HomeMy Public PortalAbout5940 OAK AVE_Electrical__ APPLICATION FOR ELECTRI PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEEReUILDING
BUILDING AND SAFETY DIVISION ADDRESS (/
JOHN A. LAMBIE, COUNTY ENGINEER
CASSATT D. GRIFFIN.8UPT OF BUILDING LOCALITY J
FOR APPLICANT TO FILL IN NEAREST
ilL-ia• �AS
P,n'� = CROSS ST.
ITEM ri NUMBER I EACH FEE OWNER i lJ
OUTL $ $ MAIL 1#45 L1NAS A�,
LIGHTS RECEPT. W
S . 10 ADDRESS aQ �{
LIGHTING FIXTURES10 O CITY .L TEL.NO.
ELEC.RANGES CLO.DRYERS ELECTRICIAN
WATER HEATERS .50 ADDRESS u
ELEC.SPACE HTRS. DISHWASHERS �,{�
CITY TEL. N GY3
GARBAGE DISPOSERS AUTO.- STATE
WASHERS STA.COOKING UNITS .25 .LICENSE NO. / 0
MOTORS: OVER INC. H.P. DISTL GROUP NE
0— 1/2 .2 s J I Q Z
1/2— 2 .so WSPECTION RECORD
2— s 1.00 r
1s— so 2.50 I!
so—zoo 5.00
._�
�, � �..s.�'_y r s+-.V.'-y/fes- c-�Y�...,�"i...�S.• /
SIGNS: NO.TRANS. a
NO.LAMPS
I
SERVICE 0-600N It 1.00
SERVICE OVER 600V s.00
MISC.
7
WIRING PERMIT 1.00 CQ
FIXTURE PERMIT 1.00 1[Ott
SUPPLEMENTARY PERMIT .50 '
TOTAL FEE $ Q
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS f D T6 INSPECTOR'S SIGNATURE V
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY II��
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ?
ELECTRICAL WIRING. -
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMI
FINA
®rI ON ARTHUR C.VETT,
(` CK NoO CASH SUPERVISING ELECTRICAL ENGINEER
5 2 7 TMV ?p 2 D 3 5.6 0 .
n�
76AS08 CE808 10 62 APPLICATION FOR ELECTRI AL PERM T
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS �- �.�
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
NEAREST
FO APPLICANTO FI IN CROSS ST
Rsc�r TOTAL No SACH Pee
OUTLETS FIRST 20 $20111 � OWNER
LIGHT ' MAIL w OF
swlrcH ADD{t� ADDRESS Q
OVER 2O t0
LIGHTING TOTAL FIRST 20 20 CITY — TEL NO
FIXTURES ADD L f0 ELECTRICIAN
ovER 20
RANGES CLO DRYERS WTR NIRS 100 ADDRESS
OARS DIBP GTA COOK
CITY TEL 6
DISHWASH AUTO WASH STATE
SPACE NTRS STA APP (A N P MAX) so LICENSE NO -7 C �V
MOTORBe OVER NOT OVER NP DIST)2 'T NO 6UP ZONE P CESSED By
O 1 1100 y
t s ISO INSPECTION RE99RD
s s 200
s is S s0
1S so Soo
SO foo Soo
BIGNSI NO TRANS
No LAMPS
SERVICE O SOOV NOT oveR YOGA 100
SERVICE O SOOV OVER 200 A 200
SERVICE OVER SOOV Soo
MISC
PERMIT ISSUING FEE 200 w
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE i O
I
I SHEBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INBPKCTOR S SlamrUlm
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE To COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
I HERESY cowriFY THAT 1 AM PROPERLY RK01BiERED AND/OR
LICENSED AS RKOUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVK
DESCRIBED RESIDENTIAL PROPERTY POWER
SIGNATURE UTILITY CO NOTIFIED
OF PBRMITT6
FINAL
CK 1,MO CASH SUPERVISINd ELECTRICAL ENGINEER
L&O 2 0 1 APR, �, 2 D 2.40-
'l;. CIT
76A067-C1806 4-60 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FADDRESS
BUILDING AND SAFETY DIVISION JOHN A.LAMBIE, COUNTY ENGINEERWILLIAM A. JENSEN, SUP'TOF BUILDING
FOR APPLICANT TO FILL IN NEARESST
CROSS T Al/,5
PERMIT FEES lk4
OWNER1TEM NUMBER EACH FEE OUTLETS � s sADDRESS 4 SL16HT8 RECEP BW. �7 .10 LIGHTING FIXTURES CITY `� G ! TE NO.f0ELEC. RANGES CLO. DRYERS ELECTRICI�IN2ALI- ,C -4�q WATER HEATERS .BO ADDRESS ! 6 /V SELEC.SPACE HTRS. DISHWASHERS CITY L-• 6 TEL.NO.
