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HomeMy Public PortalAbout9014 LAS TUNAS DR_Electrical__ COUNTY OF LOS ANGELES Pj)T/AI RX APPLICATION FOR PERMIT Department of County Engineer ELECTRIC ���� ` DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer FOR APPaLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN IL= r'C RECEIVED BY READY FOR DATISSUED ADDRE G�•FS� > illi "- �I.JI DAT[ ISSUED INSPECTION CITY_ TEL NO. A _ COUNTY LICENSE NO. ,� �� EXPIRES ADDRESS �� PERMIT FEES FEE NUMBER EACH LOCALITY b 01 LIGHT OUTLETS NEAREST f CROSS ST. 4 . RECEPTACLES , WALL SWITCHES OWNER TOTAL OUTLETS SC _$ MAIL c ELEC. RANGES S5 ADDRESS C, f01-7 op AFF ELEC. HEATERS 25 _CITY TEL. NO. j FIXTURES 5 1 HERE4 ACKNOWLEDGE THAT 1 HAAE: 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 I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR I AM-THE .LEGkL OWNER NEw Mvo. HP OVER INC. EACH OF THE RESID TIAL/P OPERTY DESCC JIB I/ BrEIVE. , i I/2 6 LESS .25 SIGNATURE O ,+! V2 2 .50 PERMITT - 2 5 1.00 INSPECTION RECORD S is 1.50 15 50 2.50 - 50 200 5.00 zOD sOD 10.00 J 500 1000 15.00 OVER 1000 20.00 rJ M.O. SET/FREQ. CHANGER-HP (Y WELDERS: AC-KVA GENERATORS - KW TRANSFORMERS - KVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF ORIG.) .ca-!!r• MISC. SIGNS NO. NO.TRANS. APP49NAI.S NO. NO. LAMPS FOR EACH PERMIT: �s�—0 DATE INSPECTOR'S NAME WIRING IP1.00 all CONDUIT FIXTURES $1.00 WIRING SUPPLEMENTARY .50 FIXTURES / Od -POWER TOTAL FEE / / UTILITY CO. NOTIFIED . FINAL 75A663 DBS#5A 2-53 'COUNTY OF LOS ANGELES APPLICATION FOR PEMT DEPARTMENT OF COUNTY ENGINEER - ELECTRIC 1 DIVISION OF BUILDING & SAFETY WUIJAM J. FOS, COUNTY ENGINEER FOR APPLICANT TO FILL JN' . DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICIAN �A ,C� .('fA / REC IVSD BY READY FOR DATE ISSUED ADDRESS p f FIRST INSPECTION CITY F vllu i Mt TEL. NO.�_ L/'f��n F:dl COUNTY LICENSE NO. 1010 lJ 0 EXPIRES fZI e BUILDING PERNIIT FEES ADDRESS l/ ` NUMBER EACH FEE LOCALITY - LIGHT OUTLETS NEAREST / RECEPTACLES CROSS WALL SWITCHES 3 OWNER TOTAL OUTLETS 5C $ I ID - MAIL " ELEC. RANGES 25 ADDRESS ELEC. HEATERS 2S FIXTURES 5S CITY TEL. NO. M18C. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS NUMBER OF LIGHT CIRCUITS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS NUMeeR HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER New MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. I/2 6 1.88$ $----.25 SIGNATURE OF I/2 2 .50 PERMITTEE 2 s 1.00 INSPECTION RECORD 5 15 1.50 .15 so 2.50 s0 200 5.00 200 --Soo 10.00 J Soo 1000 15.00 Z OVER 1000 20.00 M.G. SET/FREQ. CHANGER-HP WELDERS: AC-KVA - O GENERATORS .KW TRANSFORMERS-KVA TEMP. MOTORS (75% OF ORIG.) MOVED MOTORS (75% OF ORIG.) MISC. SIGNS 1t t l NO. NO. TRANS. APPROVALS / NO. NO. LAMPS FOR EACH PERMIT•• DATE INSPECTOR-8 AME WIRING $1.00 �� CONDUIT 1 / Up FWIRINGIXTURES $1.00 �� SUPPLEMENTARY .50 FIXTURES POWER TOTAL FEE $ UTILITY CO, NOTIFIED INA IA - i`L�•� 76A$$$ DeB.# $A. 4-52 DB S-A 4.41 2EM APPLICATION FOR PERMIT DEPARTBS .NT--OF BUILDING AND SAFETY _ .C6 W OF LOS ANGELES r ELECTRIC WM. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRI1.9T NO. GROUPI ZONE PERMIT NO. WIRING FIXTURES BERVICE c l7� RECE VED BY READY FOR DATE ISSUED RANGE HEATER POWER FIRST, INSPECTION SIGNS MISCELLANEOUS I1 r D APPLICANT FILL IN HEAVILY 01 LINED PORTION ONLY JOB = t NAME ADDRESS U qq ADDRESS LOCALITY CITY TEL.NOT L�1P NEAREST J CRBT. yl COUNTY 13 CERT.NO. EXPIRES Z-Z'$ W NAME DESCRIPTION OF WORK 3 AD RE63 NUMBER OF OUTLETS ON CIRCUITS O LOCATION BY ROOMS CITY TEL.NO. LIGHT OUTLETS SW. PLUGS FIXT I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERT A B C D E F G HIFI TE OQ,U�.A, 1 ION. CIRCUIT ------__ LIVING ROOM ELECTRICIAN. ---------- 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED DINING ROOM ABOVE. BRFST.RM. OWNER. BATH —————— — CORRECTIONS ENT.HALL HALL NO. FRONTPORCH OUTSIDE KITCHEN SERV.PCH. -- -- -_ J BDRM.NO. Z CLOSET UI iz BDRM.NO. LOSET TOTAL � NO. OF OUTLETS c $ APPROVALS NO. OF FIXTURES 3 $ DATE INSPECTOR'S NAME NO. OF MOTORS H.P. ffi CONDUIT �p NO. OF SIGNS TRANS. ffi WIRING �v 0-- ci NO. OF RANGES OR HEATERS $ FIXTURES ` MISCELLANEOUS $ POWER PERMIT FEE /►� UTILITY CO.NOTIFIEDn T OTAL FEE $ . FINAL n!/ , 7 �,',r COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY- WILLIAM WILLIAM J. FOX, County Engineer� dib �1 FOR APPLICANT TO FILL IN DISTRICT NO. GROUPJ ZONE PERMIT NO. 'ELECTRICIAN cT L r iTr coc� a RECEIVED BY READY FOR DAT ISSUED ADDRESS . 'S.- © /57fy1 L FIRST INSPECTION ,CITY a' e G TEL..NO_/ c .1 a . "COIJNTY.�LIQENSE No, G EXPIRES "rJ 's3 BUILDING ADDRESS PERMIT FEE -7 T FEE ` NUMBER EACH LOCALITY LIGHT,OUTLETS NEAREST s. CROBBST. RECEPTACLES WALL SWITCHES OWNER TOTAL OUTLETS sC III MAIL ELEC. RANGER: 25 ADDRESS. ELECHEATERS:i 25 CITY �ap�7��P L �'� TEL. NO. FIXTURES - s ' I HEREBY ACKNOWLEP6E THAT 1 HAVE READ THIS ' '.Misr'; .APPLICATION AND STATE THAT THE ABOVE 18 CORRECT NUMBER, OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES -,NUMBER-'OFRECEPTACLE CIRCUITS - AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS 1 CERTIFY THAT i POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER FEE C. EACH OF THE RESIDENTIAL`PROPERTY DESCRIBED ABOVE EW mvo� HP .7.R _ '/z a I-ris $ .2B SIGNATURE OF / c�{�! %2 S .50 �� PERMITTEE z Is 1.no INSPECTION RECORD 5 is 1.sD 15 50 2.50 50 200 5.00 - _ 200 500 10.00 - J _ Sao 1000 1s.00 :a.. Z OVER 1000 20.00 M.G..SET/FREQ. CHANGER-HP .� WELDERS:AC-KVA O ,GENERATORS - KW TRANsrORMERS - KVA _ TEMP. MOTORS (75%-OP opio.)_ - MOVED MOTORS-(75% OF DRIG.) -'MIBC. . SIGNS , NO. NO.TRANS. APPROVALS sNO. NO.LAMPS �.mk EACH PERMIT: DATE INSPECTOR'S NAME CONDUITu WIRING $1.00 :FIXTURES #1.00 WIRING ".SUPPLEMENTARY .50 FIXTURES J POWER TOTAL FEE III UTILITY CO.NOTIFIED -ry /^y FINAL L�"2- F'1S 1 76A663 DBS#5A 4-52 1 DBS S-A 12-44 APPLYCATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRIC WM. J. FOXCHIEF ENGINEER 1 DISTRICT NO. GROUP ZONE PERMIT NO.a Q NAME ADDRESId COUNTY S 4 M1 � ' CITY RECEIVEDORY READY FOR DATE ISSUED 4 Ty aX FIRSTsI 8f'ECTION ;00104&4 z• '� CERT.NO. I+ EXPIRES APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLYJOB (DESCRIPTION OF WORK ADDRESS U/a NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS FIXT CROSS ST. CIRCUIT A B C D E F G JH W NAME IY'Ll MAIL 3 ' 3 ADDRESS O CITY TEL.NO. 1 AM THE LEGAL POSSESSOR OF THE ABOVE 'LOS ANGELES COUNTY CERT AT ,OF QUALIFICATION.. ELECTRICIAN. I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER. COR.RECHONS J Q � Z_ O TOTAL NO. OF OUTLETS $ LO APPROVALS 1 NO. OF FIXTURES $ J DATE INSPECTOR'S NAME NO. OF MOTORS H.P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING I � 4 NO. OF RANGES OR HEATERS $ FIXTURES I MISCELLANEOUS $ / POWER PERMIT FEE UTILITY CO.NOTIFIED TOTAL FEE FINAL +_ COUNTY Of LOS ANGELES APPLICATION FOR PERMIT DEPARTMENT OF BOUNTY ENGINEER E L E C T I C 1 DIVISION.OF BUILDING 6 SAFETY NTY WILLIAM . FOX, COUENGINEER �SV f FOR APPLICANT TO FILL IN DISTRICT NO. GROUPZONE PERMIT NO. ELECTRICIAN b —5 ADDRESS O RECEIVED BY READY FOR DATE B7577 /1 FIR�1fJ�1BPE ION CITY Q. ELNO1 /r ( !) /Q 4 COUNTY LICENSE NO. EXPIRES30 S AD EISS O 1 � PERNIIT FEES NUMBER EACH FEE LOCALITY /C,Ly eJtAf-� LIGHT OUTLETS NEAREST T. _ A RECEPTACLES uc� WALL SWITCHES OWNER fJ TOTAL OUTLETS Sc $ MAIL ELEC. RANGES 25 ADDRESS I 0 �'• W ELEC. HEATERS 25 FIXTURES 5 Q CITY - 6L, TEL. NO. 'Q SII I MISC. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS NUMBER OF L16HT CIRCUITS G+® APPLICATION AND STATE THAT THE ABOVE IS CORRECT 7 AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER New MVD. HP OVER I INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. 1/2 a LESS $ .25 SIGNATURE OF 1/2 2 .50 PERMITTE 2 5 1 00 nqStMgCTION RECORD 5 15 1.50 �.�rV 15 50 2.50 50 200 5 00 200 500 10.00 J 500 1000 15.00 Q . Z OVER1000 20.00 M.6. SET/FREQ, CHANGER-HP WELDERS: AC-KVA 0 GENERATORS -KW TRANSFORMERS-KVA TEMP. MOTORS (75% OF ORIG.) _ MOVED MOTORS (75% OF 0111G.) MISC. SIGNS ` NO NO. TRANS. APPROVALS NO. NO. LAMPS FOR EACH PERMIT: DATE INSPECTOR'S NAME WIRING $1.00 o CONDUIT FIXTURES $1.00 I 00 WIRING /C> SV/ SUPPLEMENTARY 50 FIXTURES POWER TOTAL FEE $ UTILITY CO. NOTIFIED 1 AL I� L4 yew 603 013S# eA. a-sa _ 1 J' 78A889-CE808 3-64 APPLICATION FOR ELECTRICAL PERM T COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST, RECEPT, TOTAL NO. EACH PEE OUTLETS FIRST 20 s2O $ OWNER Foster and Kleiser Co. LIGHT MAIL ADD'L ADDRESS 1550 W• Washington Blvd. . SWITCH. OVER 20 .10 TOTAL CITY Los A n e l e s TEL.NO. RE 1 -5111 LIGHTING FiRST 20 .20� FIXTURESADD'L 10 ELECTRICIAN Baum Electric ov R 20 RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS 1550 W'. Washington Blvd. GARB.DISP. STA.COOK `CITY L O S Angeles TEL. NO. RE 1 -51 1 1 DISHWASH. AUTO.-WASH. STATE SPACE HTRS. STA.APP.(/a H.P.MAX.) ,50 LICENSE NO. l 27751 MOTORS. OVER NOT OVER H.P. DISTRICTNO I GROU t P O D B o t 1.00 I 3 1.50 INSPECTION RECORD a 3 6 2.00 OV s is 2.50 O Is SO 3.00 50 100 5.00 d N SIGNS: NO.TRANS z NO.LAMPS SERVICE 0.600V-Nor OVER 200A r 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 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT A WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR v LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDfiNT1AL PR RTY. POWER SIGNATURE UTILITY CO.NOTIFIED >/ G 5 OF PERMITTEE FINAL a ,f i � / �•' 0 LIDATION ARTHUR C. VEIT CK MO CASH SUPERVISING ELECTRICAL ENGINEER L�Go 0 1 7 21 APR 1 2 D 3.0 0— n Da a-A 7-40 HHM APPLICATION FOR PERMIT 117, DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRIC WM. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. I GROUP I ZONE PERMIT NO. WIRING FIXTURES SERVICE 5 1 r g mor= RECEIVED BY READY FOR DATEISSUED RANGE HEATER I POWER FIRST INSPECTION SIGNS MISCELLANEOUS, 2 q APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB Z NAME ADDRESS /(�l U w ADDRESS tln LOCALITY W~ NEAREST CI TEL No. CROSS ST. �j COUNTY CERT. NO. / 49 EXPIRES 3 it NAME DESCRIPTION OF WORK MAIL -- NUMBER OF OUTLETS ON CIRCUITS ADDRESS O LOCATION BY ROOMS CITY TEL NO. LIGHT OUTLETS I SW.I PLUGS IFIXT 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS CIRCUITAB C D E FH ANGELES COUNTY CERTIFICATE OF QUALIFICATION. IIG � LIVING ROOM ELECTRICIAN. 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED DINING ROOM __ I ABOVE. BRFST. RM. - ---�' OWNER. BATH -- I / CORRECTIONS ENT.-HALL HALL NO. FRONT PORCH OUTSIDE KITCHEN I — SERV. PCH. -� — ( Q BDRM. NO. I / Z CLOSET � 0 BDRM. NO. - CLOSET 14 II— -- - TOTAL I� NO. OF OUTLETS is C APPROVALS NO. OF FIXTURES $ DATE INSPECTOR'S NAME NO. OF MOTORS H. P. $ CONDUIT ,I io k NO. OF SIGNS TRANS. $ WIRING I NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER PERMIT FEE $ UTILITY CO. NOTIFIED r t >< TOTAL FEE $ ' �7 FINAL DB a-A 7-40 25M APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRIC WM. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. /GROhIP I ZONE PERMIT NO. Z• - t�\L.11 5 WIRING FIXTURES SERVICE RECEIVED BY READY FOR DATE ISSUED RANGE HEATER POWER !•� _ FIRST INSPECTION ` SIGNS MISCELLANEOUSytP~—�9r•�, APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY !r Z JOB NAME ADDRESS `u_ t � ADDRESS LOCALITY � U NEAREST W CITY ( TEL No. CROSS ST. I COUNTY v CERT. NO. EXPIRES I1: NAME DESCRIPTION OF WORK 3 MAIL NUMBER OF OUTLETS ON CIRCUITS ADDRESS LOCATION BY ROOMS CITY TEL No, LIGHT OUTLETS I SW.I PLUGS IFIXT• I AM THE LEGAL POSSESSOR OF THE ABOVE LOS CIRCUITA B C D E F G H I ANGELES COUNTY CERTIFICATE OF QUALIFICATION. k LIVING ROOMEL CTRICIAN. 1 AM THE LEGAL OWNER �T E P OP DES BED �m DINING ROOM ABOVE. 2 ERFST. RM. OWNER. BATH —— I ( CORRECTIONS ENT. HALL HALL NO. FRONT PORCH OUTSIDE KITCHEN. SERV. PCH. J BDRM. NO. Z CLOSET � a — a BDRM. No. . CLOSET TOTAL I. ) / v NO. OF OUTLETS $ APPROVALS NO. OF FIXTURES $ DATE INSPECTOR'S NAME NO. OF MOTORS H. P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR HEATERS $ FIXTURES MISCELLANEOUS $ POWER-, PERMIT FEE $ ZIA UTILITY CO. NOTIFIED TOTAL FEE $ FINAL ` -� &,FD9 s-A,�,�o aeM NT OF BUILDING AND SAFETY APPLICATION FOR PERMIT �• t�NIE • COUNTY OF LOS ANGELES ELECTRIC WM. J. FOX. CHIEF ENGINEER • NATURE OF INSTALLATION DISTRICT NO. GROUPI ZONE PERMIT O. WIRING FIXTURES SERVICE ` 9 � �• RECEIVED BY READY FOR DATE ISSUED RANGE HEATER POWER FIRST INSPECTION SIGNS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY Z JOB Q NAME I _01-0ADDRE86 - ,q! ADDRESS 42-O /S �o� (� i,/ LOCALITY NEAREST W CITY TEL No. CROSS ST. COUNTY CERT. W CERT. NO. Al-l EXPIRES '��fJ! Ir DESCRIPTION OF WORK 2 MAIL NUMBER OF OUTLETS ON CIRCUITS 3 ADDRESS LOCATION BY ROOMS OCITY TEL No. LIGHT OUTLETS I SW.1 PLUGS IFIXT I AM THE LEGAL POSSESSOR OF THE ABOVE LOS CIRCUIT q g C D E F I G H ANGELES COUNTY CERTIFI ATE OF QUALIFICATION. Ige LIVING ROOM —ELECTRICIAN. I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED DINING ROOM ABOVE. SRFST. RM. OWNER. BATH CORRECTIONS ENT. HALL __ ems. HALL NO. s FRONT PORCH Ab OUTSIDE KITCHEN ZVI SERV. PCH. BDRM. NO. - er ' Z CLOSET a. BDRM NO. O CLOSET TOTAL I I NO. OF OUTLETS APPROVALS NO. OF FIXTURES $ DATE INSPECTOR'S NAME NO. OF MOTORS H. P. $ CONDUIT NO. OF SIGNS TRANS. $ WIRING NO. OF RANGES OR HEATERS $ � FIXTURES MISCELLANEOUS S POWER ` PERMIT FEE $ / les �- UTILITY CO. NOTIFIED ��TOTAL FEE ffi ``C,, `Y FINALFINAL WORKER S'COMPENSATION DECLARATION CE-806G (2-801 APPLICATION FOR ELECTRICAL PERMIT CE-806 I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY ' insure, or a certificate of Workers'Compensation Insurance,or, j� ertirfy d c , er of(Sec 3800,Lab C.) 1�2—(� �Uk Ins. CO. FOR APPLICANT TO FILL IN JOB Policy No. Company ef the West New Residential Bldgs.