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Home My Public Portal About9821 GARIBALDI AVE_Electrical__ P 1 76A889-CE808-8-57 APPLICATION FOR ELECTRI4?1C P RMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDIN '� BUILDING AND SAFETY DIVISION ADORES JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. PERMIT FEES OWNER LIGHTS RECEPTACLES SWITCHES NUMBER ITEM EACH FEE MAIL TOTAL OUTLETS 5 .10 $ ADDRESS ELEC. R Ne rbc WATER HEATERS, �) CITY yTli L.NO. l3 6 CLOTHES DRYERS .50 {! ELEC. SPACE HEATERS, STAT-Y. COOK- ELECTRICIAN ING UNITS, GARBAGE DISPOSERS, ADDRESS AUTO WASHERS, DISHWASHER .25 LIGHTING FIXTURES ,1O CITY TEL.NO. MOTORS STATELICENSE NO. HORSEPOWER H.P. OVER INC. DISTRICT NO. GROUP ZON READY FOR INSPECTION +/z @ LESS .25 'A - 2 .50 INSPECTION RE ORD 2 5 1.00 5 — 15 1.50 15 — 50 2.50 50 — 200 5.00 MISC. SIGNS NO.TRANS NO.LAMPS SERVICE O-600V 1.00 SERVICE OVER 600V 5.00 WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT 0 .501 APPROVALS TOTAL FEE Is i-t-ri I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS ArPLICATION 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 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES CO NY AND STATE OF CALIFORNIA OR T I A THE LEGAL Rf OF THE ABO POWER DESCRIBED RESID ERT . SIGNATURE al, UTILITY CO.NOTIFIED OF PERM ITT FINAL mmilill JOHN A.LAMBIE, VALIDATIW ARTHUR C.VEIT, COUNTY ENG EER CK MO SUPERVISING ELECTRICAL ENGINEER GA8 w I, 0 6 1 2 5 MAY 6 2 A 2.0 0 RS 11 TION Worm that have carts DECLARATION C� 1a81 APPLICATION FOR ELECTRICAL PERMIT I hereksy pfflrrn that I have a certificate of consent to self �J3(76(• I4ure, or a cwllflcate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company POR APPUCAMT TO RLNADDRESS JOB Q Certified copy Is hereby fumished. Nsw Residential Bldgs. 8 Pools EACH NO. FEE (� ❑ Certified copy Is filed with the county building Inspec- 1 8 2-Famlly, Sq. Ft. LOCALITY tion department. Multi-famlly Sq. Ft. Residential Swimming Pools S Date Applicant OR FIRM NAME >W CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec L ght Sw._ MAIL COMPENSATION INSURANCE First 20 ADDRESS (ThIs section nMd not bo cornp{sted if+he work Ir volved by Total'No Additional CITY Tel. No. Are pwmtt Is for one hundred dollars (;IDG)or loss.) PLAN CHECK I certIfy that In the performance of the work for which this APP11CANT Permit Is Issued, I shall not employ any Person In any manner so as to become subject to the Workers Compensation Laws. Ughtinq Fixtures First 20 ADDRESS Total No. Additional d 7 ATplican CITY Tel. No. Date Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPUCr4NT: 1f, after making this Cert cote of n ANT r Exemption, you should become subject to the Workers' Range Heater_D.W. Compensation provisions of the Labor Code, you must forth- Oven _Dryer —W.M.