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HomeMy Public PortalAbout9514 LAS TUNAS DR_Electrical__ DBAPPLICATION FOR PERMIT DEYA�'�3.TMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRIC WM. J. FOXCHIEF ENGINEER z DISTRIC(LNO. GROUP ZONE PERMIT NO. AME i Y��._ 4�I61 ���t�r� ( ✓ 9� Q �/�) fns U ADDRESS-4 V �. 11r'�, �r� �� `° F tr , qREADY I CITY / TEL.NO./'I V �/ RECEIVED BY FIRST NSPECTION DATE ISSUED W CERT.NOCOUNTY . d�. EXPIRES /I- I& ,. 9 _113 Q.. APPLICANT FILL IN`IiEAVILY OUTLINED PORTION ONLY (DESCRIPTION OF WORK n D RESS U c ' NUMBER OF OUTLETS ON CIRCUITS LOCALITY LOCATION BY ROOMS NEAREST LIGHT OUTLET IsW.1111 UGS I FWT CROSS ST. CIRCUIT A. B C D E F G 1H wt!AME aztw i. Z MAIL 3 ADDRESS O CITY TEL.NO. 1 AM THE LEGAL POSWEESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE-0 QUAI_TrICBO( 10 a/1_ e vit ELECTRICIAN. I AM THE ixGAL OWNER OF 7HE PROPERTY DESCRIBED ABOVE i OWNER. CORREMONS i AM G" Q Z_ t7 I O }1 { LOF UTLETS $ APPROVALS IXTURES $ DATE INSPECTOR'S NAME MOTORS H.P. $ CONDUIT IGNS TRANS. $ WIRINGRANGES OR HEATERS $ FIXTURESANEOUS $ POWERFEE $ UTILITY CO.NOTIFIEDEE FINAL 76A663-CE806 8-62 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING �` ` / s v/y . BUILDING AND SAFETY DIVISION ADDRESS / G L JOHN A. LAMBIE, COUNTY'ENGINEER WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITYy NEAREST 1 FOR APPLICANT TO FILL IN CROSS ST. 6 UE" t RECEPT. TOTAL NO, EACH FEE OUTLETS FIRST 20 $ $ OWNER , S'NILIGHT - 20 MAIL c�{� !�• 1-4 swlrc H. ! OADD'L ID ADDRESS J/ G �- OVER 20 TOTAL CITY E C/ TEL. NO. LIGHTING FIRST 20 .20 FIXTURES I �I ADD,'L' 10 ELECTRlC1AN C- OV R 20 RANGES CLO:DRYERS WTR.HTRS. 1.00 ADDRESS GARB.DISK - STA.COOK CITY ��� CST TEL. NO. ,GOC DISHWASH. AUTO.-WASH. STATE SPACE HTRS. STA.APP.(;yz H.P.MAX.) •50 LICENSE NO. MOTORS: -.OVER. NOT OVER H.P. DISTRICT NO. GROUP ZONE PRQCESSED Y O 1 1.00 I 1 3 1.50 INSPECTION RECORD 3 8 2.00 8 15 2.50 15 50 3.00 IL 50 100 5.00 0 SIGNS: NO.TRANS" C NO.LAMPS O SERVICE 0.600V-Nor OVER 200A 1.00 VLIJ _ SERVICE 0.60OV-OVER 200 A. 2:00 .. N SERVICE OVER 600V 5:00 - ? MISC. rCOUNTY ISSUING FEE 2.00 MENTARY PERMIT ISSUING FEE 1.00 TOTAL FEE $ 2O REBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE TATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT .,� ALL COUNTY ORDINANCES AND STATE LAWS REGULATING AICAL WIRING. WIRINGREBY CERTIFY THAT 1 AMPROPERLY REGISTERED AND�ORED A9 REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURESRNIA OR THAT 1 AM E LEGAL OWNER OF THE ABOVEIBED RESIDENTIAL P PPOWERTURE C1r % UTILITY CO.NOTIFIED pp��[�®" a„RMITTEE FINAL �1"?o//f{!�] LIDATION ARTHUR°C. VEIT d CK MO CASH SUPERVISING ELECTRICAL ENGINEER CC, L 7 9 3 3:o' JAI 2 7 2 D 3.20- 76A663-CE806_9-, APPLICATION FOR ELECTRIC PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENTBUDING AND SAFETY DIVISION ao�REss tlN�f`S. JOHN A.LAMSIE.COUNTY ENGINEER �y ` //�• CASSATT D.GRIFFIN,SUP'T OF BUILDING LOCALITY i L n e `C NEAREST FOR APPLICANT TO FILL IN CROSS ST. O PERMIT FEES 1 T E M NUMBER EACH FEE OWNER OUTLETS: - - $ $ MAIL / (�. LIGHTS RECEPT. SW. .10 ADDRESS J- d. Df LIGHTING FIXTURES .10 CITY x(o- d , TEL.NO.. ELEC.RANGES CLO.DRYERS ELECTRICIAN {F q o. �yD, W ATER HEATERS :50 ADDRESS ELEC.SPACE HTRS. DISHWASHERS �1 /�m� GARBAGE DISPOSERS AUTO.