HomeMy Public PortalAbout9508 OLIVE ST_Electrical__ ,OlUNTY OFI.LOS A L - _ x
NGE �S"..� � r �. ,y.
��nnRTMEN_I COUNTY ENGINEER!? ri" r r DDREsS
e6U1LDING'�AND.'SAFETY DIVISION _ ilt }d'~
:. ., •--... .NEAREST _ �.._„ - 'a„•
�4.. -a'; ,• CROSS S '' ` �=i7T;�'• -
-FOR APPLICANT TO FILL-IN''
N0. EACH .OWNER 09-
OUTLETS." s 'r'Is s FIRM NAME.
RECEPT `MAIL
FIRST 20 ADDRESS
'LIGHT_ TOTAL . TEL:NO%
if 1.1: CITY. :.
SWITCH OVER 20 .10 PL�CHEC
CHECK-
IN
FIRST 20 25 AP(LIGHTING TOTAL AD3. .;
FIXTURES OVER 20• 10 CITY TEL. NO.
RESIDENTIAL APPLIANCES PERMIT
RANGE DRYER__WTR. HTR. i• -.�,
APPLICANT Val,"
STA. COOK DISP. F.A.U. ADDRESS %✓ D -
SPACE HTR. AIR COND. CITY 'ie TEL' n'
LICENSE OR
CLOTHES WASH. DISHWASH. REG. NUMBER 0 CLASS.
FAN OTHER 1.00I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORREC* AND '.PEE TO COMPLY
MOTORS, TRANSFORMERS RATING �.11 ITH ALL COUNTY ORDINANCES AND STATE LAN, 'REGULATING
IND. HEATERS, ETC. HP. KW.KVA. i ELECTRICAL WIRING.
SIZE & TYPE OVER TO I HEREBY CERTIFY THAT I AM PROP- _ 110 ISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELS AND STATE OF
0 — 1 1'00 CALIFORNIA OR THAI I AM THE LEGA_ , OF THE ABOVE
RESCRIRED RESIDENTIAL PAOPERjY. `•�-
1 - 10 3.00 /
PERMITEE ..}t� - U
10 - 50 5.00 I SIGNATURE
L/'r
50 — 100. 10.00 DISTRICT NO. ?�O� \SED BY v
100 — 500 15.00
i m:
SIGN, GASSIGN AND ONE CIRCUIT 5.00 APPROVALS DATE I INSPECTdWS SIGNATURE
TUBE, OR CUITS 1.D0 TEMP. POWER POLE
MARQUEE ADDITIONAL CIR
LFREN07OVER600VOLTSOR200AMP 1 S::I. UNDERSLAB WORK
VER 600 VOLTS OR20DAMP 1G00 ROUGH CONDUIT
ICE,POLE,&APPURTENANCES WIRING
HT OR RECEPT. SYSTEM I"3.00 FIXTURES
I r
POWER AUTHORIZED
- UTILITY CO. NOTIFIED _,'tet pp
•�r� FINAL - -ru •. i1 / �' 1" .
EE (SUB TOTAL)
NOT
}�/� .' ,- j .
CK FEE —
y:;• -
SSUING FEE 3.00 0-dFEE —
PLAN CHECK VALN)ATION - CK..;':;a_ M.o. .c PERIMITrVA (DATION :( C.• M_0:= CASH
Ifl..A 3'5
•
Vi
ll
BACK OF APPLICATION FOR^COMPLETE SCHEDULE " J rI -
FOAMS`E_ea6'e"e' APPLI ATION F ELECTRICt PERMIT
.COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN JOB t OI
New Residential Bldgs.'&Pools EACH NO. FEE ADDRESS 7
1 &12•Famlly,Sq..Ft. $ i.025 — $ LOCALITY ]iFji/',�7/,L
Multi,family Sq.Ft. .02 — NEAREST
25.00 CROSS ST. �'
Residential.Swimming Pools OWNER OR e
FIRM•NAME i! Ni 7k / i//1775/F/49
Outlets:Rec Light Sw. MAIL 'e
First 20 •50 ADDRESS
Total No. Additional .30 CITY Tel.No. �y/L/lo
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 •50 ADDRESS
Additional .30'
Total No. CITY Tel.No.
