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HomeMy Public PortalAbout9177 LAS TUNAS DR_Electrical__ 7GA663 CES06 4-65 APPLICATION FOR ELECTRIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS L, A JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W JENKINS. SUP T OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. RECEPTACLE1 TOTAL NO EACH FEE OUTLETS FIRST 20 $.20 $ OWNER Ll LIGHTJ} MAIL / SWITCH ADD'L t0 ADDRESS I 77 OVER 20 TOTAL FCITY TEL NO. LIGHTING 1 FIXTURES IRST 20 .20 FIXTURES Jr ADD'L1O CONTRACTOR �-00 , L/L OVER 20 RANGES CLO DRYERS WTR HTRS too ADDRESS S V 0 W Z � GARB DISP STA COOK CITY TEL NO. DISHWASH AUTO-WASH. STATE ` SPACE HTRS STA APP.('/z H P MAX ) .50 LICENSE NO MOTORS OVER NOT OVER HP DIS38jCT NO. GROUP ZQNEE P OC BY 1 O 1 100 0--0 p5 G- 1 3 150 INSPECTION RECORD 3 8 12001 8 15 2.50 18 50 300 O V so too 500 De SIGNS NO TRANS O NO LAMP9 OV V W SERVICE 0.600V-Nor OVER 200A 1.00 d N SERVICE 0.60OV-OVER 200 A. 200 Z SERVICE OVER 600V 500 OTHER (SEE COMPLETE FEE SCHEDULE) PERMIT ISSUING FEE 200 00 SUPPLEMENTARY PERMIT ISSUING FEE 100 TOTAL FEE $ APPROVALS DATE INSPECTOR'S SIGNATURE -sl IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERSLAB WORK AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING WIRING 1 HEREBY CERTIFY THAT 1 AM PROPERLY RE RED AND/OR rIXTURES LICENSED AS REQUIRED BY LOS ANGELES CO TV ND STATE OF CALIFORNIA OR THAT I THE LEGAL OW7T1,16AOPERTY OF NO INTEND TO POWER RESIDE IN,THE ABOV SCRIBED ID SIGNATURE UTILITY CO.NOTIFIED OF PERMITTE FINAL VALIDAT JOSEPH C. R00HAN CK MO CASH SUPERVISING SING ELECTLEcr RICAL ENGINEER ttt� 4 1 4 4 ALIG 15 2 0 5,00- 76A663"CE806 8-62 APPLICATION FOR "ELECTRICAL PERMIT ' ,`COUNTY OF LOS ANGELES ' DEPARTMENT.OF COUNTY'ENGINEER F;ADDRESS DING ,• = j�". J•� �" L" .. �� s* i ! C BUILDING AND SAFETY DIVISION JOHWA. LAMBIE, COUNTYENGINEERW�I:LLIAMA.JENSEN,-SUP•ToF Bu1Lo1Hc: LITY rEST FOR APPLICANT TO FILL"IN" S'ST. /�/1( C/ii/ :��� RECEPT. TOTAL "-. NO$` EACH FEE r- L OUTLETS FIRST 20 $.20 $ OWNER ( / /'JE 11��`/� Q/L a LIGHT MAIL ADD'L 10 ADDRESS SWITCH. OVER 20 LIGHTING - TOTAL CITY r TEL.NO: _rTOTAL 2 0 .20 n FIXTURES 1( ADD'L ,10 ELECTRICIAN OVIER 20 RANGES CLO.DRYERS WTR.HTRS. 1.00 1 ADDRESS ej�,flYwAl Do GARB.DISP. STA.COOK ' CITY LA-- - TEL.NO. C_4- ys-ya�. DISHWASH.. AUTO.-WASH. 1 STATE .. - LICENSE..NO. 0-,6 �1 SPACE HTRS. STA.APP,.(l/p H.P.MAX.) .SO "MOTOR$: OVER NOT OVER H.P. 'DISTRICT'NO; G'ROUP ZONE_.•'PROCESSED`BY 0 1 1.00 F' C•3- I 3 1.50 ' j/tfq INSPECTION RECORD y�y 3 - 8 2.00 f//!/4 3 f 1 Lh 1(05 8 15 2.50 15 50 3.00 D_ 50 100 5.00 �I ! d{" Q e"..,NO.TRANS. SIGNS '4NO.LAMPS_ N'I O. t � I SERVICE Oa500V-NOT OVER 200A LOO Q V W `3ERVICE6".600V•OVER20OA. r 2:00 J° Z SERVICE OVER SOON 5.00 y�� � �. MISC. PERMIT ISSUING FEE ' 2.00 LSUPPLEMENTARY PERMIT,I88U*ING FEE 1,00 xl �.TOTAL�FIEE'�.,�+,. $ -I HEREBY ACKNOWLEDGE'THAT I HAVE READ THIS APPLICATION ' APPROVALS DAT ,? INSPECTOR'S SIGNATURE AND STATE THAT THE'ABOVE IS CORRECT AND AGREE-TO COMPLY.. .CONDUIT .r//� WITH ALL COUNTY O DINANGES SAND STATE LAWS REGULATING �-i"h,�`(� - ,ELECTRICAL`YWIRING'ti .. WIRINGYPIA, O.'