- CITY ' (16P 'YK TEL.NO . L 2 3-7 WASHERS STA.COOKING UNITS .25 STATE LICENSE /7 D 7 LICENSE NO. / awv! MOTORS: OVER INC. H.P. DISTRICT NO. GROUP ZONE READY FOR INSPECTION O — 1/2 .25 1/2 — 2 .50 2 - 5 1.00 INSPECTION RECORD 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 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50' - TOTAL FEE . s-?- APPROVAL'S I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'SSIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING I HEREBY-CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQ BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR KHAT M THE LEGAL AYNER OF T ABOVE POWER. DESCRIBED RESI N P PERTY. 1 3 SIGNATURE -UTILITY CO.NOTIFIED q OF PERMIT T ` FINAL VALIDATI ARTItUR C. EIT, SUPERYISINGi ELECTRICAL E R GK MO. 0 3 213 '7 Lf* JUL 28 2 A 3.0 0 : . �� D9 S-A 10-41 23M APPLICATION FOR PERM � DEPARTMENT OF -BU"ING AND SAFE_ TY' ELECTRIC COUNTY OF LOS ANGELES WM. J. FOX CHIEF ENGINEER Q NAME app DISTRICT NO., GROUP_I ZONE PERMIT NO. U ADDRESS ('£ F . 3 7 2 �y?'', WCITY a�,. TEL.NO. RECEIVED BY, READY FOR DATE ISSUED .1 COUN �' / FIRST INSPECTION J W CERT.NO. v;e... EXPIRES ,; APPLICANT FILL IN HEAVELY OUTLINED PORTION O Y JOB DESCRIPTION OF WORK ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY zo LOCATION BY ROOMS NEAREST LIGHT OUTLETS SW. PLUGS Fl CROSS ST. CIRCUIT AC B C D E F G H W NAME � MAIL q e ADDRESS i 1$ - t V CITY TEL.NO: I AM THE LEGAL POSSESSORI, F THE_ OVE ANGELES COUNTX CERTIFIGAT I 'qU TION.; , I AM THE LEGAL'OWNER OF THE PROPERTY. DESCRIBED ABOVE ryF 1i. _ 4 OWNER. � CORH.ECTIONS J d Z O TOTAL V� A NO. OF OUTLETSS GJ� APPROVALS NO. OF FIXTURES DATE INSPECTOR'S NAME NO. OF MOTORS H.P. S CONDUIT NO. OF SIGNS TRANS.- ffi WIRING NO. OF RANGES OR HEATERS S FIXTURES MISCELLANEOUS S POWER PERMIT FEE S r UTILITYCO.NOTIFIED TOTAL FEE FINAL 76.0663-CE606 3-69 1 APPLICATION FOR-ELECT Lx RMIT COUNTY OF LOS ANGELES ` -DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS �j+�+. + JOHN A. LAMBIE, COUNTY ENGINEER - COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEARESTCROSS ST. NO. EACH FEE �t f �^ $ $ OWNER;95;1 �G• i/ rV/ 2 RECEIPT._ _ ADDRE ,,,y LIGHT TOTAL FIRST 20 .20 MAIL �lVC /� JEL. O ,� -lj CITY /f SWITCH OVER 20 •10 PLAN CHECK LIGHTING TOTAL FIRST 20 •20 APPLICANT FIXTURES OVER 20 •10 ADDRESS RANGE_ORYER_WTR. HTR. -CITY TEL.NO.•� STA. COOK DISP. F.A.U. CONTRACTOR/I-gO �(l/Q ���{�•/ 1� SPACE HTR. AIR COND. ADDRESS _ f U CLOTHES WASH._DISHWASH. CITY ��L.NO 4a�„Z .FAN OTHER 1.00 LICENSE NO. � CLAS _ Q MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 11 0 - 1 1.00 C..Y 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND 5TATEOF 1 - 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNE - F, AND INTEND TO RESIDE IN, THE ABOVE DES E I EN PROPERTY. O 10 — 50 5.00 V SIGNATURE _ � 50 — 100 10.00 OF PERMITTEE Q F- 100 - 500 15.00 DISTRICT NO. GROUP Z014E PR S ED 8Y V SIGN,GAS SIGN AND ONE CIRCUIT 3.00 VWj TUBE, OR Z MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: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 WIRING FIXTURES PERMIT FEE (SUB TOTAL) POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE) PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL TOTAL FEE e' JOSEPH C. ROOHAN SUPERVISING ELE FRi'@AL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO CK M.O. CASH_ SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE 76AS63-CES06 12-58 APPLICATION 0PPLICATION FOR E LE CT R I P E®M I T COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER eU1LD1NG BUILDING AND SAFETY DIVISION ADDRESS ! ✓ G�C�S �CJ /��_ JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY ZZ?'J....-%C( �f FOR APPLICANT TO FILL IN NEAREST CROSS sr. PERMIT FEES _ ITEM NUMBER EACH FEE OWNER OUTLETS: - $ g MAIL LIGHTS RECEPT. SW. .10 ADDRESS LIGHTING FIXTURES .10 CITYf4,,, , rJ I TEL.NO. I`4�-. ),J 14), ELEC.RANGES CLO.DRYERS ELECTRICIAN W AT ER HEATERS .5O ADDREESS !!r f Q � � f:l'.)' �' r9r' •J f' ELEC.SPACE HTRS. DISHWASHERS - CITY( •((9, •`L' / e. TEL.NO. l •^ •C,. GARBAGE DISPOSERS AUTO.- STATE - _ ria,.,.. WASHERS STA.COOKING UNITS .25 LICENSE NO. SL L �- �..! L/r MOTORS: OVER INC. H.P. DISTRICT NO. IGROUP ZONJ P•R D BY 0— 1/2 25 f � %f 1/2— 2 .50 INSPECTION RECORD 2— 5 1.00 5— 15 1.50 is— 50 2.50 50-200 5.00 SIGNS: I NO.TRANS. NO.LAMPS ��++ SERVICED-600V Aw1.00 SERVICE OVER 600V 5.00 - misc. WIRING PERMIT 1.00 FIXTURE PERMIT 1-.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE �� APPROVALS 1. HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. WIRING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES LD ALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE ESCRIBED RESIDENTIAL PR PERTY. POWER _ GNATURE UTILITY CO.NOTIFIED OF PER., / 0:111'4r FINAL I �•-�'i�^�""�-- ®F ARTHUR C. VEIT. SUPERVISING ELECTRICAL ENGINEER- . (7�ATION CASH, y o : r��, 2 E A 2.5 76A663 DBS 5A 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ELECTRIC ✓ WILLIAM•J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. . GROUP-1 ZONE PERMIT NO. ELECTRICIAN q / -ry•,, f RECEIVED BY READY FOR DATE ISSUED ADDRESS / .33.5- vy �' (,Y L�G( R'/�" � �' FIRST INSPECTION CITY J`(�G-'Y.!®�y TEL. NO. aa _�/ COUNTY LICENSE NO. EXPIRE 30 BUILDING �I PERMIT FEES t ADDRESS FEE / .a.6i/i➢. - NUMBER EACHLOCALITY sP " LIGHT OUTLETS NEAREST CROSS ST. X11 RECEPTACLES WALL SWITCHES OWNER fl �NIVi' s= fs. li � d TOTAL OUTLETS 5c' $ gJ MAIL ELEC. RANGES 25' ADDRESS ELEC. HEATERS 2S CITY TEL, No. FIXTURES 5 .I HEREBY ACKNOWLEDGE THAT I HAVE ' READ THIS MISC. I 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 HORSEPOWER ANGELES COUNTY LICENSE, OR I AM THE LEGAL .OWNER FEE OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. NEW MVD. HP OVER. I INC." EACH 1/2 a LESS - $ .25 SIGNATURE OF ._J 1/2 2 .50 PERMITTEE 2 5 1.06 INSPECTION RECORD 5 75 .1.50 Is 50 2.50. . a 50 200 '5.00 " 200. 500 10.001 - J 500 1000 15.00 - Z OVER 1000 20.00 (� M. G. SET/FREQ. CHANGER-HP WELDERS: AC-KVA I - O GENERATORS-KW ' TRANSFORMERS-KVA - TEMP. MOTORS (75%OF ORiG.) ' MOVED MOTORS (75%OF ORI..) MISC. SIGNS NO.