GARBAGE DISPOSERS AUTO.- 'STATE /�
LICENSE NO. / /
WASHERS STA. COOKING UNITS .2B
MOTORS: OVER INC. H.P. DISTRJT N OUP ONE. PR CE D Y
O — '/2 .25 0
'i: — 2 .50 I RECORD ,ter
2 5 1.00 a
5 15 1.50 7 7 0
15 50 2.50 w
O
BO 200 5.00 qi... _ ... _ - 1--
NO
NO TRANS. _ w
r ,
SIGNS: d.
NO. LAMPS
v>
� Z
SERVICE O.800Vi.00elL
SERVICE OVER 800V 5.00
MISC.
WIRING PERMIT 1.00 �4-O
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE S Z
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS 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 NTY AND STATE OF FIXTURES ,
CALIFORNIA OR Tli M T E L ER OF THEfB
DESCRIBED RESIBEf-jT POWER
SIGNATURE!/// UTILITY CO. NOTIFIED jG-" ;
OF PERMITTE
FINAL
A (DATION ARTHUR C.VETT.
' CK MO CASH SUPERVISING ELECTRICAL ENGINEER
l .'�4 D i 0 UC i '7
76A663 CE606 11/70 APPLICATION FOR ELECTRICAL PERMIT L1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING �� O
BUILDING AND SAFETY DIVISION ADDRESS
COLEMAN W JEN INS UP NT N UNT BUILDING LOCALITY
FOR APPLICANT TO FILL IN CROSS ST S [J�Ir7
OUTLETS O EA H FEE
L� OWNER! /aL
RECEPT_J_ $ $ MAIL
�+
LIGHT TOTAL
FIRST 20 25 /�� ADDRESS
V
SWITCH-9---.-1 �— OVER 20 10CITY TEL NO
PLAN CHECK
LIGHTING1 FIRST 20 0 1 APPLICANT
) TOTAL
FIXTURES r OVER 20 t0 ADDRESS
APPLIANCES CITY TEL NO
PERMIT
RANGE DRYER_WTR HTR APPLICANTA/64=0
STA COOK DI SP F A U ADDRESS S773 ve_1.!/4CE' eLl/D.
SPACE HTR AIR COND CITY 4,A , TEL NO -,dW
CLOTHES WASH DISHWASH LICENSE NO 1,94,96g CLASS G-�O
FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS ETC NP KW KVA ELECTRICAL WIRING
SIZE & TYPE OVER TO
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO >_
1 - 10 300 R661DE IN THE ABOVE
+DESCRIBED RES IAL PROPERTY OL
10 - 50 500 OF PERMSIGNATURITTEO 7-_ '� may V
OC
50 - 100 1000 ICTN CLASS PONE PRO E Y O
100 - 500 1500 DISTRdool 10/ 7—
4
SIGN GAS SIGN AND ONE CIRCUIT 500 NOTES h
Z
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100
SERVICENOTOVER600 VOLTS OR 200AMP 300
SERVICE OVER 600 VOLTS OR200AMP 1000 APPROVALS DATE INSPECTOR 9 SIGNATURE
TEMP POWER POLE
TEMPSERVICE POLE &APPURTENANCES 500
TEMP LIGHT OR RECEPT SYSTEM 300 UNDERSLAB WORK
ROUGH CONDIUT
WIRING
It
FIXTUR
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO NOTIFIED
PLAN CHECK FEE kc Of
FINAL
PERMIT ISSUING FEE 300 3 JOSEPH C ROONAN
TOTAL FEE 00 SUPERVISING ELECTRI)IL ENGINEER
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATIONCKM O CASH
10'3 9 4 7 Jai 13 o 7.0 OM
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
1
-T--en pre_ C' - A .