— ADDRESS —1 with comply with such provisions or this permit shall be Top — FAU —W.H. deemed revoked. Hood _ Fan _Other & CITY T.I. Nq,�-,26 LICENSED CONTRACTORS DECLARATION �y I hereby Affirm that I am licensed under provisions of Chapter 9 Dlsp. _ Roam Air Cond. UB MeT / 6— Class (commencing with Section 7000) of Division 3 of the Buslr»ss DISTRICT NO. PROCESSED B and Professions Code,End nrty license Is In full force and effect. Power Apparahn 8 Large Appliances } Size 8 Type HP, KW, KVA, or KVAR (J � License Number �j I Ic. CCIass y Up to 1 Incl. FINAL U TE Contracts Q �,•+ ate ' �7 / Over 1.to 10 Incl. DA � VALDATION 0 Over 10 to 50 Incl. F I am exempt under Sec. Over 50 to 100 Inc. BY a B.$P.C. for this reason Over 100 CL te: Services,Swbd., MCC& Panelboards 6 9 4.9 A 0 -200 Amp. Under 600 V Slgnahy 201 - 1000 Atnp. Under 600 V # o o o,•,o 2 ❑ Over 1000 Amp. or Over 600 V \ Exemption for Reg. Malnt. Elect. .1 ° • 3600 SINGLE FAMILY Temp. Power Pole 8 Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit 'o o 0 3 6.0.0 E I hereby afflrm that I am exempt from the Contractors License it h Cir Br Sign Branch Circuits Law for the following reason (Section 7Q31.5, Business and AdditionalQ a 01 8 7 Professions Code): • 1, as owner of the property, will do the work and the Misr— Conduits 8 Conductors El structure Is not Intended or offered for sale (Seciion Other(See Complete Fee Schedule)_ , 70.4-0, Business and Professions Code}. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a constructlon lending agency for the performance of the work for which this permit Is Issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name PERMIT ISSUING Fly Lenders Address I certify that I have read this application and state that the TOTAL FEE �j D above Information Is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authrize representatives of this County to enter upon the above-mentloned property for Ina Ion purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permlttee Date WOR�;�O�NS'nON•D�ATION 19Dew3/V APPLICATION FOR ELECTRICAL PERMIT I ereby 4fflrm that 1 have a certiflcate of consent to self �-0pyQ O Insure, «a certificate of W«ken' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS «a certifi�e i c�o�pyy thereof (Sec. 3800, Lab. C.) PQq/NoJQq-2 _Q! Company 5?"�4TE F LL I.1 D roe Amluxr To r�iL u+ roe Le Certified copy is hereby furnished. New Residential Bldgs. 8 Pools EACH NO. FEE- 19 9 z 3 1 - ❑Cerllfled copy Is filed with the county building Inspec- 18 2-Famlly, Sq. Ft. $ — $ LOCALITY TE H P L tion department. Multi-family Sq. Ft. NEAREST Residential Swimming Pools CROSM. L b E AJST- Date Applicant NER OR FIRM NAME HE.4(„D D 14 PJ(fir L CERTIFICATE OF EXEMPTION FRO WORKERS' MAIL COMPENSATION INSURANCE Outlets: R Light Sw._ � ADDRESS ' First 20 (This section need not be completed If the work Involved by Total No. Additional CITY Tel. No. the permtt is for one hundred dollars (=100)or less.) PLAN CHECK I certify that in the performance of the work for which this APPUGgNT permit Is Issued, I shall not employ any Person In any manner Lighting Fixtures First 20 ADDRESS C so as to become subject to the W«kers ompensation Laws. Additional Total No. CITY - Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this Certificate of AmucATK)N L E:C T-F, ) CAr L —s7w)f mrs n. Exemption, you should become subject to the