Fixed Appliances.Not Over 1 HP PERMIT
Range—Heater—D.W._ APPLICANT
Oven—Dryer W.M.— ADDRESS
Top _FAU —W.H._ CITY Tel.No.
Hood_Fan —Other LICENSE OR
Disp.—Room Air Cond. 2.50 REG.NUMBER Class.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA.
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Size&T e HP,.KW,KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
Yp REGULATING ELECTRICAL WIRING.
Up to 1 Incl. 2.50
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl. 5.00 LICENSED AS REQUIRED BY.LOS ANGELES COUNTY AND STATE OF
Over 10 to 50 Incl. 12.50 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
25.00 DESCRIBED RESIDE NTI L PROPERTY.
Over 50 to 100 Inc. PERMITEE a a
Over 100 40.00
SIGNATUR
Services DISTRICTNC PROCES D BY
0-200 Amp.Under 600 V 12.50 h
201-1000 Amp. Under 600 V 25.00 t!
Over l OOO.Amp.or Over 600 V 50.00 Z
O
Temp.Power Pole&Appurtenances 10.00- Q
Sign with One Branch Circuit 10.00
Additional Sign Branch Circuits 2.00 INSPECTION >
Misc.Conduits&Conductors 10.00 INFORMATIONON REVERSE s
Other(See Complete Fee Schedule) SIDE U -90521 A
g # 000002
d
20011,00
PERMIT FEE )Sub-Total) 0 0 0 1 1t of 0
PLAN CHECKING FEE (One-Fourth Permit Feel O
F- 0928 -78
PERMIT ISSUING FEE $7.00 0
TOTAL FEE >
INSPECTION FINALED
date/,*.y-2('0" 6 By ®s
76A66�J-CE-0Q6jS0/72 APPLICATION FOR ELECTRICAL PERMIT �
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER TADDRESS
BUILDING AND SAFETY DIVISION �L
ITY
ST
FOR APPLICANT TO FILL IN ST.
OUTLETS N0. EACH I FEE7 OER OR
F NM NAME `p
RECEPT.� $ Is _ MAIL
FIRST 20 25
LIGHT TOTAL ADDRESS
CITY TEL. NO.
SWITCH 1f— OVER 20 .10 PLA CHECK
LIGHTINGTOTAL FIRST 20 •25 O APP CANT
FIXTURES •10
OVER 20 ADDR
RESIDENTIAL APPLIANCES CITY TEL.NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT ° 1
STA. COOK—DIS-P.—F.A.U. ADDRESS /►
SPACE HTR. AIR COND. CITY 7—i (r ; TEL. N0.
CLOTHES WASH. DISHWASH. LICENSE OR
REG. NUMBER 0 CLASS.
FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS 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& TYPE OVER TO
.1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
0 = 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF'
CALIFORNIA OR THAT I AM THE EGAL OWNER OF THE ABOVE
— 1O 3.00 DESCRIBED RESIDENTIAL PROP Y. O
PERMITEE C.�
10 – 50 5.00 SIGNATURE ° C
50 – 1.00 1090 DISTRICT NO. [MPROCESED BY v
W
100 — 500 15.00
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPEC R'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 190 TEMP. POWER POLE
SERVICENOTOVER'600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK
SERVI CEOVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT
TEMPSERVICE,POLE,&APPURTENANCES 5.00 WIRING
TEMP LIGHT OR RECEPT, SYSTEM 3.00 FIXTURES
w .r
POWER AUTHORIZED
UTILITY CO. NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES:
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00 - Q
TOTAL FEE
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VA I)DATION r cR. M.O. CASH
T- 347 473 OCT 9 D
50A Ic
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
. l
t..
