48 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC ���� 'COUNTY OF LOS ANGELES WILLIAM J. FOX. CHIEF ENGINEER DISTRICT O. GRO P ZONE PERMIT NO. FOR APPLICANT TO FILL IN �^ / ELECTRICIAN 4 . � `1� RECEIVEE)"BY READY FOR 'C;ATE ISSUED) o. JJ►�,�,qd� FIRST INSPECTION ADDRESS �U.ty'�A(J(9L -y ��j. g` �p '/J/sem 1/vw CITY /J TEL. NO.gdZeW d'q J 1 q� BUILDING �p�, LICENSE NO. /I �/ EXPIRES ADDRESS '��6..iY/ n DESCRIPTION OF WORK FEES LOCALITY NUMBER 'I OUTLETS EACH CROSS LIGHTS 5c $ [ STREET C �` RECEPTACLES 5 FIXTURES g s' OWNER + I WALL SWITCHES 5 C1 MAIL ADDRESS ELEC. RANGES 25 ELEC. HEATERS 25 CITY ` e-, TEL. NO. MISC. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMBER OF CIRCUITS INSTALLED: ANGELES COUNTY LICENSE. �(1 LIGHTS RECEPTACLES �'"� MOTORS -• �_nJ; ,,,,�r'r�1'�`r ELECTRICIAN. NuMBERHORSEPOWER FEE NEW MVD. HP OVER INC. EACH I AM THE LEGAL OWNER OF THE RESIDENTIAL PROP- V2 S LESS $ .25 ERTY DESCRIBED ABOVE. 1/2 2 .50 2 5 1.00 - ,q/ • OWNER- 5 ,s ,.5o INSPECTION RECORD _ 15 s0 2.501 s0 1 200 5.00 200 500 10.00 500_10130 1 s.00 OVER 1000 20.00 M.G. SET/FREQ. CHANGER-HP I V WELDERS: AC-KVA 0 GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORm.) MOVED MOTORS (75% of ORIG.) I , MISC. SIGNS TYPE: NO.TRANS. TYPE: ND. LAMPS APPROVALS PERMIT FEE DATE INSPECTOR'S NAME FOR ISSUING PERMIT: �O CONDUIT // WITHOUT FIXTURES $1.00 I WIRING WITH FIXTURES 9.'26 I t0 FIXTURES SUPPLEMENTARY .50 POWER TOTAL FEE $ � UTILITY CO. NOTIFIED FINAL v ' ®® pq qS�� {L� D�i/ 1F1�iI�'�y `�"C 6A 663-CE806�5-62 APPLICATION LAOS' TION tl OR EC d RICAL VERM'"IT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEERJAI UILDING ` BUILDING AND SAFETY DIVISIONDRESS /_1 4 47 .JOHN A. LAMBIE, COUNTY ENGINEERWILLIAM A.JENSEN, SUPT OF BUILDINGOCALITYEARESTFOR APPLICANT TO FILL INROSS ST. �c RECEPT. TOTAL NO. EACH FEE OUTLETS FIRST 20 s $2O $ to OWNER LIGHT O ADD'L ADDRESS 10 SWITCH. �" OVER 20 , CITY TEL. NO. 1 LIGHTING TOTAL� IF1RST20l .20 �1 FIXTURES A-DL 10 ELECTRICIAN OVER 20 r RANGES CLO.DRYERS W,TRR.HTRB. 1.00 ADDRESS GARB.DIBP. 1— BTA.COOK +yam CITY ,C�.�yL/L.a( TEL. N ' DISHWASH. "L- AUTO.-WASH. 1p 1� STATE 1 LICENSE NO. 7 SPACE HTRB. STA.APP,(1/s H.P.MAX.) / ,BO J 0 ,�y MOTORS, OVER NOT OVER H.P. DISTRICT NO. GROUP ZONE P CESSED BY O 1 1.00 i 1 3 1.50 INSPECTION RECORD p J ° 3 5 2.000? G 8 15 2.50 til .A .� �J/J0- 15 50 3.00 ��� ( 0 50 100 5.00 J ° w O SIGNS: NO.TRANS NO.LAMPS SERVICE 0.600V.NOT OVER 200A 1.00 f `��r• j�, „i,,,,i v ,p.��rf�,il ~��”^"'�- N SERVICE 0.600V-OVER 200 A. 2.00 / �L r \�; Llit //��.r)iV/R./1� SERVICE OVER 600V 5.00 MISC. Y +/��/�,,� ��! �j/� `' •r L. .l�f.F%,P"�(.L•V d' �i'ft''LI (/�"YID✓�Lt,. ✓�-' PERMIT ISSUING FEE 2.00 X7(7 SUPPLEMENTA13Y PERMIT ISSUING FEE 1.00 TOTAL FEE $ 7 .6 � IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY a CONDUIT ,f LP WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ,,$ y ELECTRICAL WIRING. •y WIRING !li A, I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR Vq "f LICENSED A9 REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES 91f�! CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. POWER. SIGNATURE I - UTILITY CO.NOTIFIED OF PERMITTEE i ,LLL FINAL A1I1:+1/r�7 �✓'`- /L y'�=��''tik" OCKLIDATION ARTHUR C. VETT MOCASH SUPERVISING ELECTRICAL ENGINEER L"3 3 4 SND AUG22 2 D 7.40- cv . _, . . 76A663-CE806 9-64 APPLICATION FOR ELECTRICL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS L) 4 "6,2 /Z S JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W JENKINS, SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. TOTAL NO. EACH FEE REC EPT. - / OUTLETS FIRST 20 $20 $ `J OWNER e/9 A74^1 .-/f- pG e' LIGHT + 7 MAIL / ADD'L ADDRESS XO,64Z /1EL V - SWITCH�i L _ OVER 20 •10 / �/ Q q LIGHTING TOTAL I IFIRST 20I .20 CITY `C 4E- e/!- TEL. NO. PI�+ 93G0/ FIXTURES 3 — I ADD'L 10 ELECTRICIAN 20 OVER RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS GARB.DISP. STA.COOK CITYIZ TEL. NO. DISHWASH. AUTO.-WASH. STATE SPACE HTRS. BTA.APP.