Workers' Range— Heater—D.W. — Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS 0O HvvAPA -5t'. with clomply with such provisions or this permit shall be Top — FAU —W.H. — deem f Tel. No CTTy revbke�. Hood — Fon- —Other— I A N p V 1 LICENSED CONTRACTORS DECLARATIONDlap. — Room Air Cond. — LKS 3 (� Class. I hereby affirm that I am licensed under provlslons of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO BY CL and Professions Code,and my license is In full force nd p Size 8 Type HP, KW, KVA, or KVAR vim/ O License Number 31110 7 Llc. Class Up to 1 Incl. FINAL U T� Over 1 to 10 Incl. DATE � VALIDATION � Contractor �• 5 T. nate Over 10 to 50 Incl. nB U ❑ I am exempt under Sec. Over 50 to 100 Inc. U.] B.BP.C. f«this reason Over 100 t1 Services, Swbd., MCC&Ponelboards Date: 0-200 Amp. Under 600 V � . 2,05.3.5A ? Signature 201 - 1000 Amp. Under 600 V # • o;o.e o 2 ❑ Exemption for Reg. Maint. Elect. OvaT 1000,Amp. or Over 600 V I 3 5 5 SINGLE FAMILYe e HOME OWNER$UILDER DECLARATION Temp. Power Pole 8 Appurtenances I hereby affirm that I am exempt from the Contractors License Slgn with One Branch Circuit o o • 3 S 5,0 6 Law f« the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): 0 a 2 6,A 8 8 ❑ I, as owner of the property wl11 do the work and the M*. Conduits 8 Conductors structure Is not Intended«offered for sale(Section 7044, Other (See Complete Fee 1Schedule}_ , Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction Iertding agency for the performance of the work f« which this permit Is Issued PERMIT FEE (Sub-Total) (Sec. 3047, Civ. C). PLAN CHECKING FEE Lenders Name PERMIT ISSUING FEE Q Lenders Address I certify that I have read this application and state that the TOTAL FEE above Informatlon is torted. 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-menlloned property f« Inspection purposes. SEE REVBSe FOR EXPLANATORY LANGUAGE �s SIg re of Permitt e Ci°MPEJZ'SPTI°" gECLARATION0019Dew 3 ® APPLICATION FOR ELECTRICAL PERMIT O r off Irm that I have a certificate of consent to self CF )nsure, or a zertlficate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a certlfled copy thereof (Sec. 3800, Lab. C-) Ppllcy No Company POR AMIC NT TO FILL IN ,n ❑Certified copy Is hereby fumished. New Residential Bldgs. 8 Pools EACH NO. FEE ADDRESS (� ❑CWlfled copy Is filed wlth'the county building Inspec- 1 8 2-Famlly, Sq. Ft. $ — $ LOCALITY �� T tion department. Multi-famlly Sq. Ft. _ NEAREST CROSS-SI. a Residential Swimming Pools Date Applicant FIRM NAME hWAV CERTIFICATE OF EXEMPTION FROM WORKERS' ec L MAIL COMPENSATION INSURANCE Outlets: R Light Sw. ADDRESS First 20 r (This section need not be completed If the work Imrohred by Total No. Additional CITY Tel. No. _ 6 the perm"Is for one hundred dollars ($100)or lou.) PLAN CHECY 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 Compe ion Additional Date Ilcan Total No.�_ CITY 'A I NOTICE TO APPLICANT: If, r s rtlflcate of Fixed Appliances Not Over 1 HP PERMIT APP Ran Heater—D.W. — APPLICATION Exemption, you should become subject to the Workers' 4e,--- Compensation provisions of the Labor Code, you must forth- Oven — Dryer WM.