/ / 1 HEREBY,CERT�IF�Y THAT 1 AM PROPERLY REGISTERED AND/OR � � '/ LICENSED A9 hiQMRED BY LOS ANGELES COUNTY.AND STATE OF FIXTURES CALIFORNIA OR THAT 13'AM THE LEGAL OW OF E ABOVE ; DESCRIBED RESIDENT IA SPR PER TY. - POWER 81GNATU,RE ` ' UTILITY CO. r. -7 .r�tJ.yty�,�r�A/ F PERMITTE OE, FINAL / x1L[DATION AT R C. VEIT'— / CIC MO CASH SUPE VISING ELECTRICAL ENGINEER 76A663,CEG06v10-61 APPLICATION ' FOR ELECTelCALPER �IT1 '' ``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 1 T E M NO. I EACH FEE OUTLETS. (FIRST 20) 20 $ OWNER LIGHTS RECEPT. SW. MAIL OUTLETS (ADD'L UNITS) 10 ADDRESS LIGHTS RECEPT SW. LIGHTING FIXTURES: (FIRST 20) 20 CITY TEL. NO. �e LIGHTING FIXTURES (ADDITIONAL) .10 ELECTRICIAN r f RANGES CLO DRYERS WTR HTRS 1.00 ADDRESS 0 GARB DISP STA COOK CITY G9--4j-VTEL NO. �7/ DISHWASH AUTO.-WASH STATE SPACE HTRS STA.APP.(y,H.P.MAX ) .50 LICENSE NO MOTORS OVER NOT OVER HIP DISTR CT O G OUP ONE PRO SSED BY O 1 1.00 - C / 1 3 15o INSPECTION RECORD r a 3 B 200 Q B 15 250 V 15 50 3.00 O 50 100 500 d SIGNS. NO.TRANS H NO LAMPS Z SERVICE 0-600V-NOT OVER 200A 1.00 SERVICE 0.60OV-OVER 200 A. 2.00 SERVICE OVER 600V 500 MISC. PERMIT ISSUING FEE 200 0101 SUPPLEMENTARY PERMIT ISSUING FEE 100 , TOTAL FEE $ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APP (CATION APPROVALS DAT{E1 INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING (�� _ f•� ELECTRICAL WIRING WIRING 1 HEREBY CERTIFY THAT 1 AM PR ERLY REGISTERED AND/OR / LICENSED AS RE(U D-BY LOS AN LES COUNTY AND STATE OF FIXTURES ! f CALIFORNIA OR AT I AM THE AL OWNER OF THE ABOVE DESCRIBED RES E RTY POWER SIGNATURE UTILITY CO NOTIFIED OF PERMITT E FINAL (DATION ARTHUR C. VETT--"' CK MO CASH SUPERVISING ELECTRICAL ENGINEER _ra - 77.. 17 f 7�9.663-CE806 3-64 APPLICATION FOR ELIECTRI AL P IT ���7 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDIN y BUILDING AND SAFETY DIVISION ADDRESS' fi1S /GCl9/�6' JOHN A. LAMBIE, COUNTY ENGINEER pp J dITI WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY 'T�• �L- NEAREST FOR APPLICANT TO FILL IN CROSS ST. ` �y RECEPT. TOTAL NO, EACH FEE OUTLETS FIRST 20 $.20 $ OWNER LIGHTMAIL LP/ ]// /� e ADD'L 10 ADDRESS O j�T���f' rr� yC/ SWITCH. OVER 2O TOTAL CITY d� � TEL. NO. LIGHTING_j FIRST 20 .20 FIXTURES AOWL 1O ELECTRICIAN OVER 2O J RANGES CLO DRYERS WTR HTRS. 1.00 ADDRESS , DO GARB.DISP. BTA.COOK CITY TEL. DISHWASH. AUTO.-WASH STATE SPACE HTRS. STA.APP.(I/s H.P.MAX 1 .SO LICENSE NO. Z> MOTORS. OVER NOT OVER H.P. DISTRICT O. tGRUP ZONE PR ESSED WY O 1 1.00 1 5 1.50 INSPECTION RECORD 5 S 200 0 S 1 s 2.50 pg O 15 50 5.00 ri 50 100 500 U.1 D. N SIGNS- 110.TRANS & Z NO.LAMPS SERVICE 0.600V-NOT OVER 200A 1.00 SERVICE 0-60OV-OVER 200 A. 2.00 SERVICE OVER 600V 5.00 MISC. PERMIT ISSUING FEE 200 SUPPLEMENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE 1HEREBY 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 r, 1 i/ .