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HomeMy Public PortalAbout8613 GARIBALDI AVE_Electrical__ •"'°R`° C°"' "s""°"°E "`r'°" CF '0'81 APPOCATION FOR ELECTRICAL PERMIT ✓ I4;6r af*t p that.I have a owttftate d•consent to self Barre, or oerBfbate d Workers' Corn aticn Insurance, or a oerMed COUNTY OF LOS ANGELES BUILDING AND SAPETY MAL Dopy.thereof(--Ta 3800,L.A).C.) Porloy No- Cortpan, FOR APPLICANT 1'o FLL FN 3 "1e) dt' ❑ Oertf lad copy b hereby furnlehecl EACH Na FEE Now Ftesidertttd Bldgs S Ebola $ — $ LAC+111 fY /a fa \ © Certffled copy Is flied wtth the omnty txlldhrg h%"otbn 1 8 2�Ferrrfiy,84 R _ NEAF�8T depertrnent r Muttl-famfiy Sq.Ft Exa068 ST. o Y 4�te Appibertt AesidentV Swhnrrdng Poole OYJNER OR FUW NAL V1 Leo ( RITFiC1fiE OF EXEMPTION FROM WORi(ER3' ' OutietEr Sw. ADDFIF$8 COMPEN AlON MURANC� Flrat 20 ,` 3 ffhlsy8cUm nMd not bi conVWted K the work kwohed by the Total Na Additional • C'� TeL No' perrr)ft Es[or one hundred dollars(=100)or less.) AMdomd L-oertH thkt'ln the performenoe of tt* work for'wt�IPh this permlt ��� _ APPL]CdNT _ b Majed; I.shal not &Tplay any petaor3 In'arry manner so as to rZ D ADDRANT becorne sub)ed to fl-m Workers'Oomper�eation Law& Lkphdng Fbch Flet 20 - t Total No. CITY v Tel.Na Date Appneant Flxed Appiianoee Nd Over 1 HP PERAfT NOTICE TO, APPLrANf: ff, ,after rhakUV this Certflloete d ' P—ptlon,you should become%bJ to tie Mbrkere'Compensation Range--Fleeter_ Q�V. �'� provfalorn of the Labor Code, You must forthNtth oompfy wkh aUch Oven. Dryer� W.M._ ADDRESS prowfaione or this permft,*to be deemed revoked Top � FAU —•WH _. CITY Ter Na L3CENSED CONTRACTORS DEGLAP�TLON Fwd Fah Other [� L herel affix rn it)at I sm fioeheed Tder provl9bne of Chapter 9 Dbp,- -� �Air Com! -/ �- FE NUMER Ciw (borrtmerlckip,v tt#t Seotbn X000) of 4Niabn.3 of tJie Budrtaas arxf Pfofeeslom Code,and my U.—f$'h full force and.efTeot Df8TR1CT NQ e1 Power Apparatus S Large APdbn— n i Stra 8 Type HP,KW,K%M,or K\bkR . (! Lldense Number Lla C1eas� Up to 1 Intl.• FINAL Over 1 to 10 1 nclL DATE _ �r inLnoN W CorT�sotor Data _ - ❑ Over 10 to'60 Ind FINAL I am mmmpt under Sea Over f0 to 100 Ina' BY $dP.Q for this reason ——Over 100 co Servlaee,$wbd,MOCi! - , - z Date 0-20O Amr'9zp.u - . �" Sire 201.- j 000 Amp.Ur Over 1000 Amp.or 800 V ❑ Exemption for Req.frtalnL Qeat. 'SINGLE'DFR D S��One Br'ench Clra�rKM 07 7 7 HOME pyVfJER-B�fILDEA DEG_AFL47lON ` I hereby affirm that r am examo from the Contraotces Lbeoee Law Addttionel Sign Branch Clroufte for the,b5owft reason(�eation 7031.6, Eltonees and ProleeNons 1 ITERS tMim gmdLd,a Condudore TOTAL 211 .67 I, of the property,wfa do the work and the structure other(See Complete Fee Schedde) b Intended or offered for-sale (Sedlon 7044, amine" GECOther 1,(y�. and Professions code). � .. C I .Ij] .CONSTRUCTION LENDING AGENCY I hereby affirm that there Le a coneb-uctlon kxllng agency for the peourn noe of the work for which this pemtlt Is ba-ed(Seb.3097, PERMIT FEE (w)--Total) 1 9r—rs Cry c.), h PLAN CHECKING FSE 71r<}O 1 AN 7:*G L enders ttarne / PERMIT.488 U I Nq.FEE !/ ' L ffxWs Addreea I oerthat I have read this appBCation and state that the above TOTAL FEE ttfy kTfomwtlon la correct I spree tis comply with aH County arckxncee and State taws regulating Eleotrloal wWng, and hereby euthoftm repreeentattme of this Courtly to ender upon the aboy&-nvntbned property for hapecdon Perp— BEE F VERSE FOR EXPLANATORY LANGUAGE of Pemdttae Date