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Home My Public Portal About5746 KAUFFMAN AVE_Electrical__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR AP LICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. eR C�lp READY FOR DA E 1 RUED ADDRESS p FIRST INSPECTION CITY -/ TEL. ND. - 7 COUNTY LICENSE NO. 6 EXPIRES BUILDIN PERMIT FEES ADDRESS T (-1 V w NUMBER EACH FEE LOCALITY / a LIGHT OUTLETS NEAREST CROSS ST. QVC RECEPTACLES WALL SWITCHES OWNER TOTAL OUTLETS _� Sc $ 1/0 MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES B 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER NEw MVD. HP OVER INC• EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. I/2 & LESS $ .25 7-S SIGNATL5RE OF � I/2 2 .50 PERMITTE�� 2 s 1.00INSPECTION RECORD _ 5 1s 1.50 1 s 50 2.50 s0 200 5.00 zoo 5Do 11.013 .� SOD 10013 15.00 Z OVER 1000 20.00 (� M.G. SET/FREQ. CHANGER-HP Q: WELDERS: AC-KVA GENERATORS - KW ' TRANSFORMERS - KVA TEMP. MOTORS (75% OF DRIB-) _ MOVED MOTORS (75% OF DRIB.) MISC. SIGNS ND. NO.TRANS. N0. NO. LAMPS APPROVALS LDATE INSPECTOR'S NAME FOR EACH PERMIT: WIRING $1.00 tl o CONDUIT FIXTURES $11.00 00 WIRING i SUPPLEMENTARY ,50 FIXTURES POWER TOTAL FEE e d UTILITY CO. NOTIFIED I FINAL 7GA663 DBS.#SA 2-53 , y ` 76A66:-CE806 9-67 APPLICATION FOR LECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT-OF COUNTY ENGINEER BUILDING �f �j�f' BUILDING AND SAFETY DIVISION- • ADDRESS i // _ JCWN A. LAMBIE, COUNTY ENGINEER ` COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. NO. EACH FEE $ $ OWNER RECEPT. MAIL LIGHT TOTAL FIRST 20 .20 ADDRESS SWITCH_ OVER 20 10 CITY- TEL. NO. LIGHTING �TOTAL. FIRST 20 .20 CONTRACTOR FIXTURES OVER 20 10 ADDRESS a / RANGEDRYER_WTR.HTR.— CITYb � TEL. NO�S -7/gL STA.COOK_DISP. F.A.UU —_ LICENSE NO. '1� SPACE HTR. AIR CONDI,HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CLOTHES WASH._DISHWASH._ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. FAN OTHER 1 00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF MOTORS,TRANSFORMERS RATING CALIFORNIA.OR THAT. I AM THE LEGAL OWNER OF, AND INTEND TO IND. HEATERS, ETC. HP. KW. KVA. RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. SIZE & TYPE OVER TO SIGNATURE ` p O' - 1 1 00 OF PERMITTEE ' d 1 - 10 3,00 DISTRlyp. G�1l4P ZONE P D 10 - '50 5 00 O 50 100 10 00 NOTES: W 100 - 500 15 00 a N TUBE, A SIGN AND ONE CIRCUIT 3 00 MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 SERVICE OVER 600 VOLTS OR 200 AMP 5 00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT ISSUING FEE 2 00 WIRING FIXTURES SUPPLEMENTARY ISSUING FEE 1 00 i POWER AUTHORIZED ' PERMIT FEE UTILITY CO.NOTIFIED 4 . PLAN CHECK FEE (50% PERMIT FEE) FINAL TOTAL FEE JO EPH C. ROOHAN SUPERVISING EL AL ENGINEER PLAN CHECK VALIDATION CK. M.0 CASH PERMIT VALIDATION CK. M.O CASH -46 _s o MAY 13 2 0 6.00 ;EE BACK OF-APPLICATION FOR COMPLETE FEE SCHEDULE -- 7GA663-CEBOB 12-58 APPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES- ee DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS E� JOHN A.LAMBIE,COUNTY ENGINEER 3 CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST. OWNER ITEM NUMBERI EACH FEE OUTLETS: - $ g MAIL - LIGHTS ]RECEPT. SW. •10 -��' ADDRESS I'LIGHZING FIXTURES .10 �/ CITY TEL.NO. LE EC.RANGES CLO.DRYERS - ELECTRICIAN Electric 'V WATER HEATERS' .50 ADD RESS1 18347 ' E+ Valley Blvd, ELEC.SPACE HTRS DISHWASHERS . - CITY Of Indust -TEL.NO. 6 179 GARBAGE DISPOSERS �l1TO.