�• 1HEREBY 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 OWN HE ABOVE DESCRIBED RESIDENTIAL PROP POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMITTEE FINAL VALIDATIQt4 -) ARTHUR C. VEIT - CK MO (CASH/ SUPERVISING ELECTRICAL ENGINEER LACO-6 4 0 2- OCT 13 2 D 4.00- cla 76A66C-CE#506 5-6I APPLICATION FOR ELECTRICAL PERMIT COUNTY Oh' LOS ANGELES DEPARMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS 177 Las Tunas JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A JENSEN,SUPT OF BUILDING LOCALITY NEAREST r FOR APPLICANT TO FILL IN cRoss ST PERMIT FEES OWNER 1 T E M NUMBER EACH FEE AIL ADDRESS 1644 Wilshire Blvd. OUTLET$ S S In LIGHTS 1 RECEPT. SW .10 lo CITY TEL. NO. LIGHTING FIXTURES ], .10, 10 ELEC. RANGES CLO DRYERS ELECTRICIAN WATER HEATERS 50 ADDRESS 212 Silver Lake Blvd ELEC SPACE HTRS DISHWASHERS CITY TEL NOINT 9-2,471 GARBAGE DISPOSERS AUTO.- STATE WASHERS STA COOKING UNITS 25 LICENSE NO. MOTORS OVER INC H P. DISTRICT GRO P ONE P qD 0— 1/2 .25 1/2— 2 .50 INSPECTION RECORD 2— 5 100 d O 5— 15 1.50 u 15— 50 2.50 OG O F 50— 200 5.00 U W SIGNS NO TRANS d NO LAMPS N Z SERVICE 0-600V 100 SERVICE OVER 600V 500 MISC. WIRING PERMIT 100 FIXTURE PERMIT 100 1 O SUPPLEMENTARY PERMIT 50 TOTAL FEE S 2 20 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 COU CITY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING WIRING For 1 HEREBY CERTIFY THAT 1 AM ROPERLY REGI RED AND/OR - - LICENSED AS REQUIRED BY LOS GELES COUNTY A D STATE OF FIXTURES CALIFORNIA OR TH5�jTHE L GALOWN R OF THE ABOVEDESCRIBED RESIDENPERTY POWER SIGNATURE UTILITY CO NOTIFIED // r.-,✓ AV, OF PERMIT' FINAL , 1 1Q ­��Rwz— VAI(DATION ARTHURIC.'VEIT r - cK mo cnsH. SUPERVISING ELECTRICAL ENGINEER 1 e LFA-6 3--5 6`1-3' .DEC 1 2 ,D jr-22'.0- ;�/ WORKERS'COMPENSATIONDECLARATION 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, - - �� c ofij cox t&reof(Sec 3800, Lab C) —i� 1vell-2 FOR APPLICANT TO FILL IN 3O,B 9177 Las Tunas Policy No Company Ins. CO. ADDRESS of the West New Residential Bldgs &Pools EACH NO FEE E Certified copy is hereby furnished 1 &2-Family,Sq Ft $ — $ LOCALITY Temple Cit ® Multi-family Sq Ft — NEAREST Certified copy is filed with the county building inspection CROSS ST Hermosa department Residential Swimming Pools OWNER OR FIRM NAME Date 4-6-81 Applicant Edwards Electric 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 O (This section need not be completed if the work involved U by the permit is for one hundred dollars ($100) or less.) Lighting Fixtures First 20 ADDRESS Total No Additional Cr0 I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY Tel No I— permit is issued, I shall not employ any person in any manner PERMIT W so as to become subject to the Workers' Compensation Laws Range_ Heater_D W APPLICANT d Oven _ Dryer_W M ADDRESS Z Date Applicant Top _ FAU —W H z Hood _ Fan _Other_ CITY Arcadia Tel No 447-5096 NOTICE TO APPLICANT if, after making this Certificate of Disp _ Room Air Cond.— LICENSE OR C-10 1 Exemption 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 'deemed revoked Q ,Tri Up to 1 Incl FINAL LICENSED CONTRACTORS DECLARATION Over 1 to 10 Incl DATE Over 10 to 50 Incl (� �b//�� VALIDATION I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc- FINAL 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. License Number 257191 Lic Class C—'1.0 0-200 Amp Under 600 V EddElJu 1 82 201-1000 Amp Under 0 V Edwards ee c Contractor �rt� � 9 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) I P 4 7 7,9 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 # • • • • • 2 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY ' I hereby affirm that there is a construction lending agency • • • • • • • vL9 for the performance of the work for which this permit is PERMIT FEE (Sub-Total) issued(Sec 3097,Civ C ) ) 0 4, 1 4-81 Lender's Name PLAN CHECKING FEE (One-Fourth Permit Feel 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 �ordmances 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 akt u,tc�4 4-6-81 Signature oOPermittee Date l ?' ` WORKER'S COMPENSATION DECLARATION 9 DPW 9/89 APPLICATION FOR,ELECTRICAL PERMIT " 76A66hereby affirm that I have a certificate of consent to self Insure, 76A663 ora certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof(Sec?3.88000 Lab C) . Policy NO sZ]—Company J�PH t t FOR APPLICANT TO FILL IN JOB ADDRESS D B_ Certified copy is hereby furnished New Residential Bldgs &Pools EACH NO FEE _ LOCALITY ElCertifiedcopy is filed with the county building Inspection 1 &2-Family,Sq $ $Ft NEAREST department, Multi-family Scl Ft CROSS ST Date 2B 3-- Applicant fPg4l� &J Sl_fgg C& Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL / CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw -OWNER OR FIRM NAMERIMER HART COMPENSATION INSURANCE First 20 (This section need not be completed If the work Involved by the ADDRESS MAILpermit is for one hundred dollars($100)or less) Total No Additional I certify that In the performance of the work_for which this permit CITY Tel No is issued, I shat)J,,not employ any person In any manner so as to e become subject e Workers'Compensation Laws I r Lighting Fixtures First 20 q CHECKLAN APPLICANT N�•r Total No Additional ADD SS Date Applicant ✓� S�� 15 OR 20A,120V BRANCH CIRCUITS NOTIC O APPLICANT If, after making this Certificate of CITY Tel No Exemption,you should become subject to the Workers'Compensation 1 TO 10 INCLUSIVE EACH provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE EACH PERMIT p y p y APPLICANT provisions or this permit shall be deemed revoked 41 OR MORE BRANCH CIRCUITS EACH } LICENSED CONTRACTORS DECLARATION ADDRESS I hereby affirm that I am licensed under provisions of Chapter 9 15 OR 20A,208V TO 277V LIGHTING EACH L O (commencing with Section 7000) of Division 3 of the Business and CITY Tel V Professions Code, and my license is in full force and effect RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR Power Apparatus&Large Appliances REG NUMBER Class / ���[ Size&Type HP,KW,KVA,Or KVAR DISTRICT NO PRO ES D Y l O License Number Lic Class - �'�� V Up to 3 Incl LU � � �t7ICI Over 3 to 10 Incl FINAL t CL Contractor _5 I Date Z Over 10 to 50 Incl DATE r Q� CO ❑ I am exempt under Sec ` Over 50 to 100 Inc_I 5 7 / VALIDATION — FINAL B&P C for this reason Over 100 By _ Z Services,Swbd,MCC&Panelboards a Date _ 0-200 Amp Under 600 V r"s '• a�' Signature 201 -1000 Amp Under 600 V a ❑ Over 1000 Amp or Over 600 V _ Exemption for Re int Elect o y,q>•{'�°• SINGLE FAMILYT 3 Temp Power Pole&Appurtenances t HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits ='• '' Code) ❑ I, as owner of the property, will do the work and the structure Misc Conduits&Conductors is not Intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code) ® t;'..