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HomeMy Public PortalAbout9139 LAS TUNAS DR_Electrical__ � J u 76A663-CE80610/72 APPLICATIO ORE TRICAL PERMIT ' COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB Lf{S ✓��s BUILDING AND SAFETY DIVISION ADDRESS LOCALITY FN�p/�. NEARESTq FOR APPLICANT TO FILL IN CROSS ST. �✓ G OUTLETS NO. EACH I FEE OWNER OR $ $ FIRM NAME JI C L° RECEPT._ MAIL LIGHTTOTAL FIRST 20 25 !=� ADDRESS _I 'L - CITY TEL. N0. SWITCH OVER 20 ,10 PLAN CHECK LIGHTING � FIRST 20 .25 APPLICANT TOTAL FIXTURES tp OVER 20 ADDRESS RESIDENTIAL APPLIANCES CITY ��// ,J TEL. NO. PERM ITRANGE DRYER_WTR. HTR._ APPLICANT 1/I GA 15/ Ear STA. COOK DISP. F.A.U. ADDRESS jkrlIV' -4 SPACE HTR. AIR COND. CITY S CLOTHES WASH. DISHWASH. LIOR CENSE UMBER -7 6 6 CLASS. C-- FAN OTHER 1.00 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 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OFf CALIFORNIA OR THAI- I AM THE LEGAL OWNER OF THE ABOVE y L 1 — 10 3.00 tlIE DESCRIBEDRESIDE TIAL PROPERTY. O 10 — 50 5.00 �50 — 100 10.00 WNO. PROC ED BY100 — 500 t5.00cD 91 SIGN, GAS SIGN AND ONE CIRCUIT 5.00OVALS DATE INSPECT R'S SIGNATURE TUBE, ORMARQUEE ADDITIONAL CIRCUITS 1.00 ER POLE SERVICE NOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT TEMP SERVICE,POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.0011 FIXTURES POWER AUTHORIZED UTILITY CO. NOTIFIED PERMIT FEE (SUB TOTAL)PLAN CHECK FEE PERMIT ISSUING FEE 3.00 _310]=FINAL TOTAL 'FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. (cA ,`' 3687;73 Duil1' D 70 cv SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 16A663-CES06.10.56 APPLICATION FOR ELECTRIC PERMIT BUILDING AND SAFETY DIVISION Department of County Engineer BUILDING County of Los Angeles ADDRESS JOHN A. LAMBIE, COUNTYER BUILDING CASSATT D. GRIFFIN. Sup'T OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. PERMIT FEES Pia LIGHTS RECEPTACLES SWITCHES OWNER NUMBER I T E M EACH FEE MAIL f ADDRESS J TOTAL OUTLETS $ .10 $ ELEC. RANGES, WATER HEATERS, CITY TEL NO !/ CLOTHES DRYERS .50 ELEC. SPACE HEATERS, STAT-Y. COOK. ELECTRI IAN ING UNITS, GARBAGE DISPOSERS, ADDRE $ 1h 6A AUTO WASHERS, DISHWASHER .25 — LIGHTING FIXTURES .10 1 C' CIT G„e.� TEL. NO MOTORS STATE LICENSE NO. HORSEPOWER H.P. OVER INC. DISTRICT O. GROUP ZONENE READY FOR INSPECTION 1/2 &LESS .25 �c 1h — 2 .50 INSPECTION RECORD 2 5 1.00 5 15 1.50 ! 15 50 2.50 �l//��c5 .�'Z �b�y' »_�.'=-z.+�.� 'n _ 50 200 5.00 M ISC. SIGNS I NO.TRANS NO.LAMPS SERVICE O-600V 1.00 SERVICE OVER 600V 5.00 WIRING PERMIT 1.00 U FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 1 APPROVALS TOTAL FEE s 1,110 DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APIFLICATION 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 AN STATE OF CALIFORNIA OR TIL 1 A -SHE GAL OWNER OF HE ABOVE POWER DESCRIBED RESIRENTI P1 I SIGNATURE 1 UTILITY CO. NOTIFIED OF PERMITTEE FINAL JOHN A. LAMBIE, LIDATION ARTHUR C.VETT, COUNTY ENGIN66R C Mo CASH SUPERVISING ELECTRICAL ENGINEER 2-42 OZ.; SEP.18 2 2.20 %�* z' ��-��-' A-��/- �* . 76A s3 E806 8-62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING qI / fJ BUILDING AND SAFETY DIVISION ADDRESS L. A, JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. REC EP T. TOTAL NO. EACH FEE ♦ OTOTAL FIRST 20 .LO $20 $ OWNER Q/V LIGHT T'�- A MAIL ° �.,. ADD'L 1 ADDRESS v SWITCH. 4. OVER 20 /— .10 Q - �•/,'. TOTAL CITY TEL. NO. LIGHTING � FIRST 20 (V .20 FIXTURES ADD'L 10 ELECTRICIAN OV R 2O RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS w GARB.DISP. STA.COOK CITY - TEL.NO. DISHWASH. AUTO.-WASH. STATE SPACE HTRS. STA.APP.(1/2 H.P.MAX.) .50 LICENSE NO. a {p MOTORS: OVER NOT OVER H.P. DISTFjJCT,AI✓O. GROUP HONE PR ESSs`2 E`D�BY� O 1 1.00 C� L/ p/ C 1 3 1.50 / /INSPECTION RECORD /, 3 S 2.00 8 15 2.50 15 50 3.00 �. a 50 100 5.00 O V SIGNS: NO.TRANS NO.LAMPS O SERVICE 0.600V-Nor OVER 200A 1.00 W SERVICE 0.60OV-OVER 200 A. 2.00 C- tA SERVICE OVER 600V 5.00 Z MISC. PERMIT ISSUING FEE 2.00 SUPPLEMENTAIRY PERMIT ISSUING FEE 1.00 TOTAL FEE $ 1 HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION APPROVALS 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 ff i LICENSED Ag REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES I CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE 1 . DESCRIBED RES I DENT IA PROPERTY. POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL LIDATION ARTHUR C-VETT / CK MO CASH SUAERVISING ELECTRICAL ENGINEER WORKER S'COM PENSATION DECLARATION CE-806G (2-80) APPLICATION FOR ELECTRICAL .PERMIT 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 a certified co thereof(Sec. 3800,Lab. C.) 192-71 80-2 Ins. Co., FOR APPLICANT TO FILL IN JOB Policy No. Company ADDRESS 9139 Las• Tunas of the West New Residential Bldgs.