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Home My Public Portal About10648 OLIVE ST_Electrical__ �. WORKERS'COMPENSATION DEC), oj N 2o�t9DPW aie7 APPLICATION FOR ELECTRICAL PERMIT Q 4 herebypffirm that ti have a dcertificate�of of cottS�'nt to s�ff �.~ t ,insure,-I&a certificate of V1�orkers'Compensation Insurance, COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Nada cobified cop they (Sec.,3800 .) Po'cy Company i FOR APPLICANT TO FILL IN JOB I Cer.Q ed copy is her by furnished. New Residential Bldgs. &Pools EACH NO: FEE ADDRESS s• Certified copy is filed with the county building inspec- 1 &2-Family, Sq. Ft._�� $ _ $ LOCALITYIZZI /J � `tion department. Multi-family Sq. Ft. -'— NEAREST G Date '' plicant Residential Swimming Pools CROSS ST. OWNER OR FIRM NAME v� CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ MAIL j - COMPENSATION INSURANCE ADDRESS (This section need not be completed If the work Involved byFirst 20 CITY j Tel. No. the permit Is for one hundred dollars(;100)or less.) JotaI No. -Additional , . I certify that in the performance of the work for which this A PLCHECKPLA ICANT permit is issued; I shall not employ any penton in any manner " , so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS j Total No. Additional CITY i Tel. No. Date Applicant Fixed Appliances Not Over 1 HP PERMIT.1 NOTICE TO'APPLICANT: If, after making. this Certificate 'of FERMIT I �1 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 j 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 Section7000)of Division 3 of the Business Power Apparatus&Large Appliances DISTRO. PROC ED BY d and Professions Code,and my license is in full force and effect. i Size&Type HP, KW, KVA,or KVAR U License Number Lit. Class Up to 1 Incl. FINAL 0 r � Over 1 to 10 Incl. I DATE 2 VALIDATION 0 Contractor Date Over 10 to 50 Incl. FINAL U ❑ I am exempt under Sec. Over 50 to 1.00 Inc. BY LU B.&P.C. for this reason Over 100 n,. Services, Swbd., MCC&Ponelboards , N Date:. 1 Z 0-200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ Over 1000 Amp. or Over 600 V Exemption for Reg.Maint. Elect. SINGLE FAMILY emp. Power Pole& tena.nces HOME OWNER-BUILDER DECLARATION ne ranch Circuit At�GTo4 I hereby affirm that I am exempt from the Contractor's License , Law for the following reason:(Section 7031.5, Business and Additional Sign Branch Circuits 3307 25o511 Professions Code): j Ell, as owner of the property, will do the work and the Misc. Conduits&Conductors 1 ITEMS structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)_ , T O•��11L �o Business and Professions Code). CHECK .25.5113CONSTRUCTION LENDING AGENCY I hereby affirm that there it a construction lending agency for CHANGE .011 the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). ,I ' PLAN CHECKING FEE , Lender's Name 0000-0001. 11/16/89 PERMIT ISSUING FEE 6849 1 AM11°^7 Lender's Address ;. TOTALFEE I certify that I have read this application and state that the r above i o matin ' correct. Iagree to comply with all County i ordina c d St to laws regulating Electrical wiring, and j here orize ep sentgtives of this County to enter upon f the menton property for inspection purposes. I SEE REVERSE FOR EXPLANATORY LANGUAGE �. gnature Permitlee Date 04 WORKERS'COMPENSATION DECLARATabNr .20.0019 DPW 3/87 1 hereby affirm that-I have a certificate of content to self '7��APPLICATION FOR ELECTRICAL PERMIT O 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. 197019 Company EM=Am2 FOR APPLICANT TO FILL IN JOB ❑Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE ADDRESS 10521 OLIVE Certified co is filed with the count building $ — $ LOCALITY 7EMPIE CI`i°Y PY � y g inspec- 1 8 2-Family, Sq. Ft. 2505 Tion department. Multi-family Sq. Ft. NEAREST Date 7-111-90 7F$2RViS RTJY-IMT[' Residential Swimming Pools OWNER CROSS OR —Applicant sJ D> FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets: Rec Light Sw._ S. 'L• COMPENSATION INSURANCE First DRESS F (This section need not be completed If the work Involved by tCITY OVIA Tel. No. 359-3211 the permit is for one hundred dollars($100)or less.) Total No. Additional Donal I certify that in the performance of the work for which this PIAN CHECK permit is issued, I shall not employ a4rnpenisti APPLICANT P p y in any anner , so as to become subject to the WorkLaws. Lighting Fixtures First 20 ADDRESS Additional 2-21-90 Total No. CITY Tel. No. Date Applica Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of APPLICATION S Flr>:IC�1�xTC, IWC Exemption, you should become subject to the Workers' Range— Heater—D.W. PERMIT JE( r Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS 3876 DOWNING AVE. with comply with such provisions or this permit shall be Top — FAU —W.H. — deemed revoked. CITY ERLDWM PARK Tel. No.960-4545 LICENSED CONTRACTORS DECLARATION Hood — Fan —Other_ Disp. _ Room Air Cond. _ LICENSE 259475 Class. C-10 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 I DISTRICT NO.op P CESSED B >_ and Professions Code,and my license is in full force and effect. ' d Size&Type HP, KW, KVA, or KVAR O License Number 259475 Lic. Class�C 101 Up to 1 Incl. FINAL V JMWIM Contractor E �MTCDate2-21-90 Over 1 to 10 Incl. DATE , VALIDATION Over 10 to 50 Incl. FINAL F- ❑ I am exempt under Sec. Over 50 to 100 Inc. BY W B.