__-f`•'• "_C CONSTRUCTION LENDING AGENCYZ{ t ;•{ 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) �� f Civ C) Lender's Name PLAN CHECKING FEE `� tv� N C C PERMIT ISSUING_FEE Lender's Address �D- ` � � - 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 f r Inspection pur oses SEE REVERSE FOR EXPLANATORY LANGUAGE SI AT ECF APPLICANT AGENT DATE WORKER'bCOMPENSATION DECLARATION 9 DPW 9/89 APPLICATION FOR ELECTRICAL PERMIT 76A66 I hereby affirm that I have a certificate of consent to self Insure, 76A663 or a certificate of Worker's Compensation Insurance, or a certified COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thereof(Sec 3800 Lab C) „ Policy NO Company FOR APPLICANT TO FILL IN ADDRESS Certified copy Is hereby furnished New Residential Bldgs &Pools EACH NO FEE _ LOCALITY F] Certified copy Is fled with the county bud1 &2-Family,Sq Ft $ $ ding inspection NEAREST department Multi-family Sq Ft CROSS ST Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM.WORKERS' Outlets Rec Light�S. OWNER OR COMPENSATION INSURANCE g FIRM NAME First 20 (This section need not be completed if the work involved by the MAIL Total No Additional ' ADDRESS permit is for one hundred dollars($100)or less.) --� I certify that In the,performance of the work for which this permit CITY /,a Tel No Is issued, I shall not employ any person in any manner so as to PLAN CH ECK become subject to the Workers' Compensation Laws Lighting Fixtures First 20 APPLICANT Total No Additional ADDRESS Date Applicant NOTICE TO APPLICANT If, after making this Certificate of 15 OR 20A,120V BRANCH CIRCUITS CITY Tel No Exemption,you should become subject to the Workers' Compensation 1 TO 10 INCLUSIVE EACH provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE EACH PERMIT ` APPLICANT provisions or this parmit shall be deemed revoked 41 OR MORE BRANCH CIRCUITS EACH >_ LICENSED CONTRACTORS DECLARATION ADDRESS CL I hereby affirm that I am licensed under provisions of Chapter 9 15 OR 20A,208V TO 277V LIGHTING EACH a (commencing with Section 7000) of Division 3 of the Business and _ CITY �� Tel'No ge C./_� 0 Professions Code,and my license is in full force and effect RESIDENTIAL APPLIANCES UP TO 3HP OR cc .( 'f J� ® Power Apparatus&Large Appliances R GNSE NUM ER class C_ License Number/�x / D Lic Class Size&Type HP,KW,KVA,or KVAR DISTRICT NO P C SSED BY Up to 3 Incl `' jai— y LLI ContractoA K/W �- Date 6!- i l-C Over 3 to 10 Incl FINAL DATE A Over 10 to 50 Incl 77 Z El am exempt under Sec Over 50 to 100 Incl r�? L_ VALIDATION Over 100 FINAL B&P C for this reason _ BY Services,Swbd,MCC&Panelboards Date 0-200 Amp Under 600 V , Signature 201 -1000 Amp Under 600 V ❑ Over 1000 Amp or Over 600 V e�'V Exemption for Reg Maint Elect SINGLE FAMILY Temp Power Pole&Appurtenances �� D HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and Professions Additional Sign-Branch Circuits 2 Code) ❑ 1,as owner of the property,will do the work and-the structure 'Mlsc Conduits&Conductors is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) and Professions Code) 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) Civ C) PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the above TOTAL FEE D 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 &Pp rty for spection rposes SEE REVERSE FOR EXPLANATORY LANGUAGE - 43- .".NA, E F APPLICANT OR AGENT DATE WORKERS' COMPENSATION DECLAPATION 20-0019 DPW 3/87 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have,a certificate of consent to self CE-806G or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a cerrtiffiiefd�/copy thereof (Sec 3800, Lab C ) Policy 4oU 4 P Company r{ J FOR APPLICANT TO FILL IN JOB � An�' Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS �l !,� f W+5 DZ Certified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft $ — $ LOCALITY GA- 1 A tion department t Multi-family Sq Ft NEAREST CROSS ST Date Lii Apphcant (�L l� l!/7 Residential Swimming Pools OWNER OR f� / ,{-�I,, / 6 FIRM NAME VV d -L /A- I - CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw— MAIL (� COMPENSATION INSURANCE ADDRESS -I ( I First 20 (This section need not be completed if the work involved by Total No Additional CITY "� Tel No the permit is for one hundred dollars ($100)or less.) PLAN CHECK 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 so as to become subject to the Workers'Compensation Laws Lighting Fixtures First 20 ADDRESS /40j� f Additional J Total No CITY iel No `I Date 6 Applicant `••[� 6 t W'I �3 NOTICE TO APPLICANT If, after making this Certificate of Fixed Appliances Not Over 1 HP PERMIT Exemption, you should become subject to the Workers' Range— Heater—D W — APPLICATION { 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 — ^� I { deemed revoked CITY Tel No a- LICENSED CONTRACTORS DECLARATION Hood — Fan —Other— LICENSE OR , I hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond REG NUMBER L Class (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NO PR -ESSED BY >_ and Professions Code,and my license is in full force and effect 0_ Size & Type HP, KW, KVA, or KVAR © o License Number ��d¢7 al - Class Up to 1 Incl FINAL V Over 1 to 10 Incl DATE / Ir Contractor 1-� /�?+r fate �`�- 1 / ! r'LZ l VALIDATION 0 F-1 `' Over 10 to 50 Incl FINAL 0 I am exempt under Sec Over 50 to 100 Inc BY t'�,/ W J a B &P Over 100 C for this reason / Date A / Services, Swbd , MCC& Panelboards Z r 1 0-200 Amp Under 600 V — Signnture 201 - 1000 Amp Under 600 V ❑ Over 1000 Amp or Over 600 V Exemption for Reg Maint Eject SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp Power Pole &Appurtenances ` Sign with One Branch CircuitCPO IL I hereby affirm that I am exempt from the Contractor's License 11=:= a a 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 &Conductors structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)— -1 zi 1 fl V Clio Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for i E li�l ,� Ft•I 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 ��/{!,�`y rf-�''/�/ 1-Ij-_S!1;_:"'ii!i t; � 1 Yi4• i PERMIT ISSUING FEE 100 �b! 1 t• ,a.. Lender's Address / �'� r S� _f•= i -il S _ 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 jaws regulating Electrical wiring, and hereby authorize representttves of this County to enter upon the above-mer t�ed