• NO. TRANS. ® G p APPROVALS NO. - NO. LAMPS DATE . INSPECTOR'S NAME" FOR:EACH PERMIT: $1.00 CONDUIT ' WIRING I" FIXTURES $1.00 I WIRING " SUPPLEMENTARY .50 FIXTURES - . - G G POWER I - TOTAL FEE $•!� I UTILITY CO. NOTIFIED cp) �� FINAL WORKERS'COMPENSATION cafeDrCLARATION corse 76A669oFW9 87 APPLICATION FOR ELECTRICAL PERMIT 1 hereby affirm that I have a certificate of consent to self ce 8006G 'insure,'o•r a-certificate of Workers' Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS or ct certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company FOR APPLICANT TO FILL IN JOB 3 aCertified 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 tion department. Multi-family Sq. Ft. NEAREST CROSS ST. Residential Swimming Pools OWNER OR Date Applicant FIRM NAME f CERTIFICATE OF EXEMPTION FROM WORKERS' 1 MAIL COMPENSATION INSURANCEFirst Outlets: Rec�tight�5w._ © !{ ADDRESS '^ f' r (This section need not be completed if the work involved by Total No. — Addittiional CITY f' 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 Additional Date�_, A,�1 Applicant licant - - 4d . Lca•, 6 Total No. - CITY Tel. No. NOTICE TO APPLICANT: If,'after making this Certi ' ate of Fixed Appliances Not Over 1 HP PERMIT APPLICATION C 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 /b1 ` dAve. with comply with such provisions or this permit shall be Top — FAU W.H. — 'k- deemed revoked. Hood — Fan /Q Q CITY �' �� Tel. No. -.� LICENSED CONTRACTORS DECLARATION Other LICENSE OR Disp. — Room Air Cond. _ 46 Class. e1 I hereby affirm that I am licensed under provisions of Chapter-9 REG. NUMBER (commencing with Section 7000)of Division 3 of the Business Power Apparatus-&Large Appliances DISTRICT NO. PR SED BY d and Professions Code,and'my license is in full force and effect. G Size&Type HP, KW, KVA, or KVAR Q d �� 0 License Number /I z) sit Lic. Class e-- 1 Up to 1 Incl. FINAL fi Over 1 to 10 Incl. DATE 3 0� `I VALIDATION y Contractor �- xN+Date 1 " Ty� Over 10 to 50 Incl. I— FINAL Q U FT I am exempt under Sec. Over 50 to 100 Inc. BY �'i i�%� W B.&P.C. for this reason Over 100 Il Services, Swbd., MCC& Panelboards , Z Date: Z 0-200 Amp. Under 600 V Signature 201 - 1000 Amp: Under 600 V 77 RE OOver 1000 Amp. or Over 600 V Exemption for Reg. Maint. Elec SINGLE FAMILY Temp. Power Pole &Appurtenances HOME OWNER-BUILDER DECLARATION _T .• - _-. I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit Law for the following reason (Section'7031.5, Business and Additional Sign Branch Circuits - -t Professions Code): Misc. Conduits&Conductors Ell, as owner of,the property, will do the work and the C structure is not intendOther (See Complete Fee Schedule)— ed or offered for sale Section 7044, Rfflat ' Business and Professions Code). CONSTRUCTION LENDING AGENCY _ I hereby affirm that there is a construction lending agency for wlrw3 t ;.ls;sem i,•`;;, the performance of the work for which-this permit is issued PERMIT FEE (Sub-Total) •{�W =,,,:c3: (Sec. 3097, Civ. C.). 