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Home My Public Portal About5415 PERSIMMON AVE_Electrical__ APPLICATION F R ELEC RIC PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS tm ma JOHN A. LAMBIE, COUNTY ENGINEER ` CASSATT D.GRIFFIN,SUPT 01r.13 UILDING Ad P !�ig LOCALITY77 FOR APPLICANT TO FILL.IN NEAREST PEMT FEES CROSS ST. ITEM NUMBER EACH FEE OWNER: ,� OUTLETS: $ MAIL q ADDRESS LIGHTS .RECEPT: SW. .SO IV 19 am LIGHTING FIXTURES .10 CITY d'/'.-, Oe C4&e4 TEL:NC.. ELEC.RANGES CLO.DRYERS ELECTRICIAN/� / oo ar,p �y,/� _ WATER' HEATERS .50. ADDRESS !g A Z/f{/ff //1(��y J?& ELEC.SPACE HTRS. DISHWASHERS CITY TEL.NO. 6ARBAGE.DISP08ER$ AUTO.- STATE Q� WASHERS STA.COOKING UNITS .25 LICENSE NO. �1 - MOTORS:. OVER INC. H.P. DISTRI T ROUP - ZONE PRPCESSEDBY 0— V> .25 . so INSPECTION RECORD 2 s 1.00 4 Coo.. isv E242sarI'DIZ 8'— 18 1.50 is— so 2.50 00-200 5.00 SIGNS: NO.TRANS. NO.LAMPS SERVICE O"GOOV 1.00 SERVICE 01,4'R 500V s:oo MISC. WIRING PERMIT I.Oo a FIXTURE PERMIT 1.00 pD p SUPPLEMENTARY PERMIT j .50 TOTAL FEET p I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS' A '1,ErA 1. L. PES �,��SIGNATURE AND STATE THAT TH6 ABOVE IS CORRECT AND AGREE TO COMPLY fir/ •�. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. F s I HEREBY CERTIFY THAT .1 AM PROPERLY REGISTERED AND/OR WIRING LICENSED AS REQUIRED BY LOS ANGELES-COUNTY AND STATE OFs ry CALIFORNIA OR 1 AM THE LEGAL OWNER OF TH$ ABOVE FIXTURES DESCRIBED It DEMI •PROPERTY. POWER A SIGNATU E r UTILITYC .'NOTIFIED OF PER ITTE Fa FINAL �F A O ppUERS V LGSPVIN ETRICAL ENGINEER CK NO CASH' Lh" 3 4 7 6 0cr 4 2 D 2 .80 I. 1 A888-00084.90 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER 13UILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A.LAMBIE,COUNTY ENGINEER �r WILLIAM A.JENSEN.SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL W cRROSS ST. PERMIT FEES OWNER o ,beL jj TT 1 TE M NUMBER EACH FEE MAIL OUTLETS:, D $.10 S i� ADDRESS �� Ie,T�fV LIGHTS RECEPT. . BW. V _ LIGHTING FIXTURES .1O CITY 2 E L TEL.NO t 63 ELEO.RANGES CLO.DRYERS ELECTRI IAN IQ id nG� WATER HEATERS .50 ADDRESS ELEC.SPACE HTRS. DISHWASHERS CITY TEL.NO. GARBAGE DISPOSERS AUTO.- STATE WASHERS VIA.COOKING UNITS. ,25 LICENSE NO. MOTORS: OVER INC. H.P. DIST CTS GRQ�JP ONE P OCE .-D BY O — 1/a .25 11 z Va - 2 ,50 p INSPECTION RECORD 2 — s 1.00 per, 1.50 O U Is — s0 2.50 agO SO — 200 1-5.00 U W SIGNS: NO TRANS. H NO.LAMPS Z n - � SERVICE O.000V 1,00 SERVICE OVER SOOV 5.00 MISC. WIRING PERMIT 1.00 d FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT sO TOTAL FEE s3 gO I HEREBY ACKNOWLEDGE THAT ;V' READ THIS APPLICATION APPROVALS DATE. INSPECTOR'S SIGNATURE NDAND STATE BOVEIS CNO AGREE TO COMPLY )J ST ALL OVNTY OR AN, A LAWS REGULATING CONDUIT I RING. WIRINGHE BY CE IVY THAT AMLY R GISTERED AND/OR INS RE IRED BY S ACOU TY AND STATE OF FIXTURES CALIFO NIA T T I A OWN CF THE VE - DESCRI ED RE IAL OP a POWER SIGMA Y CO.NOTIFIED, OF PE ITTE - VALIDATI ARTHUR C.VEIT. CK MO CASH SUPERVISIAIG ELECTRICAL ENGINEER �r„7 } �c7 5 2 4..8 3 l � 6X-ate_t. r A663411808 4-80 APPLICATION FOR ELECTRICAL PERMI 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS! LSA JOHN A.LAMBIE,COUNTY ENGINEER �? WILLIAM A.JENSEN,SUP'TOF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. PERMIT FEES OWNER 1 T E M NUMBER EACH FEE MAIL OUTLETS: $ S ADDRESS, LIGHTS RECEPT. SW. .10 LIGHTING.FIXTURES .10 CITY TE O O b ELEC.RANGES