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Home My Public Portal About9024 PENTLAND ST_Electrical__ 'ORhat I have a certificate of consent to GE80BG 10rB1 APPLICATION FOR ELECTRICAL PERMIT , affirm that have a certdicete of consent to sell insure ate of V orkers Compensatan Insurance or a certified ' COUNTY OF LOS ANGELES BUILDING AND SAFETY f,(Sec 3600 Lab C O - iCOmpamy f FOR APPLICANT TO FILL IN 'JOB ADDRESS +, Certified copy is hereby furnished i� EACH NO FEE _ New Residential Bldgs & Pools T® Certified copy is filed with the county building Ins v 1 & 2-Family Sq Ft $ — $ LOCALITY. G r departmentMuhl-family Sq Ft — NEAREST �_ • CROSS ST Get e`s Applicant ' Residential Swimming Poo�ols,-+ 1 OvvNER OR n A 4 L i ,. CERTIFICATE OF EXEMPTIO •KERS ., I� rp MMA AIL f+Ab1E 'r i ` r�iCOMPENSATiON INSURANCE 19 Outlets Red Light Sw ��ESS ,(This section need not ln:completed d the work Imol •d by the First 20 CITY Tel No I permit Is for one hundred dollars ($100)or lees 1 Total No Addrtgnal •� PAN -I-certify`that In the partm orance iof the nark for which this permit 'p d t ` CHECK- AP ICANT is te6ued I shad noliemploy any person in any manner so as to' ' ` `become subject to the Workers Compensation Laws Lighting Fixtures`/ First 20-r ADDRESS "Total No 6 r Arldit Baal vi CITY z Tel No Date 'Applicant Fixed Appliances Not Over 1 HP r I n nn { NOTICE TO APPLICANT If after making_this Certificate of PAP�PDCANT r�� i gExemption you should became subject to,ihe Workers'Compensation,,,,, Range_ Heater_ DW lilEi(/ /J k r } pransions of the Labor Code you must forthwith comply with such Oven _ Dryer _ W M _- - 'i ADDRESS C) N Y provisions or this permit shall be deemed revoked Top —,FAU _ WH _ ' LICENSED CONTRACTORS DECLARATION ,( e Hood Fan _ Other_ ti CITY - Tel (40 Ihereby affir79�-- m that I am licensed under provisions of Chapter 6 _ ° UCENSE O (commencing with Section 7000) of Division 3 of the Business and Disp^ — Raam Air Cond- REG NUMBER S-q- -3,r-1 Q , Professions Code and my license is in full force and effect , .> DISTRICT BY Power,Apparatus 8 Large Appliances „ p Size& Type HP KW KVA'or KVAR Q License Number •S �O 3`r�Uc Class - - - I Up to 1 Incl I �' FINAL Contractor Vit/��^S GSL,1 Data - Over 1 to 10 Incl c DATE VALIDATION - O ` ❑ �r • Over 10 to SO Incl FINAL ��,r„,r` � CCC0JJJ I am exempt under Sec %Over 50 to 1001= Y p W B&PC for this reason Over 100 Z ^ 4 _ i .Services Swbd MCC& Panelboards Data' 0 - 200 Amp Under 600 V ► r Signature 201 1000 Amp Under 600 V - ' k Over 1000 Amp or Over 600 V - • ❑ Exemption for Reg Mamt Elect '• ,r •t,. ( - _ _ SINGLE FAMILY Temp Power Pole& Appurtenances • 2 , ,I HOME OWNER-BUILDER DECLARATION % Sun with One Branch Circuit- _ • _ hereby affirm that I am exempt from the Contractor s License Law i Additional Sign Branch Circuits = rL Arvt.* ' for the followingreason(Section 7031 5 Business and Professions 9 _ - � I+ Code)• i i , e .e i : "- _ tyL 26.50 - ❑ Mwc Conduits°& Conductors`. ' Y: " r ' Y _ 41 �k TOTAL. ITEF7+-1• I as owner of the property will do the work and the structures ? TOTAL 2fa 0 is =t Intended or offered for sale (Section 7044 Business Other_(See Complete Fee Sctiedule) ,and Professions Code) z ► `` "�_ j I • r i ' CONSTRUCTION LENDING AGENCY - ., �� , /�L�yr`� (meq( 26.50° tl hereby affirm that there Is a construction lending agency,for the _- __ >. W11b7� ' An 14 performance of the work for which this'permit is Issued(Sec 3007 PERMIT FEE' - + - (Sub-Totel) '` ^, Cm C) '4r - r 1 - PLAN CHECKING FEE . j, }- r Lenders Name . '. 