&Pools EACH NO FEE ADDRESS 9014 Las Tunas a Certified copy is hereby furnished 1 &2-Family,Sq Ft $ — $ LOCALITY Temple City Multi-family Sq. Ft — NEAREST Certified copy is filed with the county building inspection CROSS ST Sultana department Residential Swimming Pools OWNER OR 4-6-81 Edwards ElectricFIRM NAME ' Date Applicant Outlets-Rec Light_ Sw MAIL First 20 ADDRESS CERTIFICATE OF EXEMPTION FROM WORKERS' Total No Additional CITY Tel No COMPENSATION INSURANCE, PLAN CHECK t1 APPLICANT O (This section need not be completed if the work involvedU by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures' First 20 Additional ADDRESS ccTotal No. 1 certify that in the performance of the work for which this Fixed Appliances Not Over 1 HIP CITY Tel No 0 permit is issued, I shall not employ any person in any manner PERMITEdwards Electric W so as to become subject to the Workers' Compensation Laws. Range_Heater_D.W. APPLICANT tl Oven _ Dryer_W.M. ADDRESS, Cn 253 5 S. 3rd Ave. z Date ' Applicant Top _ FAU _W.H Hood Fan _Other_ CITY ArCa ia Tel No _ NOTICE TO APPLICANT If, after making this Certificate of Disp. _ Room Air Cond.— LICENSE OR C-lO -- Exemptiori, you should- become-subject to- the Workers' REG-NUMBER Class Compensation provr"sions of the Labor Code, you must forth- Power Apparatus& Large Appliances DISTRICT NO PROCESSED BY with comply with such provisions or this permit shall be Size&Type HP,, KW, KVA,or KVAR deemed revoked - Up to 1 Incl FINAL LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl DATE }� VALIDATION Over 10 to 50 Incl I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINA 9 (commencing with Section 7000) of Division 3 of the Busi- Over 100 BY ness and Professions Code, and my license is in full force'and effect. Services Cr-10 0-200 Amp. Under 600 V License Number Z57�91 Lrc.Class ' Edwards El License c July 1982 201-1000 Amp Under 600 V Contractor T3'aW Over 1000 Amp or Over 600 V � ^A 1-{OME OWNER-BUILDER DECLARATION e �U - Temp. Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractor's Sign with One Branch Circuit License Law for the following reason (Section_7031.5, Busi- Additional Sign Branch Circuits ness and Professions Code) - Misc Conduits 8i Conductors El I, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— 4 - structure is not intended or offered for sale (Section 7 Jr,9 A _ 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY 1 hereby affirm that there ig a construction lending agency # o;o 0 0 0 2 for ,the performance of the work for which this permit is PERMIT FEE (Sub-Total) 'o 0 0!0 0 0 0 issued (Sec. 3097,Civ.C) , Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) 04, 14-81 - Lender's Address PERMIT ISSUING FEE I certify that I have read this application and state that the TOTAL FEE NO 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 the above- entroned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 4-6-81 Signature of Permittee Date