- ' WASHERS STA COOKING UNIT .25 LICENSE NOC10-148635 . MOTORS: OVER INC. H.P. DIST RI yAdO. 1 GRgUE? WN OCES E BY O— 1/2 .25- Zti�L '/2•— 2 .50 j INSPECTION RECORD 2— 5 1.00 •� 5— 15 150 r 15— 50 2.50 o T /N Z5 , i EANI 0/2 50—200 5.00 ' F TIER J/✓CDM LATE, SIGNS: NO TRANS. NO LAMPS �Qi -ND /,. ^' SERVICED-600V 1.00 J RLL A 4 A/ RE SERVICE OVER 600V 5.00 =.a MISC. O" 4l tel " WIRING PERMIT 1.00 •JI��tMer'�^/"- r0, �'l/" ",0"�� FIXTURE PERMIT 1.00 DO - "+r' }��+ v• gel "� SUPPLEMENTARY PERMIT .50 ,(/ -,/,YkZfl;E/l TOTAL FEE s 7 APPROVALS IH ACKNOWLEDGE THAT I HAVE READ THIS AP LIGATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE 13 CORRECT AND 'AGREE TO COMPLY / WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. WIRING IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE - -• DESCRIBED RESIDENTIAL PROPERTY. POWER SIOGNATUR F PERM TTEE .t UTILITY CO NOTIFIED FINAL r -2z,-4 O ®" ATION ARTHUR C. VEIT. SUPERVISING ELECTRICAL ENGINEER CK MO CASH �� 1 4 .5 °; SEF' 2 4 2 A 9.75 76A663-CE806 10/74 , APPLICATI F - ELE RRWAL PERMIT' ' CT _COUNTY'OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER gooREss ✓��— BUILDING AND SAFETY DIVISION LOCALITY TEM LE CITY NEAREST " FOR APPLICANT .TO F-ILL IN CROSS ST. OUTLETS O. EACH FEE OWNER OR $' s FIRM NAMEaw s, Ti- nAVIDS RECEPT. MAIL LIGHT - TOTAL FIRST 20 P5 ADDRESS 46 KAUFFMAN _ CITY 'TEMPLE 'CITY TEL. No. 28 -84 . SWITCH OVER 20 10 PLAN CHECK LIGHTING FIRST 20 25 APPLICANT TOTAL FIXTURES OVER 10 20 ADDRESS ' ' RESIDENTIAL APPLIANCES CITY TEL. NO, PERMIT RANGE 'DRYER_WTR, .HTR. APPLICANT' „ STA, .COOK DISP. F.A.U. ADDRESS'101 . HUNTINGTON DRIVE SPACE HTR, ' AIR CONO. CITY TEL,,NO. - CLOTHES WASH. DISHWASH. LICENSE OR 26 28 "r' 'CLASS. C+ REG. NUMBER 8 FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE`THAT, 1 HAVE READ THIS APPLICATION I. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS, TRANSFORMERS RATING v WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING' IND. HEATERS; ETC. HP. KW. KVA. 1 ELECTRICAL WIRING. SIZE & TYPE OVER ' TO ' I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - 1- 1.00 `_D LICENSED A9 REQUIRED BY L09 ANGELES COUNTY AND STATE OF 7- _ CALIFORNIA OR THAI I AM 1'HE LEGAL OW NE��'•QR T E BO 1 10 900 DESCRIBED RE9 TIAL f/�j' V. 10 - 50 6,00 PERMITEE O CG SIGNATURE O) 50 - 100 10.00 w • DISTRICT N P ESSED BY N- 100 - 500 15.00 -- Z SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECT06SIGNATURE TUBE.,OR MARQUEE ADDITIONAL'CIRCUITS 1.00 TEMP. POWER-POLE' SERVICENOT OVER'600VOLTS OR200AMP 3.00 UNDERSLAB WORK - SERVICEOVER600VOLTS'OR200AMP 10.00 ROUGH CONDUIT TEMP