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Home My Public Portal About9600 LOWER AZUSA RD_Electrical__ 76Aa3CE-E (II /78) APPLICATION FOR ELECTRICAL PERMIT 'I—r—_rs� COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN JOB New Residential Bldgs"&Pools - EACH NO FEE ADDRESS �Q ...d 4C __ LOCALITY 1•&2 Family Sq Ft $ 025 — $+ Multi family Sq Ft 02 — NE REST Residential Swimming Pools 2500 CROSS STOWNER O -•.� FIRM NAME D Outlets Rec Light __Sw MAIL `40 }® # y a First 20 50 Total No_.- -Addnronal 30 CITY r_A _ HECK NTLighting Fixtures First 20 50 S Additional s 30 Total No CITY Te No Fixed Apphances.Not Over.l HP _ PERMIT Range_Heater_D W - APPLICAN '' R Oven_Dryer—W M_ ADDRE t Top _FAU, _W H v - a Tef No Hood_Fan —Other LICENSE OA Ra , —Room Air Cond _� 250 REG NUM ,?b,zl/1_W Class��f Q I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA Power Apparatus&Large Appliances TION AND STA HAT THE ABOVE IS CORRECT AND AGREE TO COMPLY W 'AL COUNTY ORDIMANEES—" N`D STATE" WS "'A"' &Type HP KW KVA or KVAR 2 50 REGULATI ELECT ICAL WIRING j Up to 1 Ind * 1 HE EBY C T1 _THAT 19�1 RE Over 1 to 10 Ind`i 00 LICENSED RE IRE BY LOS ATIr7FLES C UNTY AN TATE F �r Over 16 to 50 Incl 12 50 - t CALIF NI JH I AM THE: L ER OF Q OQRESCRIB R IRE L PROPERT —_ Over 50 to 106 Inc pERMI a ~Ctver 100 4000 v SICAq yl * g Servider �, - t ��, � DISTRICT NO *0�®cd Amq lS6der 600�/ 1 12 50 �+ a 201 1000 Amp Under 600 V 25 00— " _.- Over 1000 Amp or Over 600 V 5000 �� Z + O Temp Power-Pole&Appurtenances 1000 00 .2S3'g r c Sign with One Branch Circuit 1000 _ Additronal Sign Branch Circuits 200 INSPECTION > l o 0o INFORMATION _ Misc Conduits&Conductors + , N REVERSE Other(See Complete Fee Schedule) T SIDE T Z 0 5 18 A Q �- w r Lyy �+ # • a f s o t PERMIT FEE - (Sub TQtall - 1200'`_j _ a PLAN'CHECKING FEE t (One Fourth Permit Feel _ - 0 $ o o 0 PERMIT ISSUING FEE $7 00 5 28—e,-`G TOTAL FEE 0 > 4 ~ i i INSPECTION FINALED date w.}- '.. % BY l.�"K...'P�'k " � y' e i� C�+ ,� '} es z 76A663 CES06 9 67 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES �E�PAj'M{NT Oqq COUNTY ENGINEER FY G BUILDING ANFI SAFETY DIVISION JOHN A LAMBIE COUNTY ENGINEER COLEMAN W JEWINS, SUPERINTENDENT OF BUILDING FOR APPLICANT TO FILL IN ITOTAL NO AC FEERECEPT $ $ OWNERMAILLIGHT FIRST 20 20 QQ ADDRESS SWITCH OVER 20 10 CITY A j l TEL. /NO LIGHTING }}TOTAL FIRST 20 20 3 CONTRACTOR /Q/PQ►�✓ Arld FIXTURES l OVER 20 10 ADDRESS RANGE—DRYER—WTR HTR — CITYee,�eTEL NO-;Ig STA COOK_DISP _F A U LICENSE NO Q SPACE HTR AIR COND 1 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 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR MOTORS TRANSFORMERS RATING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO IND HEATERS ETC HP KW KVA RESIDE IN THE ABOVE D CRIB D R SIDENTIAL PROPE Y SIZE & TYPE OVER TO SIGNATURE 0 - 1 1 00 OF PERMITTEE per, 1 - to 3001 DISTBI T G OUP ZONE P V 10 - 50 5 00 oC 50 - 100 1000 NOTES 4 , VTZ 100 - 500 15 00 n' N SIGN GAS [SIGN AND ONE CIRCUIT 3 00 TUBE OR MARQUEE DDITIONAL 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 �- OQ WIRING FIXTURES SUPPLEMENTARY ISSUING FEE 1 00 POWER AUTHORIZED PERMIT FEE UTILITY CO NOTIFIED a 4c PLAN CHECK FEE (50% PERMIT FEE) FINAL TOTAL FEE O JOSEPH C ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M o CASH 9 0 0X13 2 D 1 O DON ME BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE WORKERS.COMPENSATION DECLARATION CE 8066 63 ,o,a,- APPLICAiLtc � FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self CE 8 insure or a certificate of Workers Compensation Insurance COUNTY OF LOS S BUILDING AND SAFETY or a certified copy thereof(Sec 3800 Lab C ) Policy No Company FOR APPLICANT TO FILL IN JOB Certified copy is hereby furnished New Residential Bldgs &Pools EACH NO FEE ADDRESS W /T U YA Certified copy is filed with the county building inspec 1 &2 Family Scl Ft $ — $ LOCALITY be— e ` tion department Multifamily Sci Ft — NEARESTri✓ CROSS ST Residential Swimming Pools !