CLO.DRYERS ELECTRI 61AN WATER HEATERS .50 ADDRESS ELEC.SPACE HTRS/DISHWASHERS CITY TEL.NO. GARBAGE DISPOSERS AUTO.. / STATE WASHERS STA.COOKING UNITS ' .28 , LICENSE NO. MOTORS: OVER INC. H.P. DITT' . G P I Z N 0 — .25 r'. {//ymo v:: — 2 .50 INSPECTION RECORD 2 — S 1.00 p}, 5 — 15 1.50 U is — 80 2.80 . So — 200 8.00 U W SIGNS: NO TRANS. N NO.LAMPS Z SERVICE 0.80OV 1.00 SERVICE OVER 800V 5.00 MISC. WIRING.PERMIT 1.00 V V FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE S 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. WIRING O /Q LCALIFORNIA Y CERTIFY THAT I AM PROPERLY REGISTERED AND/OR -- AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES OR THAT I AM HE LEGAL OWNER OF THE ABOVE RES TIAL P TY. POWER RE' UTILITY CO.NOTIFIED A TT FINAL O Asp VALIDATIO ARTHUR C.VEIT. m MO SUPERVISING ELECTRICAL ENGINEER Ltsuo 7 �+ 7 SGT . 2 D ,22 5 v 76ABB8 DBS BA 11-30 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ELECTRIC COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. ELECTRICIAN w.� (� _ F^F � ll`� S z sr3 RECEIVED BY READY FOR DATE ISSUED ADDRESS / f- & FIRST INSPECTION CITY J411 `il /+ TEL. NO. 4 I#/ 7 r"1 3 COUNTY LICENSE NO. /,If EXPIRES 4 BUILDING '� ✓ / PERMIT FEES ADDRESS r I f+/ .r1_ ✓2%.��2 � NUMBER EACH FEE LOCALITY 1 LIGHT OUTLETS NEAR CROSS ST. RECEPTACLES WALL SWITCHES OWNER' TOTAL OUTLETS Sc S MAIL ELEC. RANGES 85 ADDRESS ELEC. HEATERS 25 CITY TEL. NO. FIXTURES 5 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING. MOTORS V CERTIFY THAT I POSSESS THE ABOVE VALID LOS NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER EACH OF THE RESIDENTIA DE,S� ISED ABOVE. NEW MVD. HP OVER INC. 1/2 a LESS S .25 SIGNATURE OF 1/2 2 .50 PERMITTEE 2 5 1.00 INSPECTION RECORD 5 19 1 1.50 1s so 2.50 50 200 5.00 200 500 10.00 ,J Soo 1000 15.00 Z OVER 1000 20.00 ig M. G. SET/FREQ. CHANGER-HP m' WELDERS:AC-KVA 0 GENERATORS-KW TRANSFORMERS-KVA TEMP. MOTORS (75%OFORIG.) MOVED MOTORS (75%OFORIG.) MISC. SIGNS NO. NO.TRANS. I APPROVALS NO. NO. LAMPS FOR EACH PERMIT DATE INSPECTOR'S NAME WIRING $1.00 lJa CONDUIT FIXTURES $1.00 WIRING 3 '�►.(� / 1-Y,x+ SUPPLEMENTARY .50 FIXTURES _POWER TOTAL FEE S/ UTILITY CO. NOTIFIED } Ay ® ® FINAL ' e D59 5-A 5-45 441WIUVATJLON FOH YER'll'1' l DEPARTMENT OF BUH DING AND SAFETY 'COUNTY OF LOS ANGELES ELEC'T'RIC W.M. J. FOX CHIEF ENGINEER) pp ifl d�� , f .!, ,�,�� ' DIST NO. GROUP ZONE �PERMIT NO. VNAMES l/f/ _ + 7T �! �• `� ' ADDRESS , J I .S_ ;•,9J�L�„/a1-�.'- ��f F_ CIT1f-"f)dJ-�: r / TEL NOT„J �J f �1� EIVED BY READY FOR DTE ISSUED +-•-=�- ` FIRST INSPECTION W C�NNO. �� EXPIRES APPLICANT FILL IN HEAVILY OUTLINED POBTIQN ONLY JOB DESCIdIPTIION OF WORK ADDRESS °fes NUMBER OF OUTLETS ON CIRCUITS LOCALITY A- LOCATION BY ROOMS NEAREST LIGHT OUTLETS ISW. PLUGS F&T CROSS ST. -p=9�-+•> .lam- rCIRCUIT A B C D E $ P G H IC NAME �,.BLIII ) r E .h,;T- ',► 1�.-� ��._ti�3AD RD CITY,��: �rL= i TEL.No.1- � y Ili 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COU TY1 �RTIFICATZ OF QUALIFICATION- ELECTRICIAN. UAL•IFI TION- ^• �� L• + ELECTRICIAN. 