— ADDRESS VU with comply with such provlstohs or this permit shall be Top — FAtU Y' W.H. — deemed revoked. Hood — Fan —Other— CITY Tel. No. LICENSED CONTRACTORS DECLARATION LICENSE OR Dlsp. — Room Alr Coral. — REG NUMBER Clan. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business Power Apparatus 8 Large Appliances DISTRICT NO. D BY a and Professions Code,and my license Is In full force and effect. Size 8 Type HP, KW, KVA, or KVAR PR`CO License Number Lic. Class Up to 1 Incl. FINAL U Cc — Over 1 to 10 Incl. D ✓/ z VAJDATION Contractor Date Over 10 to 50 Incl. FINAL a ❑ I am exempt under Sec. Over 50 to 100 Inc. gy W B .BP.C. for this reason Over 100 d Services, Swbd- MCC 8 Panelboards Z , Z Date: 0-200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V 0 2 2 A ❑ Exemption for Req. Malnt. Elect. Over 1000 Amp. or Over 600 V -#,o o •,0 0 2 SINGLE FAMILY ( o o'� 7.75 HOME OWNER-BUILDER DECLARATION Temp. Power Pole 8 Appurtenances I' Sign with One Branch Circuit affirm I hereby arm that I am exempt from the Contractors License 0,•'0,1 .7,% 5 F5 Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Profowlons Code): 01, as owner of the property,.will do the work and the Misc. Conduits 8 Conductors �7,,� 9�8 a structure Is not Intended or offered for sale(Section 70", Other (See Complete Fee Scheduled , Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby afflrm 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,). PLAN CHECKING FES Lenders Name PERMIT ISSUING FEE Lender i Address I certify that I have read this application and state that theI TOTAL FEE above Informatlon Is correct. 1 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-mentl grope If Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE A �s Ignature of Permlttee Date 71A1[7C_ aa.o...,=/7. APPLICATION FOR ELECTRICAL PERMIT BUILDIN AND SAFETY DIVISION FOR APPLICANT TO PILL IN ,JOB New Resldentiel BId9L&Pools EACH NO. FEE ADDRESS aA J 1 &2 Finally Sq. Ft — $ LOCALITY P► - Multi-famllySq. Ft — NEAREST ' Residential Swimming Pools CROSS ST. COWNER OR FIRM NAME Outlets: Light,Swhch& Receptacle MAI L ADDRESS Flrrt 20' � p I Addltlbnal CITY TSI. No, p ItoT� PLAN CHECK Lighting Fixtures APPLICANT First 20 6 d ADDRESS Additional CITY T.I. No. PERMIT Fixed Appliances Not Over 1 HP APPLICANT Range Heater_ D.W. ADDRESS Oven Dryer W.M. I Top FAU W.H. CITY Ts 1. No. Hood Fen LICENSE OR Disp. A.0 SD REG. NUMBEfT Clea. p I H.R..Y ACKNOWL.16. THAT 1 HAV. R.A.—.111A11LICATION O. AND ■TAT. THAT THU AIS V. IS CORR.CT AND AOR.. TO I.."Y Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANC.s AND STAT. LAWS R.OULATINO I Slee&Type HP, KW, KVA,or KVAR .L.CTRIUL WIRING. Up to 1 Incl. I H.R..Y C.RTIFY THAT 1 AN FROP.RLY R.61■T.R.D ANO/OR Over 1 to 10 Incl. UC.N..D AS R.OUIR.D ■Y LOS ANO.L.. COUNTY AND .TAT. OF CALIFORNIA OR THAT 1 AN THU LZOAL HMR OF THU A.OV. �/� Over 10 to W Incl. D..CRI..D R.