p. perty f r insspectfion purposes SEE REVERSE FOR EXPLANATORY LANGUAGE V f �/� Signatu f P ittee Dat / ©s WORKERs COMPENSATION DECLARATION 20-OOi9DPW 3 e7 APPLICATION FOR ELECTRICAL PERMIT I.hereby affirm that I have a..certificate of consent to self ce s�ob3G inisurle, or a certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or a cert441ed copy thereof (Sec 3800, L7obb C ) Pollcy.NV,,.Z0 f Jyb Company ' FOR APPLICANT TO FILL IN JOB --r– C' Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS i + (�Certified copy Is filed with the county�bui�ilIng Inspec- 1 & 2-Family, Sq Ft $ — $ LOCALITYty�� NEARESTtion department —Multi-family Sq Ft yr Residential Swimming Pools WIN R Date Applicant FIRM NAME 1 t7 CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec�LlghtgW_Sw,3 D f MAIL COMPENSATION INSURANCE ADDRES (This section need not be completed if the work involved by First ti ' W 94CITY Tel NV 011 the permit is for one hundred dollars ($100)or less.) Total No Additional +�� PLAN CHECK I certify that in he performance of the work for which this APPLICANT permit Is issued, I shall not employ any person In any manner Lighting Fixtures First 20 "o p � ADDRESS so as to become subject to the Workers'Compensation Laws `160O O L Additional Total No ®� CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, after making this Certificate 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 — ADDRESSr with comply with such provisions or this permit shall be Top — FAU —W H — deemed revoked Hood — Fan —Other— le'CITY Tel No LICENSED CONTRACTORS DECLARATION LICENSE OR ER Class I hereby affirm that I am licensed under provisions of Chapter 9 NUMB Dlsp — Room Air Cond — REG (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICT NOPRO ESSED BY >_ and Professions Code,and my license Is In full force and effect p O Size 8 Type HP, KW, KVA, or KVAR a License Number ` Lic Class /d Up to 1 Incl FINAL ^^-i� qq 0 v0 DATE �J 4'G� Cr �, v� �0 2 Over 1 to 10 Incl VALIDATION O Contractor . Date ❑ Over 10 to 50 Incl FINAL ~ I am exempt under Sec Over 50 to 100 Inc BY V Over 100 d B &P C for this reason (1)Services, Swbd , MCC & Panelboards , Z Date 0- 200 Amp Under 600 V .747 Signature 201 - 1000 Amp Under 600 V ❑ Over 1000 Amp or Over 600 V Exemption for Reg 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 Circuit °i 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 Mlsc Conduits 8 Conductors 1 1 FEL structure is not intended or offered for sale(Section 7044, Other (See Complete Fee Schedule)_ ® i Business and Professions Code) T 4_i T 14L ,,_3 2 20 J 7. CONSTRUCTION LENDING AGENCY HECK +moi I hereby affirm that there Is a construction lending agency fora°i the performance of the work for which this permit Is Issued PERMIT FEE (Sub-Total) All `'Hlif-3i= °I-- (Sec 3097, Civ C ) PLAN CHECKING FEE Lender's Name I it3 I_ t� }i – 10 PERMIT ISSUING FEE Q � ��./13., 7°t i Lender's Address 1,S50 i Ari 71.4'' j certify that I have,read this application and state that the TOTAL FEE 040 1 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 bove-m tioned operty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE gnatu e o ermittee Date WORKERS