�/� Date Applicant OWNER OR FIRM NAME jlt7,AA I OF t1Z CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec Light Sw_ MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work Involved by First 20 the permit is for one hundred dollars($100)or less) Total No CITY Additional N 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 Compensatio&�) lws Lighting Fixtures First 20 ADDRESS Total No Additional Date '"' lica� CITY Tel No pp Fixed Appliances Not Over 1 HIP PERMIT NOTICE TO APPLICANT If after making this Certificate of APPLICANT Exemption you should become subject to the Workers Range_ Heater_D W Compensation provisions of the Labor Code you must forth ..Oven _ Dryer _ W Mt,— ADDRESS i32 l L with comply with such provisions or this permit shall be Top FAU —W H — deemed revoked CITY A -5-49 ,�.� Tel No y Hood _ Fan _Other_ LICENSED CONTRACTORS DECLARATION I LICENSE OR 0.2-0I hereby affirm that I am licensed under provisions of Chapter 9 Disp _ Room Air Cond REG NUMBER Class `^` (commencing with Section 7000) of Division 3 of the Business Power Apparatus&Large Appliances DISTRICT NO PROCESSED BY and Professions Code and my license is in full force and effectjj d Size&Type HP KW KVA or KVAR _ G O License Number Lic Class4J Up to 1 Incl FINAL Contractor Date Over 1 to 10 Incl DATE VALIDATION OG Over 10 to 50 Incl FINAL V I am exempt under Sec Over 50 to 100 Inc BY B&P C for this reason Over 100 Z Date Services Swbd MCC&Ponelboards ► 0 200 Amp Under 600 V Signature 201 1000 Amp Under 600V Over 1000 Amp or Over 600 V Exemption for Reg Mamt 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 Additional Sign Branch Circuits ` Law for the following reason (Section 7031 5 Business and Professions Code) I as owner of the property will do the work and the Misc Conduits&Conductors 2 6 1 9 A structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)_ # e • • 6- • 2 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY 2 • • 1750 I hereby affirm that there is a construction lending agency for r the performance of the work for which this permit is issued PERMIT FEE (Sub Total) - tie • a 17'5030: (Sec 3097 civ c ) ' - Orb,0`8—8 3 Lender s Name PLAN CHECKING FEE PERMIT ISSUING FEE 1O Lender s Address 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 representatives of this County to enter upon the abovepwfritioned ty r inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date r z DECLARATI 20 0019 WORKER I haveCOMPENSATION ate of consent to 76A663 DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT 76A6fi3 I hereby affirpi t�iat I have a certificate of consent to self Insure or a ceAflcate 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) _ ha JOB UW& 132iss); I CO NO Company FOR APPLICANT TO FILL IN ADDRESS cowlCmmite &a jur Certified copy Is hereby furnished New Residential Bldgs &Pools NO EACH FEE LOCALITY JI ❑H Certified copy Is filed with the county budding inspection 1&2 Family Sq Ft $ $ department Multifamily Sq Ft OSSSs 1.000 0200 F CIPY 400 Date Applicant Residential Swimming Pools ASSESSOR MAP BOOK PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS OWNER OR COMPENSATION INSURANCE Outlets Rec _Light Sw FIRM NAME K E 1-ZDPis First 20 MAIL n (This section need not be completed If the work Involved by the Total No Additional ADDRESS A,3ov permit Is for one