�Isea-eeaoea•ao APPLICATION FOR EL'ECTRI.CAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING /�
BUILDING AND SAFETY DIVISION ADDREss Ohee
JOHN A.LAMBIE,COUNTY ENGINEER - j'�
WILLIAM A.JENSEN,SUP'TOF BUILDING LOCALITY a I? I/ `
r:
FOR APPLICANT TO FILL IN CROSS!T fret,
CROSS ST. �Y I
PERMIT FEES
OWNER e
ITEM NUMBER EACH FEE MAIL
(OUTLET >D $ `� ADDRESS
L16HT8 RECEPT. 8W. .10 � y
LIGHTING FIXTURES .10 CITY TEL.NO
ELEC.RANGES .CLO.DRYER07 ELECTRICIAN ot, • tC
WATER HEATERS .SO ADDRESS RUX
'(L.EC.SPACE HTRS. DISHWASHERS CITY :L./ TEL.NO. h
;(GARBAGE DISPOSERS J AUTO.. STATE
/ OLS-3• ASHERS STA.COOKING UNITS ,2g LICENSE NO.
MOTORS: OVER INC. H.P.: DIS IC O. GR P P ESSED Y
91.414 s k1 r O — I/s .28 (�
Va — _2 ,$0 INSPECTION RECORD
2 — 8 1.00 l !tea /�S off.
8'— 16 1.50 G CC�2�den=�y Y U
IS 80 2.80 •�! l�)I e'+ adQ
SO — 200 8.00
W
SIGNS: NO TRANS. N
NO.LAMPS
Z
SERVICE 04600V 1,00 �®
SERVICE OVER GOOV 5.00
MISC.
WIRING PERMIT 1.00 O
FIXTURE PERMIT 1.00 . 100
. SUPPLEMENTARY PERMIT .80
TOTAL FEE S ® I
I HEREBY ACKNOWLEDGE THAT I 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
1 HEREBY CERTIFY THAT 1 AMPROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LE."L OWNE OF THE ABOVE
DESCRIBED RESIDE POWER
SIGNATURE UTILITY CO.NOTIFIED Y�
OF PERMITTE
FINA �• �P ��( n
ATION ARTHUR C.VEIT.
I OK Mo CASH SUPERVISING ELECTRICAL ENGINEER
LXos 5 1 0 S raou 17 2 n 1095 it
WORKERS'COMPENSATION DECLARATION 76A663
1
0
/81 APPLICATION FOR ELECTRICAL PERMIT
I. h of 6rr� that I have a certificate of consent to self
insure, or a certificate of Workers'Compensation lnsuranc�, 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 �!p
Certified copy is hereby furnished. i New Residential Bldgs:&Pools- EACH NO. FEE ADDRESS �ff O jr OG/f1 P y-
❑ Certified'copy is filed with the.county building inspect- 1 &2-Family, Sq. Ff. $ _ $ LOCALITY L rT
Multi-familROSS ST. e' A
tion department: y Sq. Ft.
Date Applicant ( Residential Swimming Pools OWNER OR
FIRM NAME ��
CERTIFICATE OF EXEMPTION FROM WORKERS' III Outlets: Rec Light Sw._ MAIL
COMPENSATION INSURANCE 1 ADDRESS _X 0, G-f .e
(This section need not be-completed if.the work involved by First 20
Total No. Additional CITY Tel. No.���.�Jyt 6
.the permit is for one hundred dollars($100)or less.)
I. 'PLAN CHECK
('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 s bject to the Workers'.Compensation Laws' Lighting Fixtures First 20 ADDRESS
Total No. Additional CITY Tel. No.
Date/dip 9 pplica - Fixed Appliances Not Over 1 HP " PERMIT
NOTIC TO PPLICANT: If,. r makin is Certificate 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.M.— ADDRESS'
with comply with such provisions or this permit shall be, Trop _ FAU —W.H. — -
deemed revoked. Hood _ Fan _Other_ CITY Tel. No.