'° °'°s°�'°'" APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER )1DDRESS o
BUILDING AND SAFETY DIVISION OAK
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
FRECEP ,��
TS ° FE OWNER 0
FIRM NA
MAIL
T TALFIRST 20 2SOv ADDRESS
OVER 20 CITY TEL NO
( 10 ! PLAN CHECK
FIRST 20 28 APPLICANT
TOTAL OVER 20 10 •J'f /o ADDRESS
RESIDENTIAL APPLIANCES L CITY TEL NO
PERMIT0At C
RANGE DRYER_WTR HTR APPLICANT ��
STA COOK DISP F A U ADDRESS 2_ 5# Vle
SPACE HTR AIR COND CITY S TEL NO ,3 3
CLOTHES WASH DISHWA8H RA FNUMBER V,3CLASS C�
FAN OTHER 100 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 18 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 6 TYPE OVER TO I HEREBY CERTIFY T T ZPPOP,6RLEOISTERED AND/OR
0 - 1 100 LICENSED A8 REQUIR BY TY AND STATE OF
CALIFORNIA OR TNA I R OF THE ABOVE
I - 10 800 DESCRIBED RES PRp
C7
10 - 50 600 PERMITEE
SIGNATU C2
SO - 100 1000 DISTRI NO SSED BY �
100 - 800 1000 ��O ' g
SI ON GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INlE 8810NATURE
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVI CENOT OVER 600 VOLTS OR 200 AMP 800 UNDERSLAS WORK
SERVI CEOVER 600 VOLTS OR 200 AMP 1000 ROUGH CONDUIT
TEMPSERVICE POLE &APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 800 FIXTURES S
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEE
PERMIT ISSUING FEE 800
TOTAL FEE o
PLAN CHECK VALIDATION CK M D CASH PERMIT VALIDATION CK M 0 CASH
14 59g.'tNNf 13 2 1 8.7 0 d*
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
7eweee cseOG ,Gne APPLICATIO�FELECTRil& PERMIT �I
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
TNEAREST
BUILDING AND SAFETY DIVISIONITY
FOR APPLICANT TO FILL IN CROSS ST 40 r
OUTLETS NO RACHI FE OWNER OR
FIRM NAME !
RECEPT_ 5 $ MAIL
LIGHT TOTAL
FIRST 20 29 ADDRESS
OVER 20 CITY TEL NO
SWITCH 10 PLAN CHECK
LIGHTING FIRST 20 25 APPLICANT
TOTAL
FIXTURES OVER 20 t0 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL NO
RANGE DRYER_WTR HTR APPLICANT
STA COOK DISP F A U ADDRESS a, Z
SPACE HTR AIR COND CIIITY TEL NO
CLOTHES WASH OISHWASH REG�NUMBER p 3 L CLASS d=-/o,
FAN
'-
FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMERS RATING WIT H
ITN ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS ETC HP KW KVA ELECTRICAL WIRING
SIZE & TYPE OVER TO
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - I t00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT-1 AM THE LEGAL OWNER OF THE ABOVE
4 1 - 10 DESCRIBED RESIDENTIAL ROPERTY
-- w
'PERMITEE
10 - 50 500 SIGNATUR
50 - 100 1000 DISTRICT NO SED BY WCs
C1.
100 - 500 1500 % z
SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVAL$ DATE INSPE96 8SIGNATURE
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVICENOTOVER 600 VOLTS OR 200 AMP 800 UNDERSLAS WORK
SERVI CEOVER 600 VOLTS OR 200 AMP 1000 ROUGH CONDUIT
TEMPSERVICE POLE &APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 800 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL �7
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEE
,
PERMIT ISSUING FEE 800
TOTAL FEE
PLAN CHECK VALIDATION CK M D CASH PERMIT VALIDATION M o CASH
51 "Imaz 18.0 0
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE v
WORKER S COMPENSATION DECLARATION 260019 DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT
1 hereby affirrirthat I have e"certiAc t\4 of consent to self insure 78A8lD
or a certificate of Worker a Compenihoratlnsurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy thersoflSec 38Q0 Lab C)
Policy No V:j 7 Company 5bq-4e—F&df41 FOR APPLICANT TO RLL IN JOB �j��
q�/� �
E] Certified
4:64:6.e'Certified copy Is hereby furnished New Residential Bldgs &Pools NO EACH FEE LOCALITY
❑ 1&2 Family Sq Ft — $ $
Certified copy,is filed with the county budding Inspection _ NEAREST
dopa me 01 Multifamily Sq Ft CROSS ST
Data A + Applicant Residential Swimming Pools ASSESSOR
MAP BOOK � PAQE OwpPARCEL G
CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Ree I Light S. �2— FFOR
I MENAME S a,
COMPENSATION INSURANCE
(This section need not be completed If the work Involved by the First CRESS
permit is for one hundred dollars($100)or leas) Total No Additional
I certify that in the performance of the work for which this permit CITY Tel No
is issued I shall not employ any person in any manner so as to PLAN CHECK
become subject to the Workers Compensation Laws Llghbng Fixtures First ZO APPLICANT
Total No Additional
ADDRESS
Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP
NOTICE TO APPLICANT If after making 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 suchP RLICANT
provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances
LICENSED CONTRACTORS DECLARATION Size&Type HP KW KVA or KVAR ADDRESS