&Pools EACH NO. FEE 0 Certified copy is hereby furnished. 1 &2-Family,Sq. Ft. $ — $ LOCALITY Temple Multi-family Sq. Ft. — NEAREST El Certified copy is filed with the county building inspection iSwimming Pools CROSS ST Hari- department. Residental Swmmng oos OWNER OR 11-6-81 Edwards Electric . FIRM 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 d APPLICANT 0 (This section need not be completed if the work involved0 by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First ADDRESS Total No. Additional 1 certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No. permit is issued, I.shall not employ any person in any manner PERMIT U so as to become subject to the Workers' Compensation Laws. Range_ Heater_D.W. APPLICANT Edwards Electric a Oven _ Dryer_W.M._ ADDRESS 2535 S. 3rd Ave. Z Date Applicant Top FAU _W.H.. CITY Tel No. Hood — Fan —Other i — Arcadia — NOTICE TO APPLICANT: If, after making this Certificate of Disp. _ Room Air Cond._ LICENSE OR C-1 O Exemption, you should become subject to the Workers' REG. NUMBER Class Compensation provisions 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 deemedrevoked. Up to 1 Incl. FINAL Over 1 to 10 Incl. DATE / /� VALIDATION ` LICENSED CONTRACTORS DECLARATION Over 10 to 50 Incl. t•�L I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc. FINAL BY 9 (commencing with Section 7000)of Division 3 of the Busi- Over 100 ness and Professions.Code, and my license is in full force and effect. Services ;. License Number 257191 Lic.Class C-10 0-200 Amp. Under 600 V 201-1000 Amp. Under 600 V Contractor Edwards EleetU�q July 1982 Over 1000 Amp.or Over 600 V HOME OWNER-BUILDER DECLARATION 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&Conductors I, as owner of the property, will do the work and the Other (See Complete Fee Schedule)— structure is not intended or offered for sale (Section 4 717 7 A 7044, Business and Professions Code). 1 ; CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency # 04010.0 0 2 for the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued (Sec. 3097,Civ.C.). 0 0 0 0;0 0 0 2 Lender's Name PLAN CHECKING FEE (One-Fourth Permit Fee) 0 -,4—8 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-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY'LANGUAGE 4-6-81 Signature of Permittee Date 0 WORKERS'COMPENSATION DECLARATION 76-663 10/81 CE-806G APPLICATION FOR ELECTRICAL PERMIT • f,;pereby aft4m that I have a certificate pf consent to self insure, or.•a-certificate cif Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Seal.38Q b C.) Policy tI�' 2/i7/ �ompanyFASIV� FOR APPLICANT TO FILL IN JOB EACH NO. FEE ADDRESS 3 /Z Oertified copy is hereby furnished. New Residential Bldgs.& Pools LOCALITY +Certified copy is filed with the county building inspection 1 & 2-Family,Sq.Ft. $ _ $ departri / Multi-family Sq.Ft. NEAREST, r7CROSS ST. Daf `2 � App Residential Swimming Pools OWNER OR _ FIRM NAME ♦� CERTIFICATE OF EXEMPTION FROM WORK S' Outlets:Rec Light Sw./� MAIL COMPENSATION INSURANCE � O ADDRESS (/ This section need not be completed if the work involved b the First 2b ( Y CITY G^ Tel.No. permit is for one hundred dollars($100)or less.) Total No. Additional _04 I certifythat in the performance of the work for which this permit PLAN H CK p �APPLICANT .is issued, I shall not employ,any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 0 ADDRESS Total No.,3 Additional CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE.TO APPLICANT: If, after making this Certificate of PERMIT Exemption,you should become subject to the Workers'Compensation Range_ Heater_ D.W. _ APPLICANT gill provisions of the Labor Code, you.must forthwith comply with such Oven Dryer _ W.M._ ADDRESS 9 12,f ISSI#_ provisions or this permit shall be deemed revoked. Top FAU- _ W.H. _ CITY � . Tel.No. O LICENSED CONTRACTORS DECLARATION Hood Fan _ Other_ 22/M I hereby,affirm that I am licensed under provisions of Chapter 9 REG.LICEEOR NUMBER (commencing with Section 7000) of Division 3 of the Business and Disp. — Room Air Cond. �3 Class. REG. Professions Code,and my license is in full force and effect. DISTRICT NO. PROCEs D BY Power Apparatus& Large Appliances rl Size& Type HP,KW,KVA,or KVAR J License Number D__ Over Class Up to 1 Incl. FINAL ` V `�"�'' Date Over 1 to 10 Incl d DATE / VALIDATION. a Contractor O4 ver 10 to 50 Incl. 0 ❑ FINAL .I am exempt under Sec. Over 50 to 100 Inc. By W B.&P.C.for this reason Over 100 + Services,Swbd.,MCC& Panelboards Z WO 0- 200 Amp.Under 600 V Signature201 - 1000 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect, SINGLE FAMILY Temp.Power Pole& Appurtenances 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit` AA��.m/� I hereby affirm that 1 am exempt from the Contractor's License Law �1CC .T for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): 330 3tJT� �t i • ElMisc.Conduits& Conductors' i ITM I,as owner of the property,will do the work and the structure TOTAL A is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) �Y17l.► I +G 1.��0 and Professions Code). n�/y CONSTRUCTION LENDING AGENCY CHECK 241.E I hereby affirm that there is a construction lending agency for the CWGE .00 performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) Civ. C.). PLAN CHECKING FEE Lender's Name U000—LJt1 $l 4/89 PERMIT ISSUING FEE 4W2 1 ee"12.13 Lender's Address I certify that I have read this application and state that the above TOTAL FEE 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-mentioned pro rt y for'nspectio p po es. SEE REVERSE FOR EXPLANATORY LANGUAGE - Signature ofPermitte.0 Date WO76A663 RKER'S COMPENSATION DECLARATION 9 DPW 9/89 APPLICATION FOR ELECTRICAL PERMIT 76A66 ' I hereby a+firm that I have a certificate of consent to self insure, or`a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV. cdpy thereof(Sec.3800 Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB Q� �y��, /a�/`�+ ADDRESS {� IwNT`� �P Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE $ LOCALITY �-' $ ,nLF- C< _ 1 &2-Family,Sq.Ft. Certified copy is filed with the county building inspection NEAREST / � department. Multi-family Sq.Ft. CROSS ST. W?LA "N-v Date Applicant Residential Swimming Pools MASS SSOR r PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' 43 4 OWNER OR COMPENSATION INSURANCE Outlets:Rec._Light Sw. IRM NAME A 6A �&AL-T First 20 � �D MAIL (This section need not be completed if the work involved by the d ADDRESS TV� t,l� permit is for one hundred dollars($100)or less.) Total No. Additional 7`I � Y -- I certify that in the performance of the work for which this permit CITY _ 4.T Tel.No���_� 74 is issued, I shall not employ any person in any manner_so as to / PLAN CHECK become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 /• 70 �0 APPLICANT VQNOV-060 iii a6� Total No. Additional c!t Laff- I ADDRESS Date •� Applicant- SNS Treed—ji nl 15 OR 20A,120V BRANCH CIRCUITS NOTICE TO APPLICANT: If, after making this Certificate of j� 3C CITY Tel.No. Exemption,you should become subject to the Workers' Compensation 1 TO 10 INCLUSIVE EACH 10 <,(}2 provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE EACH ERMIT j/ `"' „ ' /�o P Y P Y APPLICANT t� Y!�'�'�,1 I t.� �[ 1 (s provisions or this permit shall be deemed revoked. 41 OR MORE BRANCH CIRCUITS EACH f >_ LICENSED CONTRACTORS DECLARATION ADDRESS 6�� 2 I hereby affirm that I am licensed under provisions of Chapter 9 15 OR 20A,208V TO 277V LIGHTING EACH (commencing with Section 7000) of Division 3 of the Business and CITY �XM1gFIeI% Tel.No. W3-;bbl U Professions Code,and my license is in full force and effect. RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR O /�, �T3� {'^� Power Apparatus&Large Appliances REG.NUMBER Class. d� License Number V -0�" Lic.Class 'v" Size&Type HP,KW,KVA,or KVAR DISTRICT NO. PROCESSED BY 44 �MJOVD Up to 3 Incl. LU � t� / �Up Contractor�"�"'7 nZlC/l• fIJ/�Date �O r 2� Over 3 to 10 Incl. DATE U) Over 10 to 50 Incl. /`�„!,! � � ❑ I am exempt under Sec. Over 50 to 100 Incl. b ! VALIDATION Over 100 FINAL B.