1 . ABO M TIM LEQAL.OWNER OF THL?PROPERTY DESCRIBED / v r q / �� , OWNER. COIIR MONS L J Q Z 19 IY 1] TOTAL gg NO. OF OUTLETS pp ffi fra AP IIOVALS NO. OF FIXTURES ry �� ffi � I ,DATE INSPECTOR'S/NAME NO. OF MOTORS H.P. • ffi CONDUIT V NO. OF SIGNS TRANS. ffi + WIRING NO. OF RANGES OR HEATERS ffi FIXTURES MISCELLANEOUS ffi `` POWER PERMIT FEE ffi V UTILITYCO.NOTIFIED TOTAL FEE 0° + FINAL &-1 G '!1 r f WORKERS'COMPENSATION DECLARATION �1 76-663 10/81 APPLICATION FOR ELECTRICAL PERMIT I'hereby affirm„xhat,l have`'a certificate of consent to self insure, CE-soBG• cit.a•'dortificate of-*rkers' Compensation Insurance,or a certified " COUNTY OF LOS ANGELES ' BUILDING AND SAFETY copy,thereof,(Sec.3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. EACH NO. FEE ADDRESS Sit New Residential Bldgs.&Pools $ _ $ LOCALITY T t E] Certified copy is filed with the county building inspection 1 &2-Family,Sq.Ft. .department. Multi-family Sq.Ft. NEAREST � CROSS ST. Date Applicant Residential Swimming Pools OWNER OR p FIRM NAME "P� r CERTIFICATE OF EXEMPTION-FROM WORKERS' Outlets:Rec—Light.—Sw.— 'ADDRESS J { IM U11,b110 AIL COMPENSATION INSURANCE (This not be cbm feted if the work involved by the First 20 ( P CITY ,. Tel.No.tiLIJ,:Z,'�lri permit Is for one hundred dollars($100)or less.) Total No. Additional I certify that in the performance of the work for which.this permit �PLALICANT CHECK SOI,v� C.I.CU Is.issued, I shall not employ any person in any mahrier so as to become subject to the Workers'.Compensation Laws. Lighting Fixtures First 20 ADDRESS ylj} L„WVV--,by*0 Additional ��1, 'r Total No. CITY Tel.No. 2"(� r Date Applicant Fitted Appliances Not Over 1 Hp PERMIT 1 _ -_ NOTICE TO APPLICANT: If, after making this Certificate of APPLICANT L t�.� Exemption,you should become'subject to the Workers'Compensation Range_ Heater D.W.• _ provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ ADDRESS provisions or this permit shall be deemed revoked. Top _ FAU _ W.H. _ CITY �r G Tel.No. LICENSED.CONTRACTORS DECLARATION Hood — Fan _ Other_ I hereby affirm that I. :am licensed under. Disp. — Room Air provisions of Chapter 9 CondLICENSE OR . REG.NUMBER Class. (commencing with Section 7000 of Division 3 of the Business and • Professions Code,and my license is in full force and effect. power Apparatus&'Large Appliances DISTRICT NO. PROC ED Size&Type HP,KW,KVA,or KVAR Y P:..0 License Number L'ic.Class Up to'1 Incl. FINAL Over 1 to 10 Incl. DATE / VALIDATION Contractor. Date I0 ❑ i Over 10 to 50 Incl. FINAL 1 am eXempt:under Sec. Over 5.0 to 100 Inc. BY 11.161 L1. ZB&P.C.for this reason Over 100 o • Services,Swbd.,MCC&Panelboards Date: 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. $u b Pa n e-' I ffv SINGLE'FAMILY Temp.Power Pole&Appurtenances 2 HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuita I hereby affirm that I am exempt from the Contractor's License Law ACCT-7 for the following reason(Section 7031.5,Businass and Professions Additional Sign Branch Circuits K,Q7 49.00 Code): Misc.Conduits&Conductors 1 ITEMS❑ I,as owner of the property,will do the work and the structure Other(See Complete Fee Schedule) is not intended or offered for sale (Section 7044, Business p TOTAL 49.00 and Professions.Code). CONSTRUCTION LENDING AGENCY CHECK 49.011 1 hereby affirm that there is a construction lending agency'for the CHANGE{ANGE a 00 performance of the work for which this permit is issued(Sec.3097, PERMIT FEE. (Sub-Total) Civ.C.). PLAN CHECKING FEE � �� 4/ 2/90 Lender's Name PERMIT ISSUING FEE -39840 I AM 80 .33 Lender's Address1 I certify that I have read this application and state that the above , TOTAL FEE ,O information is correct.I agree to comply with all County ordinances i and State laws regulating Electrical wiring, and hereby authorize ' representatives of this County to enter upon the above-mentioned property for inspection purpos s. SEE REVERSE FOR EXPLANATORY LANGUAGE - 4gnWu`r-e�of Permittee Date WORKERS'COMPENSATION DECLARATION 78-863 10/81 APPLICATION FORELECTRICAL PERMITJ,heteby affirm that I have a certificate of consent to self insure, CE-806G or a certificate of Workers' Compensation Insurance, or a certifiedCOUNTY OF LOS ANGELES BUILDING AND SAFETY •ccpy'lhetebf,.