SERVICE,POLE, &'APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT, SYSTEM 3.00 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED :< FINAL PERMIT FEE (SUB TOTAL) NOTES: PLAN CHECK FEE PERMIT ISSUING FEE_ 3.00 TOTAL FEE PLAN CHECK VALIDATION CK. M CASH PERMIT VALIDATION CK M'.0. CASH SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ' COUNTY OF Los ANGELES APPLICATION FOR PERMIT Department of County Engineer UK in DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. li T/ S/ ��0 ELECTRICIAN ! / �� Z)/f— � —" RECEIVED BY READY FOR DATE ISSUED ADDRESS FIRST INSPECTION CITY / 'Z- TEL. NO. / . /� COUNTY LICENSE NO. 14I EXPIRES ADORERS F.= ^/ PERMIT FEES NUMBLER EACH FEE LOCALITY T®LE d/rY - LIGHT OUTLETS - NEAREST RECEPTACLES r� CROSS ST. WALL SWITCHESr1 OWNER TOTAL OUTLETS _ / / 5c S MAIL ELEC. RANGES 25 ADDRESS ELEC. HEATERS 25 CITY TEL NO. FIXTURES 5 '>/ I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE 18 CORRECT NUMBER OF LIGHT CIRCUITS _7AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS 'AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS '1 CERTIFY THAT I POSSESS THE ABOVE VALID LOE NUMBER HORSEPOWER ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER FEE NEw MVD. HP OVER INC. EACH OF THE RESIDE=k_,_2X44 -4�7_' TYY DESCRIBED ABOVE. �/2 & LESS, $ .25 SIGNATURE OF _%2 2 .5DPERMITTEE 2 5 1 INSPECTION RECORD 5 is 1.sO _ 15 50 S:.SO _ 50 200 5.00 200 _SO❑ 10.00_ J 500 1000 15.00 Z -OVER 1000 20.00 (�J M.G. SET/FREQ. CHANGCR-HP _ a WELDERS:AC-KVA O GENERATORS - KW - TRANSFORMERS - KVA TEMP. M0TOR4 (75% OF ORio•) MOVED MOTORS (750% OF ORIG.) MISC. SIGNS fI NO. NO.TRANS. (. ' APPROVALS _ NO. NO. LAMPS — -- DATE INSPECT R'S NAME FOR EACH PERMIT: —'—' WIRING $1,00 ) CONDUIT FIXTURES $1,00 WIRING I'1J5f SUPPLEMENTARY .50 •FIXTURES of_ POWER TOTAL FEE s8 10 UTILITY'CO. NOTIFIED / / A FINAL 76A663 DBS#5A'4-52 TEMPLE CITY 1 76A663-CEBOfi 10-09 APPLICATION FOR .EL.ECTRIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF'COUNTY ENGINEER BUILDING -7 BUILDING AND SAFETY DIVISION ADDRESS JOHN A. L.AMBIE. COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST PERMIT,FEES CROSS ST. 1 T E M NUMBER EACH FEE OWNER Ac �S /✓ ��_ OUTLETS $ $ MAIL ADDRESS 6 O . Q LC yCJ LIGHTS _�RECEPT: SW. - .10 LIGHTING FIXTURES - 10 CITY IG��TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIA WATER HEATERS .50 ADDRESS ' ELEC.SPACE HTRS- DISHWASHERS - CITY 04 TEL. NO. GARBAGE DISPOSERS AUTO.- STATE WASHERS STA.COOKING'UNITS .2$ LICENSE NO. MOTORS: OVER INC. H.P. - DI 'RIC T NO. jGR0j,,IPl ZONE Ip ESSED BY' 0— 1/2 - .25 JT/vn 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- - X1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT :SO - TOTAL FEE S �� b 1 HEREBY ACKNOWLEDGE THAT ['HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE ' ,A..-STATE-THAT THE ABOVE JS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES.AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. WIRING (• x•d 8�. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1, LEGAL OWNER OF,--*E ABOVE DESCRIBED REBID`' OP POWER SIGNATURE1. a UTILITY CO.NOTIFIED •' �/ OF PERMITTE III"`III - _ FINAL ®r - DATION. ARTHUR C.VETT, _ cK MO CASH SUPERVISING ELECTRICAL ENGINEER LACO?;4 O DE 2 2 0 . 3 .3 0 . 76,1663-.CE806 I i/4 o �APPLICATION FOR ELECTRICAL MIT LI• COUNTY OF LOS ANGELES DEBUIRTMENT-OF,COUNTY ENGINEER BUILDING LDING AND'SAFETY DIVISION- ADDRESS 5 �� LOCALITY �� COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING / /� ��v�11 M // FOR APPLICANT TO FILL IN CROSSNEAREST T. //L/� IE. I(f 1WIgy •• OUTLETS NO EACH FEE $ $ OWNER RECEPT. MAIL ' FIRST 20 25, E O ADDRE LIGHT TOTAL SS• J7 S �� /�•- �7.�I'� "/^7�� SWITCH < OVER 20 CITY C� TEL. 10 NO.. PLAN CHECK LIGHTING TOT FIRST 20 o •APPLICANT �'AL •25� J FIXTURES OVER 20 ADDRESS ; 10 APPLIANCES CITY TEL. NO. PERT RANGE DRYERWTR. HTR. - -APPLII ANT _T_ 7Ti 7J5 a �✓ STA. COOK DISP. •F.A.U. - ADDRESS Zj Gl.,� v�/�C�4-1 SPACE HTR, AIR CONO. Cl TY.. - TEL. N0. �j =G�751 CLOTHES WASH. DISHWASH. LICENSE NO. CLASS./j FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND_AGREE TO COMPLY MOTORS,,TRANSFORMERS RATING - WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND. HEATERS, ETC HP. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO - I HEREBY',CERTIFY THAT,I'AM PROPERLY REGISTERED AND/OR _ 0 - 1 100 LICENSED AS REQUIRED BY 'LOS ANGELES-COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO �- I - 10 300, RESIDE IN, THE 7ABO�V. DESCR IB D RESIDENTIAL PROPERTY. OSIGNATURE10 - 50 500 OF PERMITTEE 50•— 100 10000 DISTRICTNO. CLASS V ZONE PROCESSED BY 100 - 500 15001 O a `5 SIGN,•GAS SIGN AND ONE CIRCUIT 500 - NOTES: wA Z, TUBE, OR _ MARQUEE ADDITIONAL CIRCUITS 100 SERVICENOTOVER 600 VOLTS OR 206AMP 3 D APPROVALS DATE INSPECTOR'S SIGNATURE SERVICEOVER600VOLTS OR200AMP . 10.00 , TEMP.POWER POLE _ TEMP SERVI CE,POLE, &APPURTENANCES 5 D UNDERSLAB WORK ' TEMP LIGHT OR RECEPT. SYSTEM 300 ROUGH CONDIUT WIRING FIXTURES " "• POWER AUTHORIZED ' PERMIT FEE (SU,B TOTAL) ' UTILITY CO. NOTIFIED PLAN CHECK FEE - p �� PERMIT ISSUING FEE 300 3 a FINAL 7 JOSEPH C."ROOHAN TOTAL FEE •S�e SUPERVISING, € CAL ENGINEER. PLAN CHECK VALIDATION CK. M 6. CASH PERMIT VA_LIDATI c M.0 CASH Fio 4 � 6 FEB1 2 'D- 5,50 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE - WORKERS'COMPENSATION OECIARA. , , CE-806G 10 81 APPLICATION' FOR ELECTRICAL PERMIT ' , ' I hereby affirm that 6 have a certificate of consent to self,msure, : or a ceitrficate of VVorkets' Compensation Insurance, or a'certifie COUNTY OF,LOS ANGELES BUILDING AND SAFETY -r c6py thereof(Sec. 3800 ab C �• ° Policy N?! Company, FOR APPLICANT TO FILL,IN r - -JOB �. - � Certrfie copyls hereby furnished. EACH NO:' FEE ADDRESS M dt h ' -'New Residential Bldgs Pools y . ) . .t-.� ,, ,,,c.,;�,: I -. $ — $� .LOCALITY. ' s�^�- �$-.' �-•- ��' . Certifieo- copy,is filed with the couAlty building inspection 1 & 2-Family, Sq.Ft. — department.• r - Multi-family Sq:Ft CROSS ST Date b'—� Applicant ' ` Residential Swimming Pools '" OWNER OR p .. ,:, _ _ FIRM NAME '11 CERTIFICATE OF EXEMPTION:FROM WORKE. MAIL + Outlets-Rec Lghf S' U COMPENSATION INSURANCE ADDRESS I3-� J' .