&P.C. for this reason Over 100 d Date: Services, Swbd., MCC&Ponelboards Z Z 0-200 Amp. Urider 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 ACCT.10 Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits Professions Code): 3307 133.255 ❑ I, as owner of the property, will do the work and the Misc. Conduits 8 Conductors i ITENE structure is not intended or offered for sale(Section 7044, Other(See Complete Fee Schedule)— Business and Professions Code). , TOTAL -0 38 o 25 CONSTRUCTION LENDING AGENCYi CHECK 47s"oar I hereby affirm that there is a construction lending agency for _ the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) 125 25 CHANGE (Sec. 3097, Civ. C.). PLAN CHECKING FEE Lender's Name L�i�;,•l j PERMIT ISSUING FEE 13 00 Lender's Address 9159 1 Aft 9e i> I certify that I have read this application and state that the TOTAL FEE 138.2 above information is correct. I agree to comply with all County ordinances and State laws regulating Electrical wiring, and hereby authorize rept sentatives of this County to enter upon the abo e-mentio a roperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE a-Zv Signature of Permittee Date ®s WORKERS'COMPENSATIONIDECLARACIN onle CE-806 10/81 APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that•I have a•certificate-of corisent to`elf CE-806G insure, or a certificate of%Oorkers'Compensation Insurance, COUNTY OF LOS ANGELESBUILDING AND SAFETY or a certifie �y�d t ereof(Sec. 3800 oj�:'C ) Policy No.• Company FOR APPLICANT TO FILL IN JOB ' f Certified copy is hereby furnishe New Residential Bldgs. &Poo EACH NO. FEE ADDRESS Certified ca is filed with the count building inspec- — LOCALITY PY Y 9 P I 1 &2-Family, Sq. Ft. $ �� — $ �idt2L f LIP tion department. P\ e ; Multi-famjly Sq. Ft. NEAREST 2-Z.1T. It/ �y SeOdy�L Residential Swimming Pools FOWNERIRM NCROSS AOR ME IrdgzBl Date Applicant CERTIFICATE OF EXEMPTION FRO WORKERS' Outlets: Rec Light Sw._ MAIL S. IbA COMPENSATION INSURANCE First 20 ADDRESS /'l (This section need not be completed if the work Involved by Total No. Additional CITY 0 intrOV Tel. No. the permit Is for one hundred dollars($100)or less.) PLAN CHECK I certify that in the performance of the work f which this APPLICANT permit is issued, I shall not employ an person i ny manner i so as to become subject to the Wor rs'Co a ation L ws. Lighting Fixtures First 20 ADDRESS �„'Zi•_1Q , Total No. Additional CITY ' Tel. No. Date Appljc Fixed Appliances Not Over 1 HP PERMIT q NOTICE TO APPLICANT: If, after making this Certificate of teff 5 CC + e, Exemption, you should become subject to the Workers' Range_ Heater_D.W. APPLICANT � h Compensation provisions of the Labor Code, you must forth- Oven — Dryer —W.M.— ADDRESS `6 —7 OL�9 with comply with such provisions or this permit shall be Top _ FAU —W.H. — y� deemed revoked. CITY � tJL,j� A f rr\Tel. No. LICENSED CONTRACTORS DECLARATION Hood _ Fan _Other_ LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Dis p' _ Room Air Cond. C�REG.NUMBERZ-51175— Class. (commencing with Section 7000)of Division 3 of the Business power Apparatus 8 Large Appliances DISTRICT NO. P SED B a and Professions Code,and my license is in full force and effect. v 0 �� C -10 1 Size&Type HP, KW, KVA, or KVAR a D License Number Lic. ClassJ � Up to 1 Incl. FINAL i O ICC Over 1 to 10 Incl. DATE VALIDATION �. Contracto ' a e Over 10 to 50 Incl. OV— FINAL I W ❑ I am exemp under Sec. Over 50 to 100 Inc. BY N B.&P.C. for this reason Over 100 Cn Date: Services, Swbd., MCC&Panelboards ► 0 -200 Amp. Under 600 V Signature 201 - 1000 Amp. Under 600 V ❑ ; Exemption for Reg. Mainf. Elect. Over 1000 Amp. or Over 600 V .� SINGLE FAMILY Temp. Power Pole&Appurtenances HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit ACCTA I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Additional Sign Branch Circuits 3307 137.65 Professions Code): 1 ITEM, ❑ isc. Conduits 8 Conductors I, as owner of the property, will do the work and the �• •--u 4—s a=- structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ , TOTAL X137 o 7044, Business and Professions Code). CHECK 1370$5 CONSTRUCTION LENDING AGENCY CHANGE `�� I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE (Sub-Total) (Sec. 3097, Civ. C.). PLAN CHECKING FEE 13 0o 0DOC1-0001 2/27/90 Lender's Name PERMIT ISSUING FEE 9160 1 ACS 9419 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 aws regulating Electrical wiring, and hereby a thorize repr he oentat,v.s of this County to enter upon t -mentio a roperty for inspection purposes. I SEE REVERSE FOR EXPLANATORY LANGUAGE 2_4 -z! -go ignature of Permittee Date