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Home My Public Portal About4924 ROBINHOOD AVE_Electrical__ FOAGGB_CESOS_G_S, APPLICATION FOR ELECTRIC PERMITi COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING a11AIr BUWING AND SAFETY DIVISION ADDRESS JOHN A.LAMBIE,COUNTY ENGINEER CASSATT D.GRIFFIN,SUPT OF BUILDINai LOCALI NEAREST FOR APPLICANTIIS ILL IN CROSS ST. OWNER LIGHTS RECEPTACLES SWITCHES NUMBERI ITEM EACH FEE MAIL TOTAL OUTLETS $ .10 ADDRESS $ ELEC. RANGES, WATER HEATERS, CITY TEL.NO. CLOTHES DRYERS '50 ELECTRICIAN ,9 ELEC.SPACE HEATERS, STAT-Y. COOK- ING UNITS. GARBAGE DISPOSERS, ADDRESS o y AUTO WASHERS, DISHWASHER .25' � �p LIGHTING FIXTURES .10 CITY .Ir TEL. MOTORS STAT LICENSE NO. HORSEPOWER H.Pr OVER INC. 51STR O.CT NGR O READY FOA INSPECTION .� Va 8 LESS .25 1/8 2 .So INSPECTION RECORD 2 s 1.00 5 is i.SC 1s s0 2.80 50 200 5.0C MISC SIGNSi NO.TRANS e NO.LAMPS SERVICE O-600V 1.00 F SERVICE OVER 600V 5.00 WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 APPROVALS TOTAL FEE $ DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP LIC TION AND STATE THAT THE ABOVE IS. CORRECT AND AGREE TO COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING mai I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN RLZAo— IOHN ABOVE POWER DESCRIBED RESIDENTIA ROPPTY. SIGNATURE �(}��pp UTILITY CO.NOTIFIED OF PERMITTE ® �`s= MAL A.LAMBIE. VAIMATI ARTHUR C. EIT, rOUNTY ENGINEER $UPERVI8ING ELECTRICAL ENGINEER CIC MO N 04544 NOV 5 2 2.20 � �s r r- +6A888-CEH08-H-87 APPLICATION FOR ELECTRIC PE:RMITi COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING d BUILDING AND SAFETY DIWSION ADDRESS JOHN A.LAMBIE,COUNTY ENGINEER ;. CASSATT D.GRIFFIN,SUP'T OF BUILDING LOCALITY FF NEAREST FOR APPLICANT TO FILL IN CROSS ST. PERMT FEES OWNER ,,q LIGHTS RECEPTACLES SWITCHES NUMBER: 1 TE M EACH FEE MAIL ADDRESS 76 TOTAL OUTLETS $ .10 $ ELEC. RANGES, WATER HEATERS., CITY TEL.NO. n CLOTHES DRYERS .50 ///�� ELEC. SPACE HEATERS,STAT-Y. COOK- ING UNITS. GARBAGE DISPOSERS, ADDRESS ea AUTO WASHERS. DISHWASHER .25' / LIGHTING FIXTURES .10 CITY TEL.N s MOTORS 4_7STATE I L� LICENSE NO. l7 HORSEPOWER 'DISTRICT NO. GRO ZON READY FOR INSPECTION H.P.- OVER INC. y�a LESS .25 Ilk — 2 .50 1 INSPECTION RECORD 2 is 1.0o s Is I.sd 1s so 2.50 50 200 5.00 MISC. SIGNS I NO.TRANS NO.LAMPS SERVICE O-BOOV 1.00 SERVICE OVER 600V 5.00 �y WIRING PERMIT 1.00 V FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT 50 APPROVALS TOTAL FEE $ DATE INSPEdSiGNATURE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LIGATION AND STATE THAT THE ABOVE iS CORRECT AND AGREE TO COMPLY CONDUIT c, ��ELECTRICAL WIRING.WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGWIRING F-S .5'v /L/"I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURESLICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM T E LEG L OW ER OF THE ABOVE POWER DESCRIBED RESIDENTIAL OPSIGNATURE UTILITY CO.NOTIFIEDOF PERMITT FOHN A.LAMBIE. VALIDAT= ARTHUR C.VEIT. + rOUNTY ENGINEER CK NO(L4�g SUPERVISING ELECTRICAL ENGINEER ' too 5454 DEC 31 2 13.20 - WORKERS'COMPENSATION DECLARATION 78-883 ,D/e, APPLICATION FOR ELECTRICAL PERMIT' T I h reby affirm that I have a certificate of consent to self insure, CE-8o8G or a certificate of workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy theVof(Sec.3800.Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN JOB ❑ Certified copy is hereby furnished. EACH NO. FEE ADDRESS /�fV New Residential Bldgs.&Pools ❑ y� q• 1 &2-Family,S Ft. $ — $ LOCALITY Certified copy is filed with the county building inspection department. Multi-family Sq.Ft. — NEAREST Residential Swimming Pools CROSS ST. OWNER OR Date Applicant FIRM.NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec y Light�Sw. MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by the First 20 CITY � �4 Tel.No. 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 APPLICANT K ,is issued. I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Lighting Fixtures First 20 ADDRESS Total No. f Additional CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after making this Certificate of PERMIT Exemption,you should become subject to the Workers'Compensation Range_ Heater D.W. _ Y APPLICANT provisions of the Labor Code,you must forthwith comply with such Oven _ Dryer_ W.M._ ADDRESS provisions or this permit shall be deemed revolved. Top _ FAU _ W.H. CITY Tel.No. LICENSED CONTRACTORS DECLARATION ,Hood — Fan _ Other_ I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR (commencing with Section 7000)of Division 3 of the Business and REG.NUMBER Class. Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances DISTRIC'LHQ. PR SED BY a 1 Size&Type HP,KW,KVA,or KVAR J r lJQ License Number_ -Z f�a b Lic.Class C 0 Up to 1 Incl. FINAL V � 66 ..�� ,,��% Over 1 to 10 Incl. L C G12H'�i' Date z DATE I VALIDATION Q Contractor Over 10 to 50 Incl. FINAL ❑ I am exempt under Sec. Over 50 to 100 Inc. BY : W ' D.. B.&P.C:for this.reason Over 100 N Services,Swbd.,MCC&Panelboards ® 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 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 it h Ci Sign Branch Circuits for the following reason(Section 7031.5,Business and Professions Additional ACCT.CCT o Q ❑ I,as owner of the property,will do the work and the structure Misc.Conduits&Conductors 3307 14.25 is not intended or offered for sale (Section 7044, Business. Other(See Complete Fee Schedule) _ ® 1 and Professions Code). TOTAL ��o 2'.25CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a. construction lending agency for the CRECK 14.255 performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub Total) //+.(��//�� Civ.C.). 5.•fll E .00 PLAN CHECKING FEE Lender's Name PEPIMIT ISSUING FEE $/ ,�$ Lender's Address 4, I certify that I have read this application and state that the above TOTAL FEE 190L 5647 i An 9.-05 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 f Signature of Permittee Date 2