�� Y_ ` (This,section need�not be completed if the work involved by the First 20 permit-is for one hundred dollars;($100)'ocless.), , Total No Additional. CITY ca-Jr 'kqy- �U Tel No. kPLAN I certify that in-the,perforrriance of the work for which this permit', a z' APPLCAN7K.', is issued, l 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.• CITY - Tel No: . Date =` .Applicant ` Fixed Appliances Not Over 1 HP PERMIT NOTICE:.TO. APPLICANT- If, after .making thi's 'Certificate of APPLICANT Exemption,you should become'sublect to'the Workers'Compensation 'Range_.Heater 'DW."_ provisions of the'Labor Code, you must forthwith comply with such Oven _.Dryer —'W.W_ ADDRESS• - provisions'or this permit shall'be deemed revoked ' Top _— FAU WH LICE_NSED CONTRACTORS DECLARATION Hood — Fan _•Other_ CITY '. 1� Tel No S• ' •I hereby'affirm that I am licens ed'under`;provisions of, Chapter 9 LICENSE OR �+ _ ..}-••., i - Disp: Room Air"Gond REG NUMBER Class `�j •- (coinmencing'with Section 7000)`of'Division 3 of the Business and Professions Code,and m'y license is in.full force,and effect,' DISTRICT NO ESSED BY Power Apparatus& Large Appliances• �_ Size.& Type HP,KW,KVA,or KVAR License Number Lic-Class +- - Llp,to •1 Incl. , FINAL _ Over 1 to.10 Incl DATE Contractor -'-1•• Date' (((///"` ) VALIDATION, Over 10�to 50 Incl ' U _ FINAL ��(�'�,_: _ El I am exempt under Sec Over 50 to 100,Inc .° BY !lY' lJ� W Over 100 n- B&P.0 for this reason, N •Services,Swbd,MCC& Panelboards Z Date. r-.. ' 0- 200 Amp.Under 600 V Signature 201 - 1.0.00, Amp Under 600:,V r • - Over 1000 Amp or Over 600 V. " Exemption for.Reg.Maint-Elect c SINGLE-FAMILY - ,. ' Temp. Power.Pole & Appurtenances.. " '`�` - ' HOME OWNER-BUILDER-DECLARATION' ' , Sign with,One Branch Circuit', •' , •. • •a I'hereby affirm that I am exempt;from the Contractor's License Law ACCTaY forthe following reason(Section 7,031 5, Business and Professions •, Adddional.Sign Branch Circuits Code) ' M7 18c;75 Misc Conduits,& Conductors. 1 IT I'a's,owner of the property,.wdl'do,the work and the structure is not intended or offered for sale (Section 7044,'Business ,Other(See Complete'Fee,Schedule) ; andtProfessions,Code) 17. 11TOTAL 18 m.75 1 ", t-CONSTRUCTION LENDING AGENCY-' _ _ - -CHECK 1 hereby.affirm that there.is a construction,lending agency for,the CHANGE" a�l' performanceof,the work for which this permit is issued(Sec 3097, FPERMIT,FEE (Sub-Total) t - - ,,. . ray' PLAN CHECKING FEE n ` Lender's-Name 000-0001 ' , 10/20/89' PERMIT-ISSUING FEE Lender's-Address ' _.. 6314, '1 AM 9:28 I certify athat I',have read this application and-state that-the above i TOTAL FEE nformation is correct I agree to comply with all County ordinances and-State laws•regulating Electrical winng,-'and hereby authorize ' ,represen tives';of his County to enter.,upon,the above-mentioped. r-'• rty or msp cion purposes I SEE REVERSE FOR EXPLANATORY LANGUAGE Sig ature ofSig ature of.Perm�e Date