•ID IAL PROF.RTY. Over 60 to 100 Incl. PHRMITai Over 100 EIGNATU RE- DISTRICT H DI RICT NO. CrCYSSED BY Seryices a ' p (J 0-200 Amp. under 600 V � 201 -1000 Amp. Under 600 V APPROVALS DATE I R Over 1000 Amp.or Over 600 V IGNATURE TEMP. POWER POLE Temp. Power Pole&Appurtenances UNDERSLAB WORK Sign with One Branch Circuit ROUGH CONDUIT Additional Sign Branch Circuits �} (Other) WIRING 1 `1 FIXTURES ]POWER AUTHORIZED PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL '7� PERMIT ISSUING FEE NOTES TOTALFEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONC M.O. CASH 1.-3 a cL,--,1AN 13 2 a 8.9 0 � (7Y�? Q,Q/cs'/ri�l�L �TQt iV At 76A669-CESOG-11-E.YAPPLICATION FOR ELECTRIC PERMIT COUNTY OF LOS ANGELES J DEPARTMENT OF COUNTY ENGINEER ADDRBUILDESS BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, County Engineer CASSATT D. GRIFFIN, Supt of Building LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. /'. 'v PERMIT FEES ITEM NUMBERI EACH FEE OWNER OUTLETS: $ $ MAIL LIGHTS RECEPT. SW./'— .�f!`I .10 ;� D ADDRESS LIGHTING FIXTURES /'X .10 ?_ CITY TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN vIC � WATER HEATERS .50 ADDRESS ELEC.SPACE HTRS./ DISHWASHERS l ' GARBAGE DISPOSERS / AUTO.- CITY / '.-i TEL.NO.: WASHERS STA.COO/KING UNITS ,25 STATE LICENSE NO. MOTORS: OVER INC. H.P. 0 — V. 25 DISTRICT NO. GROUP ZONE READY FOR INSPECTION I/2 — 2 .50 2 — 5 1.00 INSPECTION RECORD 5 — 15 1.50 15 — 50 2.50 50— 200 5.00 SIGNS: NO.TRANS. .I NO.LAMPS SERVICE 0-600V 1.00 SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50' TOTAL FEE IsAPPROVALS 1/0 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT 44, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING D� /r� I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTIAL PROPERTY. _ SIGNATURE �''. UTILITY CO.NOTIFIED OF PERMITTE / :.1 i FINAL r VALIDATION ARTHUR C.VEIT. SUPERVISING ELECTRICAL ENGINEER ,'CK r MO CASH 76AG63-CEBOS-9-57 APPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING _ BUILDING AND SAFETY DIVISION ADDRESS JOHN A.LAMBIE,COUNTY ENGINEER I J /� /7 Q CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY •!oQ/- NEAREST FOR APPLICANT TO FILL IN CROSS ST. PERMIT FEES 1 T E M NUMBER EACH FEE OWNER OUTLETS: $ $ MAIL ale - LIGHTING RECEPT. SW. .10 ADDRESS e�'V /j�if GGL� LIGHTING FIXTURES .10 CIT' ,e TEL. NO. K� ELEC.RANGES CLO.DRYERS ELECTRICIAN WATER HEATERS .50 ADDRESS ELEC.SPACE HTRS. DISHWASHERS CITY TEL.N0. GARBAGE DISPOSERS AUTO.- WASHERS STA.COOKING UNITS .25 STATE LICENSE NO. MOTORS: OVER INC. H.P. DISTRICT NO. GP NE READY FOR INSPECTION O — 1/i 25 ROU 1/2 — 2 .50 INSPECTION RECORD 2 — 5 1.00 5 — 15 1.50 15 — 50 2.50 50— 200 5.00 SIGNS: NO.TRANS. NO.LAMPS SERVICE 0-600V 1.00 SERVICE OVER 600V 5.00 MISC. WIRING PERMIT 1.00 U FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 L TOTAL FEE $ C APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY STATE OF CALIFORNIA OR THAT AM THE LEGAL OWNE THE ABOVE p ER DESCRIBED RESIDEN WJ,:{?ROP TY. SIGNATURE 7/ ILITY CO.NOTIFIED - - OF PERM[TTE FINAL VALID �( ARTHUR C.VETT. CK CASH SUPERVISING ELECTRICAL ENGINEER 'o2 4 5 6 O MAR28 2 A 2.00 `"°flKECOMI?ENSf¢IOtJ pECLARAT,oN '0'81 APPLICATION FOR ELECTRICAL PERMIT .