HomeMy Public PortalAbout4931 ROBINHOOD AVE_Electrical__ 76.0669-CEfirlfi 10/74
APPLICATION F R ELECT&AL PERMIT .r
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION
LOCALITY _>I C Wly
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. /a."eui
OUTLETS NO, EACH FEE FIRM NAME 1"�tZ ��•/
RECEP
$ 5 MAIL
FIRST 20 25 d V ADDRESS
LIGHT TOTAL 10
CITY TEL. N0.
SWITCH OVER 20 .10 PLAN CHECK
LIGHTING FIRST 20 .25 4 #0
APPLICANT
TO AL
FIXTURES
OVER 20 •10 ADDRESS
RESIDENTIAL APPLIANCES CITY 94 TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT Pvx / N L
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR. AIR COND. CITY %o�,- TEL._NO.qf-s'lro3
CLOTHES WASH. DISHWASH. LICENSE-0If �'
REG. NUMBER Z� CLASS. G"-J
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
` I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
S 0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAI AM LEGAL OW R OF THE A VE
1 - 10 3.00 DESCRIBED RESIDE AL OP RTY. V
10 - 50 5.00 SIIGNAITURE ICD,
V
50 - 100 10.00 DISTRICT N0. CES D BY y
100 - S00 15.00 V [J 0 Q Z
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DAT INSPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.001 TEMP. POWER POLE
SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT ��lp
TEMP SERVICE,POLE,&APPURTENANCES 5.00 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIED
FINAL
I PERMIT FEE (SUB TOTAL) NOTES:�e � -7 Irn
PLAN CHECK FEE �Q�\ Y p G67
PERMIT ISSUING FEE 3.00 "^
TOTAL FEE
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.0. CASH
2 6 89JUM 4 'l 2 0 ora
SEE BACK OF APPLICATIQN FOR COMPLETE SCHEDULE .•. f •,
IBA688-CESCO-9-57 APPLICATION FOR ELECTRIC PE.RMITi
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING// E
BUILDING AND SAFETY DIVISION ADDRESS x`7'7
JOHN A.LAMBIE.COUNTY ENGINEER
CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY
NEAREST `f
P
FOR APPLICANTF ITO IN CROSS ST. /V
OWNER
tUBTEgR
RECEPTACLES SWITCH.
ITEM EACH FEE . MAIL
ADDRESS
TOTAL OUTLETS .10 $ELEC. RANGES, WATER HEATERS, CITY T L.NO.
Sp ELECTRICIAN XGELEC. SPACE BLU&S-STAT'Y. 000K- �y
ING UNITS. GARBAGE DISPOSERS, ADDRESS
AUTO WASHERS, DISHWASHER .25 '��
LIGHTING FIXTURES ,10 CITY TEL.NO
STATE
MOTORS LICENSE NO. l D
HORSEPOWER r
D1STR1CT�10. GRO P N OVER INC. READY FOR INSPECTION
y(�r�
&LF-89 .25
a s I.so r�'? INSPECTION RECORD 1, 411 J�
•v
s 15 f.sd
1s — so 2.50
50 200 5.00
SIGNS I NO.TRANS ,
NO.LAMPS
SERVICE O-GOOV 1.00
SERVICE OVER GOOV 5.00
WIRING PERMIT 1.00 490
FIXTURE PERMIT 1.00 J 99
SUPPLEMENTARY PERMIT .50 APPROVALS
TOTAL FEE $ DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE.TO CO Y CONDUIT y
ELECTRICAL WIRING.WITH ALL COUNTY ORDINANCES AND STATE REGU it G .< WIRING I41'Gz I �f�✓,; _�.�/•�__� .
I HEREBY CERTIFY THA AM PROP E ED AND OR FIXTURES
LICENSED AS REQUIRED B OS ANGEL D T T OF
CALIFORNIA OR THAT I THE LEG F T BOVE POWER
DESCRIBED RESIDER IAL OPERTY.%
SIGNATURE 'UTILITY CO.NOTIFIER-/—.7
OF PERMIT-E FINAL
IOHN A.LAM ATION ARTHUR C.VEI
"OU
NTY EN61 R MC cA9N SUPERV18IN6 ELECTRICAL ENGINEER
322OS OCTI1 2 11 .90
0
firm th R *,;e `g PENSATION DECLARATION CE-806G '°'a' APPLICATION FOR ELECTRICAL PERMIT
•I.h2�by affirm th'�t'�1ave a-bertificate of consent to self insure,
or a cert4ate_.w.i*rkers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY
copy thereof(Sea 3800.Lab.C.) "fl
Y Policy No• Company FOR APPLICANT TO FILL IN JOB Q
Certified copy is hereby furnished. New Residential Bldgs.&Pools
EACH NO. FEE ADDRESS0.6y
Certified copy is filed with the county building inspection
1 &2-Family,Sq.Ft. $ — $ LOCALITY
department. Multi-family Sq.Ft. — NEAREST
CROSS ST.
Residential Swimming Pools OWNER OR
Date Applicant FIRM NAME
CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec—Light_Sw. MAIL j
—
COMPENSATION INSURANCE ADDRESS
(This section need not be completed if the work Involved by the First 20
permit is for one hundred dollars($100)or less.) Total No. Additional CITY Tel.No.j�/ Q
I certify that in the performance of the work for which this permit PLAN CHECK
is issued, I shall not employ any person in any man r so as to APPLICANT
become subject to the Workers' sation Laws. Lighting Fixtures First 20 ADDRESS
Additional
s Total No. CITY Tel.
Date r Applicant Fixed Appliances Not Over 1 HP
NOTICE TO APPLICANT: If, of making this Certificate of PERMIT
Exemption,you should become su ct to the Workers'Compensation Range_ Heater_ D.W. _ APPLICANT
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_
I hereby affirm that I am licensed under provisions of Chapter 9 Disp. — Room Air Cond. LICENSE OR Class
(commencing with Section 7000)of Division 3 of the Business and M.NUMBER
Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances DISTRICT NO. '/ PROCESSED BY
a�/
Size&Type HP,KW,KVA,or KVAR Wn
License Number Lia Class Up to 1 Incl. FINAL 8
Over 1 to 10 incl. DATE V�
Contractor Date O
❑ Over 10 to 50 Incl. G !/
FINAL
I am exempt under Sec. Over 50 to 100 Inc. g LaJ
B.&P.C.for this reason Over 100
Ad
Services,Swbd.,MCC&Panelboards ,l Z
Date: 0-200 Amp.Under 600 V (J
Signature 201 - 1000 Amp.Under 600 V ;9-7 8 7.2 A
Exemption for Reg.Maint.Elect. Over 1000 Amp.or Over 600 V 0 0 0 0 0 2
SINGLE FAMILY Temp.Power Pole&Appurtenances
o 02550
HOME OWNER-BUILDER DECLARATION Sign with One Branch Circuit _,
I hereby affirm that I am exempt from the Contractor's License Law o 0 0 S
for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits 2 Jr 0 u
Code):
�.,� Misc.Conduits&Conductors 0 9.G 9—8 7
EI,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) _ Poo.
Professions Code).
CONSTRUCTION LENDING AGENCY
1 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)
Civ.C.).
PLAN CHECKING FEE
Lender's Name PERMIT ISSUING FEE
Lender's Address
I certify 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
ggnaltgure
tatives of t ' County to enter upon the above-mentioned
for inspec r n purposeA, 1—
� SEE REVERSE FOR EXPLANATORY LANGUAGE
of Permittee Date
I