1 PLAN CHECKING FEE Lender's Name PERMIT ISSUING FEE , vO Lender's Address I certify that I have read this application and state that the TOTAL FEE �0 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 v Signature of Perm'tee . Date WORKERS'COMPENSATION DECLARATION 20-0019 DPW 3/87 , 3 ' APPLICATION FOR ELECTRICAL PERMIT _ I hereby affirm,that I have a certificate of consent to self ',CE-806G 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 FOR APPLICANT TO FILL 1N JOB Certified copy is hereby furnished. New Residential Bldgs. & Pools EACH NO. FEE ADDRESS r_1 tion copy is filed with the county building inspec- 1 &2-Family, Sq. Ft. $ — $ LOCALITY G tion department. All, Multi-family Sq. Ft. — NEAREST '3CROSS ST. Residential Swimming Pools OWNER T. DateOR Applicant FIRM NAME rt CERTIFICATE OF EXEMPTION FROM ORKERS' Outlets: Rec Light Sw._ MAID First 20 COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by Total No. CITY Tel. No. the permit is for one hundred dollars ($100)or less.) Additional PLAN CHE 1 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 becom subject to the Workers" mpensation Laws. Lighting Fixtures First 20 ADDRESS Additional �y/� Total No. CITY Tel. No. Date Applicant Gv® Fixed Appliances Not Over 1 HP PERMIT NOTICE T A PLICANT: If, after makincythTis 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..— ADDRESS 9 • �lU with comply with such provisions or this permit .shall be Top — FAU —W.H. deemed revoked. -- CITY - Tel. No. LICENSED CONTRACTORS DECLARATION Hood — Fan —Other— 1 Disp. _,Room Air Cond. — LICENSE OR /i� ClassLB/JP' I hereby affirm that I am licensed under provisions of Chapter 9 REG. NUMBER tet' (commencing with Section.7000)of Division 3 of.the Business Power Apparatus,&Large Appliances DISTRICT NO. PROQESSED BY ?- and Professions Code,and my license is in full force and effect, U Size &Type HP, KW, KVA, or KVAR 5, i 7 Q License Number Lic. Class /'00Up to 1 Incl. FINAL q — Over 1 to 10 Incl. DATE — I VALIDATION Contractorote 0 Over 10 to 50 Incl. FINAL ` ❑ I am exempt un er Sec. Over 50 to 100 Inc. BY ,wJ U W Over 100 B,&P.C. for this reason a Z Date: Services, Swbd., MCC & Panelboards Z 0- 200 Amp. Under 600 V — Signature 201 - 1000 Amp. Under 600 V ❑ ' Exemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Temp. Power Pole &Appurtenances I hereby affirm that I am exempt from the Contractor's License Sign with One Branch Circuit r3f is Law for the following reason (Section 7031.5, Business and Additional:Sign Branch Circuits I Professions Code): --' I, as owner of the property, will do the work and the Misc. Conduits&Conductors i'.a fr.11-.� structure is not intended or offered for sale Section 7044, Other (See Complete Fee Schedule)_ TATA; Business and Professions Code). 1„:��1„•-• y1e„t-1 CONSTRUCTION LENDING.AGENCY I hereby affirm that there is a construction lending agency for CHANIGE „ 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 PERMIT ISSUING FEE Fl—s b 6 Lender's Address I certify that I have read this application and state that the TOTAL FEE a DO above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authonzrepr sentatives of this County to enter upon the above-me !tone pr erty for inspection purpos ssj. SEE REVERSE FOR EXPLANATORY LANGUAGE ©s Signature of P mittee Date /