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 Section 7000)of Division 3 of the Business DISTRICT NO. P SED BY
and Professions Code,and my license,is in full force and effect. Power Apparatus 8 Large Appliances / A
Size&Type HP, KW, KVA1 or KVAR• �'Q d O
License Number Lic. l�Class FINAL
Up to 1 Incl.
Over 1 to 10 Inc]. DATE//—�—�/' VALIDATION 09
Contractor Date ' Over 10 to 50 Incl. FINAL./ C/
❑ I am exempt under Sec. Over 50 to 100 Inc. BY
B.&P.C. for this reason Over 100 U)
Services, Swbd., MCC&Panel boards ® z
Date: 0 -200 Amp. Under 600 V a ?'
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 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
structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_
7044, Business and Professions Code). ;15 7 3.2 A
CONSTRUCTION LENDING AGENCY # 0 0 0 0 0 2
1 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) I 0 0 4 Q 5 0
(sec, 3097, Civ. C.).
PLAN CHECKING FEE 0 0 0 4(15 0
Lender's Name / (122-86
' PERMIT ISSUING FEE / U 1
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 ove-.men d property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
.rye
ignatmeeurto
t
WORKER$'COMPENSATION DECLARATION" I76A663 1D,ij; APPLICATION FOR ELECTRICAL PERMIT
`�..
J.
I hereby affirm that I have a certificate of consent'to'self CE,806( ��'�-
insure, or a certificate of Workers'Compensation Insurance, I'i COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof(Sec. 3800, Lab. C.)
policy No. Company I FOR APPLICANT TO FILL IN JOB
Certified copy is hereby furnished. New Residential Bldgs. &Pools
EACH NO. FEE ADDRESS -0 d I
1 &2-Family, S Ft. $ _ $ LOCALITY
Certified copy is filed with the..county building inspec- y q• NEAREST
tion department. Multi-family Sq..Ft,
CROSS ST.
Z I _$ Residential Swimming Pools OWNER OR
Date APPlican FIRM NAME
CERTIFICATE OF EXEM N FROM WORKERS' Outlets: Red�Light�Sw..7 ADDIL
RESS 'Q C�J!V
COMPENSATION INSURANCE First 20 ` 10
his section..need not be completed if the work involved by �— CITY T. No. r
(T Total No. Additional e - C b.
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
to as to become subject to the Workers'.Compensation Laws. Lighting Fixtures First 20 ADDRESS
Total No._S_ CITY Tel. No.
Date- /►pplicant Fixed Additional
Appliances Not Over 1 HP
NOTICE TO APPLICANT: If, after makingthis Certificate of PERMIT
APPLICANT yr r !
y ,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.— ADDRESSF3 ,, rTe
with comply with such provisions or this permit shall be Top _.FAU —W.H. —.
deemed revoked. Hood _ Fan _Other_ CITY a �y - J Tel. IVo.� 7�7p7�
LICENSED CONTRACTORS DECLARATION LICENSE OR
I hereby affirm that I am Licensed-under provisions of Chapter 9
Disp. — Room Air Cond. REG. NUMBER Qj� s Class.` ,
(commencing with Section 7000)of Division 3 of the Business DISTRICT NO. PROCESSED BY
and Professions Code,and my license is in full force and effect. Power Apparatus 8 Large Appliances �•� Q� IL
Size&Type HP, KW, kVA, or KVAR' (� O
License Number Lic. Class—/ _ Up to 1 Incl. FINAL V
ContractU44 pate / ''— Over 1 to 10 Incl. DATE y ( VALIDATION 09
Over 10 to 50 Incl. FINAL �+ r�
❑. I am exempt under Sec. Over 50 to 100 Inc. ;BY V
B.&P.C. for this reason Over 100 '
Date:
Services, Swbd., MCC&Panelboards L D//fPV7
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 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
structure is not intended or offered for sale .(Section Other(See Complete Fee Schedule)_
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY { ®� 9.9 WE- A
I hereby affirm that there is a construction lending agency for
the performance of the work for whic� this permit is issued PERMIT FEE (Sub-Total) ;''c a o oto
(Sec. 3097, Civ. C.).