(y+H.P.MAX.) .50 LICENSE NO. MOTORS: OVER NOT OVER H.P. DISTRICT NO. I GROUP ZQNE I=PCESSED BY O 1 1.00 + 1 3 1.so INSPECTION RECORD 3 s 2.00 CL O B 15 2.50 L.7 15 50 3.00 O 50 100 5.00 ~ U w SIGNS: NO.TRANS h NO.LAMPS Z SERVICE 0-600V-NOT OVER 200A 1.00 SERVICE 0.60OV-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTAgY PERMIT ISSUING FEE 1.00 TOTAL FEE 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI ATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING Z I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND TATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AN INTEND TO RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROP T POWER SIGNATURE UTILITY CO.NOTIFIED A A OF PERMITTEE CJZ- J FINAL 177- VALMO (C SH JOSEPH SIC. ROOHAN CK MO CASH SUPER ISING ELECTRICAL ENGINEER L_AU0 2 4 7 9 r JUN 9 2 D 4.0 0 WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, 76A663 or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec. 3800 Lab. C.) Policy NO. Company FOR APPLICANT TO FILL IN ADDRESS ❑ �(~ Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE$ $Ft Sq. . LOCALITY — Certified copy is filed with the county building inspection 1&2-Family, _ NEAREST department. Multi-family Sq. Ft. CROSS ST. Residential Swimming Pools ASSESSOR Date Applicant a MAP BOOK PAGE "' PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' f Outlets:Rec. Light Sw. OWNER OR I f. FIRM NAME `:�. •y^' COMPENSATION INSURANCE First 20 This section need not be completed if the work involved b the MAIL ( p y Total No. Additional ADDRESS r` permit is for one hundred dollars($100)or less.) - -- Icertify that in the performance of the work for which this permit CITYr? ; ..{.' '._a Tel.No. 3 i f',,'y} is issued, I shall not employ any person in any manner so as to PLAN CHECK ! become subject to the Workers'Compensation Laws. Lighting Fixtures r First 20 APPLICANT Total No. Additional l ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT p p y provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. >_ (commencing with Section 7000) of Division 3 of the Business and CITY TelNo. 4. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. LICENSE OR 0 Over 50 t0 100 Incl. REG.NUMBER Class. U Over 100 DISTRICT NO. PROCESSED BVLLI A License Number Lic.Class J_ Services,Swbd.,MCC&Panelboards ✓� 0-399 Amp.Under 600 V FINAL Contractor Date DATE cc ❑ 400-1000 Amp.Under 600 V I am exempt under Sec. VALIDATION Over 1000 Amp.or Over 600 VIr FINAL B.&P.C.for this reason BRANCH CIRCUIT FEES BY A Date: 15A,or 20A,120V,Lighting or Recept. 1 To 10 Branch Circuits LLI Signature 11 To 40 Branch Circuits I'_ EJ Exemption Or More Branch Circuits Exemption for Reg. Maint. Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit iL I hereby affirm that I am exempt from the Contractor's License Law a r:r'? for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits �-yy,._ iA Code): t) 11 ,• F I, as owner of the property,will do the work and the structure Misc.Conduits&Conductors is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) s i and Professions Code). ' t a 's " l..._ l Pa> P4 CONSTRUCTION LENDING AGENCY r 011+ 'Y� I hereby affirm that there is a construction lending agency for the - "y: ia performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) 1 J! a Civ. C.) Lender's NamPLAN CHECKING FEE t• , - ir' e PERMIT ISSUING FEE ` Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring,and hereby authorize representatives of this County to enter upon the above-mentioned property foOr spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF PERMITTEE W ,''°"� DATE) V! a; WORKERS'COMPENSATION DECLARATION 76A663CE-8Q6 1!)/81 APPLICATJON FOR ELECTRICAL PERMIT 1 ti! hereby %firm.that"I have a certificate of cL"9nt to,self insure,- , CE-ar6G �or..a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY q(py�heniki(Sec.3800,Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. New Residential Bldgs.