hundred dollars($100)or less) I certify that in the performance of the work)or which this permit CITY 7,,Mkr. cityTel No 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 APPLICANT Total No � Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP NOTICE4TAqqS, LICANT if after makiifg this Certificate of CITY Tel No Exemption you should become subject to the Workers Compensation OTHER APPLIANCES NOT OVER 3 HP _ _ provisions of the Labor Code you must forthwith comply with such PERMIT (- provisions or this permit shall be deemed revoked I Power Apparatus&Large Appliances APPLICANT Lo/—M r LICENSED CONTRACTORS DECLARATION Size&Type HP KW KVA or KVAR ADDRESS X 1130 LdL'O W I hereby affirm that I am licensed under provisions of Chapter 9 Over 3 to 10 Incl (,)1 (commencing with Section 7000)of Division 3 of the Business and CITY 0U�fliDC, p�Teellfq0q, aa�f n .. bp( Professions Code and my license is in full force and effect Over 10 to 50 Incl LICENSE OR C004137- 69,33aR 1�3�' G- Over 50 to 100 InclClass 2 ^l C~ g Over 100 DISTRICT NO P OCESSED BY 0 License Number �J �^ Lic Class yv 0 - �,�++/) �/ Se ices Swbd MCC&Panelboards o��Qv Q Contractor • LOT-PIKE tuahate 0 399 Amp Under 600 V FINAL DATE �- O 400 1000 Amp Under 600V — �DTA 1ON W F1 I am exempt under Sec Over 1000 Amp or Over 600 V AL t �� ACC Agl��V B&P C for this reason BRANCH CIRCUIT FEES BY M. Date ]5A or 20A 120V Lighting or Recept ITE2 R7909 Z Signature �(�,//�, `(� d� 1 To 10 Branch Circuits �D 11 To 40 Branch Circuits rtrtnr1r!ii F141 Or More Branch Circuits —VUU1 � jr Exemption for Reg Maint Elect 15A,20A 2DBV To 277V Lighting Br Circuits TM1 SINGLE FAMILY Temp Power Pole&Appurtenances HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractors 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) poll. 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 certifythat I have read this application and under penalty of puqury state TOTAL FEE vJ' ' that the above information Is correct I agree to comply with all County 710. ordinances and State laws regulating Electrical wiring and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection urposes SEE REVERSE FOR EXPLANATORY LANGUAGE 7 95 SIGNATUREEOF PERMITTEE DATE WORKERS COMPENSATION DECLARATION CE-806 1081 APPLICATION FOR ELECTRICAL PERMIT Fitreby affirm that I have a certificate of consent to self CE-8060 re ora certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY 14. certified copy thereof (Sec 3800 Lab C ) Po(i Ifo WCGQ4.�� ompony n..,,,F,„ Pam FOR APPLICANT TO FILL IN JOB Q tiCertified copy is hereby furnished l!/� New Residential Bldgs &Pools EACH NO FEE ADDRESS 9600 LOWER AZIJZSA ED ❑ Certified copy is filed with th unty ilding inspec 1 & 2 Family Sq Ft $ — $ LOCALITY TEMPLE ` tion department Multi family Sci Ft — NEAREST �3,1� CITY BL CROSS ST Date 2/5/91 q licant Residential Swimming Pools OWNER OR ' PP - FIRM NAME CHING LO CERTIFICATE OF EXEMPTION OM WORKERSMAIL COMPENSATION INSURANCE Outlets Rec�Q_Light_2QSw�_ .90 18 0 ADDRESS 9711 E. VALLEY BL This section need not be completedFirst 20 ( if the work Involved b► Total No�_ Additional .6 CITY RO$�D Tel No the permit is for one hundred dollars ($100)or less ) PLAN CHECK A 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 Total No 20 Additional CITY Tel No Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO-APPLICANT If after making this Certificate of APPLICANT KaIIIaSYIlan FAectriC Inc 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 7032 Sophia AV with comply with such Provisions or this Permit shall be Top — FAU —WH deemed revoked CITY Tel No LICENSED CONTRACTORS DECLARATION Hod _ Fan _Other_ LICENSE OR an s 91406 782— 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 3 of the Business Power Apparatus&Large Appliances DISTRICT NO PR SED BY >- and Professions Code and my license is in full force and effect Q d Size&Type HP KW KVA or KVAR ��O Q License NQdempt r Lic Class r-1 n FINAL - V Up to 1 Incl 2/5/91 Over 1 to 10 Incl DATE /V4/ VALIDATION 0 Contr I a09 Date FINAL l V ❑ , Over 10 to 50 Incl I aA under Sec � Over 50 to 100 Inc BY i sY IL B&P C for this reason Over 100 Z Date Services Swbd MCC&Ponelboards 0 200 Amp Under 600 V t Signature 201 1000 Amp Under 600V ❑ Exemption for Reg Moint Elect Over 1000 Amp or Over 600 V SINGLE FAMILY Temp Power Pole&Appurtenances +n HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit L I hereby affirm that I am exempt from the Contractor s License Additional Sign Branch Circuits AIL�� .a Law for the following reason (Section 7031 5 Business and Professions Code) -. 31-F07 ff..{t ❑ I as owner of the property will do the work and the Misc Conduits&Conductors structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ , f i� 7044 Business and Professions Code) TUTAL. 66® 40 CONSTRUCTION LENDING AGENCY LHECK 66041 j hereby affirm that there is a construction lending agency for HAGE ,[ILI the performance of the work for which this permit is issued PERMIT FEE (Sub Total) 53 0 (Sec 3097 Civ C ) 1 PLAN CHECKING FEE DWO– �� i �} Lender s Name i f!F 1 Lender s Address PERMIT ISSUING FEE 13 0 5536 1 AMID a.16 I certify that I have read this application and state that the TOTAL FEE 66 40 I above information is correct I agree to comply with all County ordinances a State laws regulating Electrical wiring and hereby author ze representatives of this County to enter upon th e m tinned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Date Sign re o Permittee WORKERS COMPENSATION DECLARATION 76A66G (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 copy thereof(Sec 3800 Lab C) FOR APPLICANT TO FILL IN JOB 01 Policy No Company New Residential Bldgs &Pools EACH NO FEE ADDRESS 9600 Lower Av4.9, lid. ❑ Certified copy is hereby furnished 1 &2 Family Scl Ft $ — $ LOCALITY Temple UitY ❑ Multifamily Scl Ft — N AREST Temple y • Certified copy is filed with the county building inspection Residential Swimming Pools CR department OSS ST FM NAME George Sotolon o Date Applicant Outlets R&.� Light Sw MAIL First 20 ADDRESS 9 Wulnut Grove CERTIFICATE OF EXEMPTION FROM WORKERS Total No Additional CITY roemead Tel Not `I!9 1 } i E PLAN CHE K tl APPLICANT U (This section need not be completed if the work involy Lighten Fixtures First 20 ` r one hundred dollars ($100) or less Total No Additional AD 1 11 1`_SS O I certify that in the performance of the work for which this CITY Tel No Fixed Appliances Not Over 1 HP� permit is issued I shall not employ any person in any manner ERMJ-T' i so as to become subject to the Workers Compensation Laws Range_ Heater D W APPLICANT N Oven — Dryer`W M ADDRESS i Z Date Applicant Top _ FAU _W H Hood — Fan _Other— CITY No NOTICE TO APPLICANT If after making this Certificate of Disp _Room Air Cond_ LICENSE OR 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 PP6CES ED BY with comply with such provisions or this permit shall be �� I deemed revoked Size&Type HP KW KVA or KVAR Up to 1 Incl Over 1 to 10 Incl ATL LICENSED CONTRACTORS DECLARATION VALIDATION Over 10 to 50 Incl 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 ness and Professions Code and my license is in full force and effect , Services License Number Lic Class 0 200 Amp Under 600 V 201 1000 Amp Under 600 V Contractor Date R Over 1000 Amp or Over 600 