(Sec.3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS q 1 5 S t O r_1 "Certified copy is hereby furnished. New Residential Bldgs.&Pgols EACH NO.. FEE ❑ 1 &2-Family,Sq.Ft. $ — $ LOCALITY r12 .r f__Certified copy is filed with the county building inspection department. Multi-family Sq.Ft. — NEAREST CROSS SI: Date Residential Swimming Pools OWNER OR Applicant ( FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Red—Light—Sw.— MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work Involved by the ; First 20 Total No. Additional CITY Tel.No. i permit'is for one hundred dollars($100)or less.) PLAN CHECK I certify that in the performance of the work for which this permit APPLICANT is issued,I shall not employ any person in any manner so as to become subject to the Workers'Com ensation Laws. a Lighting Fixtures First 20 ADDRESS p Additional �n Total No. CITY Tel.No. Date + Applican 11y I\ Fixed Appliances Not Over 1 HP PERMIT NOTICE TO APPLICANT: If; after making this Certificate of APPLICANT Exemption,you should become subject to the.Workers'Compensation Range_ Heater D.W. provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ ,ADDRESS provisions or this permit shall be deemed revoked. Top _ FAU _ W.H. _ CITY Tel.No. .LICENSED CONTRACTORS DECLARATION, Hood — Fan _ Other_ hereby affirm that.1 am licensed under provisions of Chapter 9LICENSE OR (commencing with Section 7000)of Division 3 of the Business and Disp. — Room Air Gond. REG.NUMBER Claw. Professions Code,and my license is in full force and effect. Apparatus&Large Appliances DISTRICT NO. PROCE E BY y Power Size Type HP,KW,KVA,or KVAR �op40 V �,License Number Lid.Class Up to 1 Incl. FINAL Contractor Date Over 1 to 10 Incl. DATE q `� VALIDATION• Q Over 10 to 50 Inc]. FINAL !' 15 I am exempt under Sec. Over 50 to 100 Inc. BY a B.&P.C.for this reason Over 100 N Services,Swbd.,MCC&Panelboards ® Z Date: 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 2 I hereby affirm that I am exempt from the Contractor's License Law ;.-- a for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits ACC-71 pg Code): I 37307 271.00 I El 1, Conduits&Conductors I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _ i ITEMS and-Professions Code). ® TOTAL 27,.00 CONSTRUCTION LENDING AGENCY CHECKoL( 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) ` �- CHANGE -Civ.C.). - PLAN CHECKING FEE Lender's Name r i PERMIT ISSUING FEE 0000-0001 10/ 8/90 Lender's AddressG" f 1�"4 A�#I(�;Ij 1 certify that I have read this application and state that the above TOTAL FEE r. '� 1 information is co ct.I agree to comply with all County ordinances i and State laws gulating Electrical wiring, and hereby authorize representatives of this County to enter upon the above-mentioned p rty for inspeloci rposes. SEE REVERSE FOR EXPLANATORY LANGUAGE � - Low Sign ure of Permitted Date WORKER'S COMPENSATION DECLARATION 9 DPW 9fB9 I APPLICATION FOR ELECTRICAL PERMIT u hereby affirm that I have a certificate of consent to self Insure, 7BA6678A663 or a certificate 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.) Policy No. Company FOR APPLICANT TO FILL IN JOB ADDRESS ❑ Certified co Is hereby furnished. EACH NO. FEE f� N PY Y New Residential Bldgs.