HomeMy Public PortalAbout10750 GRAND AVE_Electrical__ Ih s:y 'uye a cord,,, ,DE��0N � 10,81 APPLICATION FOR ELECTRICAL PERMIT
I hereby affirm that I hese a certfflcaba d corned( to sett h,sura;
oop ti)aroerfflcafe'of VkdwfB' Compertsatbrl Ioeurenoe, or a cerUiled
COUNTY OF LOS ANGELES' BUILDING AND SAF fiTYA411 '
Dopy thered(Seo.38Q0,Leti.
�Pdlcy .�. FOR APPLPt,axr 1v Fni ri los \0 SQ' . �tl
LT ���,+t� EACH' NO.' FEE
' T"""'""'Dopy b hereby furrlkehed , New Reeldemtlel SVdgs_a Poole LOC,.AIJTY
re�rttlfed.atopy ie feed wkh the county WOW 1 a 2-Faq*,,Sq.Ft� a — $ �+�� +`�
depa Miftl-femfty`q-Ft, — NEAREST. Y
dxm SF.
- !Y Residential SwlmrrdN Poole �.,�•ti ' - OR 4 1u
FLRM NAME,
fRT IOATEflFN PROM WORKERS' Outlets:Reo-Light Sw. '
GOMPENSAMN INSUIRANCE., ADDRESS
(this"dtlon need not be comps -if the-work tmrefved by th• Flrei 20 ` CTry Tat,t4a
p�rrt M for.o"hundred dd4grs IS 160)or,le a) Tota)No.r Additl�r}s3,, 4 t 1
CHECK
Itcr)rtffy thm
at'In the perforarpe de;thwork for mhloh rm
(hla peft ti 4 ' J ��►�
b , I."1 riot employ,airy peraon fn any manrner'so ae t4 ." \ .• ��. MPPi�C'MfF
becorne.bubleat m theYlkstl 'C,ompe setion.�evra.• Ligtrting Fbtires Fftat 2-0 ~' A�DRESS
fibtal No. Additiorlaf C1TY No.
Date ApQlbent _
NpMirE.�,T0 APgJQANT; Jf,, after,mq►dnq tfale ertgkmte d d ee Not Over 1 NP ,
scerhptlen,-you BFlo�d beorxne'eub}egt: wltb to the Workers'COrtiperua n Beat-_ D.w, � r ,� , '� '- ;s:-1' ^PPLIC-�"T ^� ;� >kfiM1'
loaoris n of`the Labor Qode.Wu muck forthcomply wf such Oven Dryer WI lit Ai7bFtFti49 .
Am+'islot�o or,this peanH'shall be deemed rQVolaed - Top rAQ 1VN. T n
LICENSED CQWFRACTORS REC4�ON.
- :.I hereby attlrmi that I aFn;lbensed under pro/ielorn.of Qhepter 9 Hood— Fan Other— ILUMF_OR
(convne K"j with Sgp8ph 7000) d Dlvblgn 3 of the 6uan6M end — Room Ar Cora. NU l /e / /
Prdeaalone•Co*and Rry'd omsa Is In full forte and effect. Power Apparatua&Large pppl DI.gTk` Cr Na BY -
r -- 1
c /jy Sib a type HP,KW,ICS Or}CWFI
•Lbwm Mimbef .4 e /../ Uo-Claes_[c C� - Up to 1 Irpl. F1NAL
�a
0%W 1•to 10 bot. DATE
Contractor Deth O.ef 10 to 6Q Ingk
I am 60.to.100 tnc.. r BY
RAP.Q.for thb reason Over 100
> ServfGee•SWbd,MGC 11,Pehdbderda Poo _.
0-200'Amp.Under 000 V
srgr 201.- 1000 Amp.under 1500 v . ;2 1 44, 1 A
p ,�WI Over loob Ant.or Quer.600 v �.J
r Examptfon for Reg. nL 1?bot- - -- f i'F�o .0 -0 0 2
$INQLE FAMLY Temp.Power Pole&Appurtsnarpse -- I o 0 2.9.0 0.
HOME QWNER-BLRLDER Qf_r_'L AT}ON, Signwith One&urrch Uroult
I the afttrm'ttrat I am exempt from'tbe Contraotpre Lbsnee Law 0 0 0 2.9 0 0�
for the fdMg reseal(Sac".7031.6, Bum and prdeasbrre Addttioriel Sign Branch groufta .
Com): 12 3 0: 88
' 0 ..Cao owner of the pr6p4r'ty,wt 11 do tfre-work and the etr'oohre Mleo CondCithl a Corlductgre
ie not Intar,dQd or offered for Bale (Section 7044, Buelnees Other (See Complete Fee Schedule)'
end Pmfeasfors Coda). ►
C0NSIT?WM+0N LENPNN(3 AQF,[JCY
I herepy affhm that there Ie'a ax trrxriim lardfnG agency'for the
performance of the work for which thta permft to tamed(Sec.3047, WRMI T FEE (Sub-Total)
PLAN CHECKItJO FEE
Lenders Nah,e r'
PERMrr 1$&UINlQ FEE ,
Lprdero Addfees TOV�L FEE
f oerttty filet I,have.reed thb application and otflte that the above - -
Informatlonb correct.I agree IQ oompty with all County ordtnarnee
-end State laws regulating Dlectri wlrft, and hereby authortre ,
represerkatfves of this County to enter upon the above-rtlerrtlooed
.t for UnpeaBm SEE REVERSE FOR EXNJMATC>RY 1_AWUAGr=
:i� �
Permittee Det,