V HOME OWNER BUILDER DECLARATION Temp Power Pole&Appurtenances I hereby affirm that I am exempt from the Contractors Sign with One Branch Circuit Additional Sign Branch Circuits License Law for the following reason (Section 7031 5 Busi 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 'c 2 2 5 3 A 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY # * *'a • • 2 I hereby affirm that there is a construction lending agency for the perWrmance of the work for which this permit is) PERMIT FEE (Sub Total) - 2 • •p• 8 5 Q issued(Sec 3097 Civ C Lenders Name PLAN CHECKING FEE (One Fourth Permit Fee) • • • • 8,50g Lender s Address PERMIT ISSUING FEE Y 0923i-8Q I certify that I have read this application and state that the TOTAL FEE i 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 -23-gyp nature of ermittee i Date r ,� r WORKERS COMPENSATION DECLARATION 7OA663 10"— `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 BUILDING AND SAFETY or a certified copy thereof(Sec 3800 Lab C ) Policy No Company FOR APPLICANT TO FILL IN JOB ADDRESS V r: 2W.4 Certified copy is hereby furnished New Residential Bldgs &Pools EACH NO FEE NEAREST�p — Certified copy is filed with the county builds inspec 1 &2 Family Sq Ft $ — $ LOCALITY /W E tion de rfinent Multi family Sq FT CROSS ST i Residential Swimming Pools OWNER OR Date Applican FIRM NAME i CE TIFICATE OF EXEMPTI N F ORKERS Outlets Rec Light Sw_ MAIL COMPENSATIO IN E First 20 ADDRESS emo 00, r 2 (This section need not be com d 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 woFk for which this PLANCHET F L(� �� 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 Total No Additional r CITY 0 Tel No —7S/ Date Applicant Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT If after making this Certificate of r' Exemption you should become subject to the Workers Range_ Heater_D W APPLICANT Compensation provisions of the Labor Code you must forth Oven _Dryer _W M = ADDRESS 6 with comply with such provisions or this permit shall be Top _ FAU —W H deemed revoked CITY Tel LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other_ LICE SE OR �O 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 3 of the Business DISTRICT NO PROC D BY and Professions Code and m license is in full force and effect Power Apparatus 8 Large Appliances !. y ' Size 8 Type HP KW KVA or KVAR � License Number Lic Klass Up to 1 Incl FINAL09 V U I J r� Over 1 to 10 Incl DATE VALIDATION 0 Contractor Date b U Q El Over 10 to 50 Incl F AL I am exempt under Sec Over 50 to 100 Inc B&P C for this reason Over 100 c ll g Date Services Swbd MCC&Panelboords R` 0 200 Amp Under 600 V Signature 201 1000 Amp Under 600V c 3 50 ❑ ' Exemption for Reg Maint Elect Over 1000 Amp or Over 600 V # • • • • 2 SINGLE FAMILY Temp Power Pole&Appurtenances 2 2 b 2 6 0 0 HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor s License Additional Sign Branch Circuits - 2&2,600Z Law for the following reason (Section 7031 5 Business and 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 Other(See Complete Fee Schedule)_ E ► 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for z 3 5 1 0 A the performance of the work for which this permit is issued PERMIT FEE (Sub Total) (Sec 3097 Civ C ) # • • • • • 2 Lender s Name ,VC &M-`^ PLAN CHECKING FEE - 2 • 02600 1a, PERMIT ISSUING FEE Lender s Address W • • • 261 0 0 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 0708-8-3 ordinances and State laws regulating Electrical wiring and hereby authorize re pre a tatives of this County to enter upon the abov ntioned r perty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE I ofur o er ftee Date