PLAN CHECKING FEE ` 2�
Lender's Name /_ o o, ���
'PERMIT ISSUING FEE
Lender's Address }! " ` ` 2 0
I certify that I have read this application and state that the TOTAL FEE r
�i V
above information is correct. I agree to comply with all County
ordinances and State laws regulating Electrical wiring, and
hereby authorize representatives this'County to enter upon // O
the obo -mentioned pr perty f nspection purposes. SEE REVERSE FOR,EXPLANATORY LANGUAGE
—/
Signature of Permittee Date
Y
WORKERS'COMPENSATION DECLARATION CE80O IT 10/81 APPLICATION FOR ELECTRICAL PERM
I hereby affirm that I have a certificate of consent to self CE-BO6,G
insure, or a certificate of Workers'Compensation Insurance, COUNTY OF LOS ANGELES BUILDING AND SAFETY
or a certified copy thereof(Sec. 3800, Lab. C.) r
Policy No. Company FOR APPLICANT TO FILL IN JOB
/�: Q��vL: .5/ �"'
Certified copy is hereby furnished. New Residential Bldgs. &Pools EACH NO. FEE
❑ 1 &2-Family, ✓
LOCALITY
Certified copy is filed with the county building inspec- y, Sq. Ft. $ — $
tion department. Multi-family Sq. Ft. — 'NEAREST
Residential Swimming Pools CROSS ST. �L,1!/OQ .
Date Applicant OWNER OR J
/ FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' / � -,F-- MAfL
Outlets: Rec —Light Sw. O Q�/V� T
COMPENSATION INSURANCE 3 Z ADDRESS
This section need not be completed If the work Involved b First 20
( p Y Tdtal No. Additional CITY ;Ar,01Yli���lJ/ Tel. No.,q, ���
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 asATO
e s ect to the.Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS
�i� n d+orl.99� Additional.
OiJ /_&CAM^'J�/��ir'/W{/6 Total No.e_ CITY No.
Date Applica 4'i."1�y Fixed Appliances Not Over 1 HPPERMIT
NOTIPLICANT: If, offer 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.M.— ADDRESS
with comply with such provisions or this permit shall be Top ._ FAU —W.H.
deemed revoked. CITY Tel. No.
LICENSED CONTRACTORS DECLARATION Hdod _Fan _Other—
Disp. _ Room Air Cond. REG.
I hereby affirm that I am licensed under provisions of Chapter 9 REG.NUMBER Class.
(commencing with Section 7000)of Division 3 of the Business .DISTRICT NOPROCE D BY
Power Apparatus&Large Appliances 3�
'
and Professions Code,and my license is in full force and effect. r
Size&Type HP, KW, KVA, or KVAR• J
License Number Lip..Class Up to 1 Incl. FINAL V
ViiDATE: �G
Over 1 to 10 Incl.
Contractor Date VALIDATION❑ Over 10 to 50 Incl. V FINAL
I am exempt under Sec. Over 50 to 100 Inc. BY to
B..&P. Over 100 C. for this reason ® �
Date- Services, Swbd., MCC&Panelboards
0 -200 Amp. Under 600 V
Signature 201 -4000 Amp: Under 600 V
r
IDExemption for Reg. Maint. Elect. Over 1000 Amp. or Over 600 V
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): 1 9 4,1 A
❑ I, as owner bf the property, will do the work and the Mist. Conduits&Conductors
structure is not intended or offered for sale (Section Other(See Complete Fee Schedule)_ ® t 0 0 0 0 0 2
7044, Business and Professions Code). 2 0. o 1
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency'for 0, 0 1 0
Ca
the performance of the work for which this permit is issued PERMIT FEE (Sub-Total)
(Sec. 3097, Civ.. C.). ifol .0 12-8 3
PLAN CHECKING FEE
Lender's Name
PERMIT ISSUING FEE !1
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 ;
Xgn.t.re
a-menti property for inspection purposes.cSEE REVERSE FOR EXPLANATORY LANGUAGE
s o mittee ate