- I her4by vfflrm khat r haw'A oardIcate Qf wept to-eetf Vem, CE-aoecj or,* oerttM1oate of Wbrksre' Compeneatiba Insurance, or a cedtfTed COUNTY OF LOS ANGELES BUILDING-AD sAmTy copy thoreof 3ao01 c) •P6116y PdR Ap'puc wr To FLL>N i09 Q-:Cera <r oW b hereby furnleh� . New Realderrtlal Bldgs l'oote EAOFi. `NO. FEE L.00ALTIY . 44 C,rt}tletl'coFi� iA filed -ft the,county.building'h&p&cIion 1& 2-F"ly,s4 Ft .—� i Mdtl4mlty.S'q+,Fk — NFARE9T. l Y1_J, t Reeldenttel Sivhrunrn0 Poofd ONR.EAF0W� r, Dte' mA� cCERTrtATE OF EVA PTION FROM.WORKEF3S' � Lpht COMPtSO NSU4ANCE Outleto Rao • AAMDLDR E88 fM*Millon r-ed not-�e.eornpfetid It#-"Involved 4,r Elle, r y CCCY Tei. pwndt is for-na-hued dbUl ry ;100)oc• TOS .. I certtfy,ttW•rn the pgnVTrence of the w*for 1M;11oh:}hte pwmjt ie,keaudd,,I 11 not employ.Any,pen n In,any manmpr.eo ab to become }act t01,4 Mbrkera'.Eortiporleation Leve. - Llulqng Fbchgea' Prat,20' &DRESS., Total No. Adrift � - CITY TN.No. Date Applicant , Fixed Ap MrK9 ea Not O%br 1 1-iP PERMi NOTICE, TO APPtrC :.•ti„ after Makft Ns,' Cert�''o� Ex13rnPtfon,you shgddbecon eab}ept,to the Wtxkero`Cbrnp�r>�tbn -. Range— Heat�-D.W. ° �' W WWone of the La17Qr•Code,you'mupt;fortfiOth c'on#�tj! with euGh Oyen —. Dryer: Wl1._ ADORES$ I, provtS*'Qr t*PW*She1I;bei deemed re"E4& Top FAU W.H O - TeI.tJo. ZNSED QOWk4CT�DECL4RA7lON Food Fin �T��Other_ 1 hereby gfi m tf�ad r- tn:l�oeneed uratier prgvielone.04.Chaplet'8. Dom, — F.Dorn Alr-C-ord.'- R ,NMS (ooinmerxng wfth'sedi�V 7006) of btvtalon"3 of the " and Dr9C7.N4.• PAqGE8� ProWsior�a Code, I&I>cer+ae is Yr'tuH fgrce'and e r P—AppWtue+ Large A`pQllon— ' .. _ . 8tze S Type HP,KWIC^oc`KkA 7' " Q� tJoer+se Nunlber LIQ - Up to i hibc _+" Fl Over.1 to 10lnct _ .1. � .. Over-•10 tQ&O Ind. Fl rl"3 I Qrn exam vrx.W Seo a 1 ` F �.. �� Qver 60 to 100-IN- S BhP.C.•for this reabb6 I' Over 1 QO Services,SWtd;,M6C S Penelboerde z Date -G-200 Amp.Urder 600 Y Stature 201 1000 Amp.Undo{600'V 0�w 10Q0'grrrp.or Over 600 V C .' Exemptlai for Rep.MatMt_Elect • �. i -r' Sl NO LE FAMILY Terttp FQwor Polb AWurtenenceb ' -HOME OWNERrBUILDER MCLAI ATiONsign 2 with Or1e Brerroh•CtrcnR 1 hereby affirm'that-t am exempt from the Contraotors Llcertee Law ',for the Tdbwtrq reason(Section '7031.6, Bmkpaa and Profeealone QddttlQrurl S}pit Brarxh CI[ ACCT.i " ' Code)- ARfac Corxi<dtS h.Coo¢uduro s07 2o' •[ci ' I;'ee,owrw of the property,wnl do the work'end the structure ,. f 1 ITEMS Is riot Jritended of afteaed for Selo (Seoilop 7044, &Abieee Other See Complete Fee Schedule) '. r and.Profe6skm Code). 7 "f TAL 20 b r CON9TWCMN LENDNC3 AGENCY" 7 - �� ZIJ■L�]' f Tiereby affil'. that thetb�•rq a'oanatwatlon lending r th agen y foe pVf- ante A(?ho work for Which this,permit b,Issued(Seo:3097+ N PERMIT FEE � (Sub-Total) Ctv:C.t. W71fiLL .{r.l y� -PLAN CHECKINQ FEE. _ LOI11101 aName • ` •, •F' �. _FERMrl ISSUINQ,FE� _ 1 - �ig 1 Landes Addr>3ae 1 � u ? 1 CTU I cafufy tha# r have read this application and state that the above ?4 FSE z lalg,pwtioo IS correct. I agree to pxrpty with alI'Qalrty ordkienoee and.State lave reguiating Ei obioel wiring, and hereby authortre Of thboun Cty to enter Won the above mentioned Q ' y / SEE REVERSE FOR EXPLANATORY LJ NGtAGE 4 ; //J r i