& Pools EACH NO. FEE ADDRESS ❑ 1 & 2-Family,Sq.Ft. $ — $ LOCALITY Certified copy is filed with the county building inspection department. Multi-family Sq. Ft. — NEARESTCROSS ST. Date Applicant Residential Swimming Pools OWNER OR /� FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec-A- .,Light Sw. MAIL COMPENSATION INSURANCE ADDRESS. This section need not be completed if the work involved b First 20 ( Y the CITY Tel.No. permit is for one hundred dollars($100)or less.) Total No. Additional I certify that in the performance of the work for which this permit PLAN CHECK APPLICANT is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Additional Total No. 5 CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. _ APPLICANT provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _"W.M._ ADDRESS provisions or this permit shall be deemed revoked. Top — FAU _ W.H. _ CITY Tel.No. LICENSED CONTRACTORS DECLARATION Hood — Fan _ Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE (commencing with Section 7000) of Division 3 of the Business and REG.NUMBER ER Class. Professions Code,and my license is in full force and effect. Power Apparatus& Large Appliances DISTRICT NO . O PROQVWCL Size & Type HP,KW, KVA,or KVAR License Number Lic.Class Up to 1 Incl. FINAL V Over 1 to 10 Incl. DATES (L p 7 i VALIDATION Contractor Date Over 10 to 50 Incl. FINAL ❑ I am exempt under Sec. Over 50 to 100 Inc. BY �- W B.&P.C.for this reason Over 100 f.- Cn Services, Swbd.,MCC& Panelboards + Z Date: 0- 200 Amp.Under 600 V Ute• Signature 201 - 1000 Amp.Under 600 V ��- ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole & Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit t� s I hereby affirm that I am exempt from the Contractor's License Law AGC'T°g for the following reason (Section 7031.5,Business and Professions Additional Sign Branch Circuits 3307 36.75 Code): ° ❑ I,as owner of the property,will do the work and the structure Misc.Conduits& Conductors 1 ITEMS is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) Tp and Professions Code). T1TOTAL36.75 CONSTRUCTION LENDING AGENCY CHECK 36.75 I hereby affirm that there is a construction lending agency for the CHANGE °NI performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ.C.). PLAN CHECKING FEE Lenders Name 0000-0001 10/13!39 PERMIT ISSUING FEE 6212 1 AM11e125 Lender's Address 6 -4 I certify that hatIhave read this application and state that the above TOTAL FEE information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection pur ses. SEE REVERSE FOR EXPLANATORY LANGUAGE SigkSure of Permittee Efate WORKERS' COMP€ if DECLARATION 76CEAA806GO63 DPW 9 97 APPLICATION FOR ELECTRICAL PERMIT O I hereb'°D affirm that I have a a certificate of consent to self ` insure, oc,a certificate of Workers' Compensatiori Insurance;' COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS dr a c&fified copy.thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB / ���` �� ❑Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS (7 ❑Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY tion department. Multi-family Sq. Ft. — NEAREST Residential Swimming Pools CROSS ST. OWNER OR Date Applicant FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec t Light Sw._ MAIL COMPENSATION INSURANCE 3 iQU ADDRESS . (This section need not be completed if the work involved by Total No � Additional First 20 onal CITY Tel. No. the permit is for one hundred dollars ($100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPLICANT permit is issued, I shall not employ any person in any manner Lighting Fixtures First 20 ADDRESS so as to become subject to the Workers'Compensation Laws. I-- Additional -- /— Total No. CITY Tel. No. Date Applican � NOTICE TO APPLICANT: If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range— Heater—D.W. — APPLICATION Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. Hood — Fan —Other_ CITY Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBER Class. (commencing.with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO. PROCESSED BY >_ and Professions Code,and my license is in full force and effect. n O Size &Type HP, KW, KVA, or KVAR 1, License Number Lic. Class Up to 1 Incl. FINAL 'U 1 Over 1 to 10 Incl. DATE �` f VALIDATION O Contractor Date Over 10 to 50 Incl. FINAL ' ❑ I am exempt under Sec. Over 50 to 100 Inc. BY B.