&P.C.for this reason BY Services,Swbd.,MCC&Panelboards e' 0-200 Amp.Under 600 V Signature 201 -1000 Amp.Under 600 V EJExemption 1000 Amp.or Over 600 V Exemption fo eg.Maint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law Sig =a}[ for the following reason (Section 7031.5, Business and Professions Additional Sign Branch Circuits Code): r t d &C it d Conus Conductors _ I,as owner of the property,will do the work and the structure Misc. is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). T.ii P CONSTRUCTION LENDING AGENCY " I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, PERMIT FEE (Sub-Total) v'� Civ.C.) PLAN CHECKING_FEE '-� •• •• Lender's Name i- PERMIT ISSUING FEE 7Y Lender's Address j✓ I certify that I have read this application and state that the above TOTAL FEE 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-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE SIGNATURE OF APPLICANT OR AGENT DATE WORKERS' COMPENSATION DECLARATION 76A663 DPW 3/87 -APPLICATION PPI ICATION FOR ELECTRICAL PERMIT O I hereby affirm that I have a certificate of consent to self cl:-eoaG insure, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS or a certified copy thereof (Sec. 3800, Lab. C.) ✓ Policy No. Company "r FOR APPLICANT TO FILL IN JOB n r Fl copy is hereby furnished. '" New Residential Bldgs. & Pools EACH NO. FEE ADDRESS +� Certified copy is filed with the county building inspec- 1 & 2-Family, Sq. Ft. LOCALITY ❑ � _ $ s tion department. s' Multi-family Sq. Ft. NEAREST CROSS ST. Residential Swimming Pools Date Applicant OWNER OR ._1 FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ AMAIL DDRESS �� COMPENSATION INSURANCE First 20 r (This section need not be completed if the,.work involved by Total No. Additional CITY el. NO. `^' the permit is for one hundred dollars ($100)or less.) PLAN HECK J 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 fighting Fixtures First 20 ADDRESS so as to become subject to the Worker 'Compensation Laws. 0. 7 Additional (� / Total No. CITY , el. No. Date V ;4"ppIicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If, after making this C Itificate of APPLICATION 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 with'comply with.such provisions or this .permit shall be Top — FAU —W.H. — deemed revoked. CITY Tel. No. Hood — Fan —Other— LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. REG. NUMBER Class. (commencing with Section 7000)of Division Sof the Business Power Apparatus& Large Appliances DISTRICT NO. P C ED BY >_ and Professions Code, nd my licen in full force and effect, t1 Size&Type HP, KW, KVA, or KVAR �d� License Number Lic. Class Up to 1 Incl. FINAL U Over 1 to 10 Incl. DATEVALIDATION 01- Contractor Date `�� �r'�� 0 Over 10 to 50 Incl. may. E– ❑ _I am exempt under Sec. Over 50 to 100 Inc. BY AL ` _ U LU Over 100 o- B.&P.C. for this reason 1�: Services, Swbd., MCC& Panelboards ' ut U) ate:•` Z 0-200 Amp. Under 600 V — Signature 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V , Exemption for R . Maint. Elect. ! SINGLE-FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from,the Contractor's License Sign with One Branch Circuiti..;s Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): ❑ I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ Business and Professions Code). CONSTRUCTION LENDING AGENCY. –,•t• M I hereby affirm that there.is a construction I g agency for the performance of the work for wh' is permit'is issued' PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE € ),_. –i"i_R Lender's Name - PERMIT ISSUING FEE :t Lender's Address "s i nil I certify that I have read this application and state that the TOTAL FEE above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize r rese tatives of this County to enter upon thea ve-menti d p o rty for i ction purposes. .- / SEE REVERSE FOR EXPLANATORY LANGUAGE SignaturE 0ate l•/ ©s