&Pools $ _ $ LOCALITY i C_ �-'L Lr Certified copy is filed with the county building inspection 1&2-Family,Sq.Ft. _ NEAREST department. /A� p Multi-family Sq.Ft. CROSS ST. 0011� 2�l � ��^b� Residential Swimming Pools ASSESSOR Date pliCant MAP BOOK OFA 1PAGE PARCEL CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Roo Light& S FFIIRM NAME NQ�rt=- COMPENSATION INSURANCE .� 36 /,,n � First 20 MAIL (This section need not be completed if the work involved by the Total No. //D Additional ADDRESS �11 S J permit Is for one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit CITY Ir-c— Tel.No.4tEA-7-T is issued, I shall not employ any person in any manner so as to PLAN CHECK �. become subject to the Workers'Compensation Laws. p Lighting Fixtures First 20 APPLICANT �q+ � 2^1�1� QL.'QLI C _ aTotal No.� Additional{� }6v.7i�"" ADDRESS Date Applicant15 OR 20A,120V BRANCH CIRCUIT NOTICE TO APPLICANT: If, after making this Certificate of CITY Tel.No. Exemption,you should become subject to the Workers'Compensation 1 TO 10 INCLUSIVE EACH provisions of the Labor Code, you must forthwith comply with such 11 TO 40 INCLUSIVE EACH PERMIT APPLICANT �n►inS{�. provisions or this permit shall be deemed revoked. 41 OR MORE BRANCH CIRCUITS EACH }• LICENSED CONTRACTORS DECLARATION 15 OR 20A,208V TO 277V LIGHTING EACH ADDRESS d I hereby affirm that I am licensed under provisions of Chapter 9 0 (commencing with Section 7000)of Division 3 of the Business and CITY Tel.No. V Professions Code,and my license is In full force and effect. RESIDENTIAL APPLIANCES UP TO 3HP LICENSE OR gni Power Apparatus&Large Appliances REG.NUMBER Clara O �q License Number � Lic.Class - ~A Size&Type HP,KW,KVA,or KVAR DISTRICT NO. ` PROC SEED BY U Up to 3 Incl. ��O u m-�sLc/ W Over 3 to 10 Incl. FINAL Contracto Data Over 10 to 50 Incl. DATE W ❑ I am exempt under Sec. Over 50 to 100 Incl. Ll VALIDATION B.&P.C.for this reason Over 100 FINAL BY Services,Swbd.,MCC&Panelboards f Date: " 0-200 Amp.Under 600 V 100" Signet ure 201-1000 Amp.Under 600 V ❑ Over 1000 Amp.or Over 600 V Exemption for Reg.Maint.Elect. SINGLE FAMILY Temp.Power Pole&Appurtenances 'r' JL HOME OWNER-BUILDER DECLARATION P F'C •I a a ith Ci B With One Branch Circuit I hereby affirm that I am exempt from the Contractor's License Law Sign w for the following reason(Section 7031.5, Business and Professions Additional Sign Branch Circuits �307 +'-700q°65 Co 1 ITEMS� I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors TOTAL o -�� is not intended or offered for sale(Section 7044, Business Other(See Complete Fee Schedule) and Professions Code). , CHECK 289065 CONSTRUCTION LENDING AGENCY CHANGE a MC) 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) IR411 Civ.C.) PLAN CHECKING FEE 0000-0001 2116/93 Lender's Name °205 1 AM11.048 PERMIT ISSUING FEE ar Lender Address pP 1f 9 I certif 'that I have read this application and state that the above TOTAL FEE 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 roperty for Inspection purposes. 1 SEE REVERSE FOR EXPLANATORY LANGUAGE IGNATURE OF AP li NT OR AGENT DATE