&P.C. for this reason Over 100 d Services, Swbd., MCC& Ponelboards ' _S '`°`"`1 Date: 0-200 Amp. Under 600 V , "} i _` Signature 201 - 1000 Amp. Under 600 V �— 4I' _ `. F] Exemption1000 Amp. or Over 600 V Exemption for Reg. Maint. Elect., EY:!LiL,t SINGLE FAMILY Temp. Power Pole &Appurtenances FirC ,1A.1 HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): ( :;t _isl Misc. Conduits &Conductors L,0-1, as owner of the property, will do the work and the _.�. structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ , Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is.a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). 13 PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the TOTAL FEE above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize representatives of this County to enter upon I he ove-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Si nature of Permit Date ©s WORKER'S COMPENSATION DECLARATION 20-0019 DPW(12-91) 76A663 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, or a certificate Q!Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. copy thereof(Sec. 3800 Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JCB O /� �� ADDRESS p� Certified copy is hereby furnished. New Residential Bldgs.&Pools NO. EACH FEE $ $ LOCALITY ❑ Certified co Is filed with the count building inspection 1 &2-Family,Sq. Ft. PY Y 9 P — NEAREST department. Multi-family Sq.Ft. CROSS ST. Date Applicant Residential Swimming Pools_ MAP BOOKPAGE a�p !i PARCEL l CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER OR COMPENSATION INSURANCE Outlets:Rec. Light Sw. 7 FIRM NAME �_jj�� First 20 -pro (This section need not be completed if the work involved by the Total No.\� Additional �0 ADDRESS ���►� permit is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITMAO 'hi Tel.No. ,9 is issued, I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 V APPLICANT Total No.—I& Additional / '019 52 BO ADDRESS Date Applicant Ile RESIDENTIAL APPLIANCES NOT OVER 3 HP. NOTICE TO APPLICANT: If, after making this Certificate of CITY 'VT-**lTel.No. Exemption,you should become subject to the Workers' Compensation OTHER APPLIANCES NOT OVER 3 HP. provisions of the Labor Code, you must forthwith comply with such PERMIT provisions or this permit shall be deemed revoked. Power Apparatus&Large Appliances APPLICANT LICENSED CONTRACTORS DECLARATION Size&Type HP,KW,KVA,or KVAR ADDRESS I.hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl. (commencing with Section 7000) of Division 3 of the Business and CITY Tel.No. Professions Code,and my license is in full force and effect. Over 10 to 50 Incl. >_Over 50 t0 100 Ind. LICENSE OR REG.NUMBER Class. CL Over 100 DISTRICT NO. PROCESSE 0 License Number Lic.Class Q C)Services,Swbd.,MCC&Panelboards o VAPICL 0-399 Amp. Under 600 V FINAL Contractor Date DATE I— ❑ 400-1000 Amp.Under 600 V VALIDATION U I am exempt under Sec. Over 1000 Amp.or Over 600 V FINAL d B.&P.C.for this reason BRANCH CIRCUIT FEES BY (� Date: 15A,or 20A, 120V,Lighting or Recept. Z 1 To 10 Branch Circuits Signature 11 To 40 Branch Circuits F141 Or More Branch Circuits Exemption for Reg.Maint.Elect. 15A,20A,208V To 277V Lighting Br.Circuits SINGLE FAMILY Temp.Power Pole&Appurtenances 2 HOME OWNER-BUILDER DECLARATION ith One Branch Circuit n wACCT, I hereby affirm that I am exempt from the Contractor's License Law Sig for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits . Code): 3303 186.90 / ,as owner of the property,will do the work and the structure Misc.Conduits&Conductors 1 ITEMS Al,Ais not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ' TOTAL 186 o � and Professions Code). 'f CONSTRUCTION LENDING AGENCY CHECK 136.90 I hereby affirm that there is a construction lending agency for the CHANGE .00 performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) Civ.C.) Lender's Name PLAN CHECKING FEE 0,0030-0001-0001 6/24/96 PERMIT ISSUING FEE 706 1 Al ;49 Lender's Address I certify that I have read this application and under penalty of purjury state TOTAL FEE that the above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring,and hereby authorize representatives o this County to enter upon the above-mentioned property fo spection p rposes. SEE REVERSE FOR EXPLANATORY LANGUAGE I TURE OF PERMITTEE DAT