I'hereby affirm that I Am licensed under provisions of Chapter 9 Over 3 to 10 Incl
(commencing with Section 7000)of Division 3 of the Business and CITY — Tel No
Professions Code and my license is In full force and effect Over 10 to 50 Incl G/ >,
Over 50 to 100 Incl REONNUMBER ~d aj (L
Over 1 00
License Number DISTRICT NO SSED BY'7(,vy Lic Class V
Services Swbd MCC&Panelboards est,�� Q
Contractor GCJen ���OCS-L& Data 0 399 Amp Under 600 VDATE
0
r—rc
❑ I am exempt under Sec 400 1000 Amp Under 500 V �` VALIDATION W
Over 1000 Amp or Over 800 V FINIAL a
B&P C for this reason BRANCH CIRCUIT FEES BY co
Date 15A or 20A 120V Lighting or Recept
1 To 10 Branch Circuits
R�enature�_ 11 To 40 Branch Grcuds
cuits
❑ Exemption for Reg Maint Elect 15A 20A 208V To 277V Lighhtin Bir Branch
2
SINGLE FAMILY Temp Power Pole&Appurtenances ACLT i
HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit
I hereby affirm that I am exempt from the Contractor a License Law 3303 49 80
for the following reason(Section 7031 5 Business and Professions Additional Sign Branch Circuits
Code) 1 ITEMS
❑ 1 as owner of the property will do the work and the structure Misc Conduits&Conductors PTAL 49.80
is not intended or offered for sale(Section 7044 Business Other(See Complete Fee Schedule)
and Professions Code) , CHECK 49.80
CONSTRUCTION LENDING AGENCY GHph(GE aO
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 00OD-0001 11/ 994
Lender a Name ?(441 1 FM12 u0
PERMIT ISSUING FEE (p
Lender a Address
I certify that I have read this application and under penally of puqury state TOTAL FEEso pie
that the 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
)d i I)I—q 4-
~TURE OPPERMITrEE DATE I
WORKERS COMPENSATION DECLARATION B3
CE408G (2 80) APPLICATION FOR ELECTRICAL PERMIT
E8
I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES T 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 • • -"��
Policy N Company New Residential Bldgs &Pools EACH NO FEE ADDRESS x/111) a �f//Ce
Certified copy is hereby furnished 1&2 Family Sq Ft $ — $ LOCALITY i ` L
Multifamily Sq Ft
CertifIod copy>8 filed with the m
co y building inspection CROSS S7 1!
departmentResidential Swimming Pools OWNER OR
/�j�� 1 is
Date�iR�Applicant #Ad '� FIRM NAME I�tOriLL .s!/�
pp Outlets Rec._Lig Sw MAIL
First 20 ADDRESS
CERTIFICATE OF EXEMPTION FROMWORKERS Total No Additional CITY el No }
COMPENSATION INSURANCE d
PLAN CHECK
(This section need not be completed if the Work involved APPLICANT
Bred dollars ($100) or less) Lighting Fixtures First 20
by the permit >s for one hundred ADDRESS
Total No Additional 0
I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY I No 41
permit is issued i shall not employ any person in any manner PERMIT
so as to become subject to the Workers Compensation Laws Range_Heater D W _ APPLICANTOW.
Oven — Dryer_W M ADDRESS Tel N� . A#/,f 2- a
Date d'� Applicant Top _FAU _W H _
IF - Hood _Fan _Other_ CITY �� �� 4•.C?
NOTICE TO APPLICANT If afte king this Certificate of Disp _Room Air Condi_ CENSE R �r� p
Exemption you should become ubject to the Workers REG NUMBER 6 / Class o
Compensation provisions of the Labor Code you must forth Power Apparatus&Large Appliances DISTRICT NO PROC SED BY
with comply with such provisions or this permit shall be Size&Type HP KW KVA or KVA
deemed revoked
Up to 1 Incl
� Over 1 to 10 Incl FINAL
LICENSED CONTRACTORS DECLARATION DATE �/ VALIDATION
Over 10 to 50 Incl 1
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 Bust Over 100 BY ` 6
ness and Professions Code and my license is in full force and
effect Services
License Num Lic Class 0.200 Amp Under 600 V
201 1000 Amp Under 600 V 0 o Y 7 / 3
""�ontrilct Date S+�-. - Over 1000 Amp or Over 600 V
�� HOME OWN R BUILDER DECLARATION Temp Power Pole&Appurtenances ,
I hereby affirm that I am exempt from the Contractors Sign with One Branch Circuit
License Law for the following reason (Section 7031 5 Busi Additional Sign Branch Circuits 23838 A
ness and Professions Code) # a a a a a 2
Mist Conduits&Conductors
I as owner of the property will do the work and the Other(See Complete Fee Schedule)— 2 a a 2 7
structure is not intended or offered for sale (Section
7044 Business and Professions Code)
CONSTRUCTION LENDING AGENCY a a'a 1 2 7 0 5
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is PERMIT FEE (Sub Total) f W 04.30-82
issued(Sec 3097 Civ C)
Lender a Name PLAN CHECKING FEE (One Fourth Permit Fee) '
Lender s Address PERMIT ISSUING FEE �D
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 s
ordinances and State laws regulating Electrical wiring and
hereby authorize representatives of this County to enter upon
theAbon maelfione rorty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
3a gay
Signature of Permitte Date