0000-0001 6/ 5/89 PERMIT ISSUING FEE �63 7 Lenders Address t OJ 8 0�1 1 I certify that I have read this application an state that the above. TOTAL FEE I, r - _ information us correct I agree to opnpy ion all County ordinances - , land State laws regulating Electrical win" hereby authomm representatives of this,County to enter he above-mentioned- , - • �' f Property for mspact purpppggryss5eees , // % _ SEE REVERSE FOR EXPLANATORY LANGUAGE Signal o r /J Date 4, WORKERS COMPENSATION DECLARATION urol°opwsie' APPLICATION FOR ELECTRICAL PERMIT O yl hereby affirm that I have a certificate of consent to sell `�' f;msure or a certificate of Workers Compensation Insurance COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS T or a certified copy thereof (Sec 3800 Lab C ) Policy No V Company FOR APPLICANT TO FILL IN )OB �J p ❑Certi ed copy is hereby furnished New Residential Bldgs 8 Pools EACH NO FEE ADDRESS /C,2- rtified copy is filed with the county building inspec 1 8 2 Family, Sq Ft $ — $ LOCALITYLIL C hon department �r Multi family Sq Ft f — I NEAREST , Residential Swimming Pools CROSS ST s Date Appbcant ` g OWNER OR � FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERSMAIL COMPENSATION INSURANCE Outlets Rac_Ltght_t 2 _ 4 ADDRESS S f E Fust 20 ' (This section need not 6e completed If the work involved by Total No Additional CIN Tel Na the permit is for one hundred dollars ($100) or lou ) r PIAN CHECK I certify that in ,he performance of the work for which this gppLIGAM Permit is issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Lows Lighting Fixtures First 20 ADDRESS • Additional Total No CITY Tel No Date—Applicant Fixed Appliances Not Over I HP PERMIT NOTICE TO APPLICANT If after making this Certificate of Exemption you should become subject to the Workers Range— Heater—DW' APPLICATION (J . /G,/ vV 'Compensation provisions of the Labor Cade,-you must forth- Oven — Dryer —W M ADDRESS 9 1 Ar---• 4 ilc with comply with such provisions or this permit shall be Top — FAU —W H ' deemed revoked Hood — Fan —Other— CITY Tel No j LICENSED CONTRACTORS DECLARATION. HooDisr, _ Room Air COth — LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 REG NUMBER .j'yi Class f 3 (commencing with Section 7000)of Division 3 of the Business Power Apparatus& Large Appliances DISTRICh� P D B } and Professions Code, and my license is in full force and effect ✓ D (� •/' 0 y Sire 8 Type HP KW KVA or KVAR r 0 �> 0 License Num r Sf Lsc Class a Up to 1 Incl FINAL {y V t - /� -��-0 VALIDATION �".� S US _ ,_ Over 1 to 10 Incl DATE Q oniractor Dote O Ever 10 to SO Incl FINAL f' ❑ xl am exempt under Sac Over 50 to 100 Inc BY _ W B SP C for this reason Over 100 r-nQ (neo d Dote Services, Swbd MCC 8 Ponelboards ' Z 0 200 Amp Under Epp V - Signature 201 1000 Amp Under 630V - A M I ❑ Os er 1000 Amp or Over 600 V Exemption for Reg Moint Elect SINGLE FAMILY Temp Power Pole 8 Appurtenances _ HOME OWNER BUILDER DECLARATION - - - - ---- -- 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) 37,07 - 45.50 ❑ 1, as owner of the property will do the work and the Misc Conduits&Conductors - 1 ITEMS structure is not intended or offered for sole(Section 7044 Other (See Complete Fee Schedule) — Busmess and Professions Code) poll TOTAL 4.5 _ 5Q CONSTRUCTION LENDING AGENCY _ - s 45.Td) 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-Totol) i CHARGE .[I[I (Sec 3097 Civ C ) . PLAN CHECKING FEE Lender s Nome '"""�1 `12/13/59 PERMIT ISSUING FEE VVVV Lender s Address TOTAL FEE 5 7482 1 AM 8:4,, 1 certify that I have read this appl hon and state that the above information is correct I ogre a comply with all County ( - - ordinances and Stale laws regul g Electrical wiring and r hereby authorize representahvei thi to enter upon the above mention d pr ar inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE es Sign re m erittee Data -