COMPENSATION DECLARATION 76-663 10/81 APPLICATIONI hereby affirM that I have a certificate of consent to self insure, CE-806G FO R E LE CTR I^p L PERMIT EpYIT or a cett4fi6ate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy th(Eh of(Sec 3800,Lab C) w Policy No Company FOR APPLICANT TO FILL IN JOB ❑� Certified Copy is hereby furnishedEACH NO FEE ADDRESS New Residential Bldgs & Pools F1Certified & 2-Family,Sq Ft $ — $ LOCALITY �• Certrfied copy is fled with the county building inspection department Multi-family Sq Ft — NEAREST Residential Swimming Pools 0 CROSS Date Applicant OWNER OR � FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets Rec Light Sw MAIL �� COMPENSATION INSURANCE ADDRESS w (This section need not be completed if the work involved by the First 20 permit Is for one hundred dollars($100)or less) Total No Additional CITYIL Tel No ,e ,• I certify that in the performance of the work for which this permit PLAN CHECK 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 ADDRESS Additional �j Total No CITY Tel No Date//- �(, 9BApplicant/�/ —�Qe Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If, after making this Certificate of APPLICANT . Exemption,you should become subject to the Workers'Compensation Range_ Heater_ DW provisions of the Labor Code, you must forthwith comply with such Oven _ Dryer _ W M ADDRESS Ir provisions or this permit shall be deemed revoked Top — FAU _ W Hw LICENSED CONTRACTORS DECLARATION Hood — Fan Other_ CITY / L Tel No ,0Cr1 I hereby affirm that I am licensed under provisions of Chapter 9 Disp — Room Air Cond LICENSE Class OC—,le (commencing with Section 7000) of Division 3 of the Business and REG NUMBER Professions Code,and my license is in full force and effect Power Apparatus & Large Appliances DISTRICT No �j PROCE SED BY r. �{ Size& Type HP,KW,KVA,or KVAR 1}d 0 a`1./1 License Number �+' 9/ Lic Class C-140 Up to 1 Incl FINAL DATE �� „ i Date �j Contracta. _ Over 1 to 10 Incl VALIDATION Over 10 to 50 Incl ❑ FINAL I am exempt under Sec — Over 50 to 100 Inc BY B&PC for this reason Over 100 N Services, Swbd,MCC & Panelboards ® Z Date 0- 200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V ❑ "k Exemption for Reg Maint Elect Over 1000 Amp or Over 600 V ' •r s SINGLE FAMILY Temp Power Pole& Appurtenances 'I` ' °Ir HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit Z7. j.7 �r,il*I 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and Professions Additional Sign Branch Circuits Code) ITEMS ❑ Misc Conduits & Conductors TOTAL I AL ,_C3 ® 00 I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) ® CHECK ��),9IJ and Professions Code) y•����� I I CONSTRUCTION LENDING AGENCY .01 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) Civ C) PLAN CHECKING FEE 3 Lender's Name .�,844 1 AN 9:rLc PERMIT ISSUING FEE Lender's Address I certify that I have read this application and state that the above TOTAL FEE �U information is correct I agree to comply with all County ordinances and State laws regulator Electrical wiring, and hereby authorize representatives o this my to enter u on the above-mentioned pro for in t p SEE REVERSE FOR EXPLANATORY LANGUAGE Sign e o rmitt eDate