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Home My Public Portal About5409 ROBINHOOD AVE_Electrical__ �APPLICATION FOR ELECTRICAL PERMIT r. BUILDIN AND SAFETY DIVI ION FOR APPLICANT TO FILL IN . NOJOB. A \ U EACH FEE �y11 00 a New Residential Bldgs.&Pools _ ADDRESS � 1 &2 Finaily Sq. Ft. $ — $ LOCALIT C V� Multi-family Sq.Ft. — NEAREST 1 Residential Swimming Pools CROSS ST.OWNER OR ua al FIRM NAME q.LL Outlets: Light,Switch&Receptacle AD L S First 20 d Additional d CIT Tel..No. ��•Q PLAN CHECK Lighting Fixtures APPLICANT . First 20 ADDRESS Additional CITY Tel.No. PERMIT Fixed Appliances Not Ov r 1 HP APPLICANT f%%A a v%;g Range_ Heater D.W. ADDRESS ' Oven Dryer _ W:M. � Top _ FAU _ W.H. _ CITY I fIA&L" Tel.No. . 1 Hood Fan LICENSE OR C REG. NUMBER 1D Class. Disp. A.C. v 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION Power A pparatus&Lar e A liances g PP AND STATE THAT THE.ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING Size&Type HP,KW,KVA,or KVAR ELECTRICAL WIRING. Up to 1 Incl. PHECREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR. y Over 1 to 10 Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE Over 10 to 50 Incl. DESCRIBED RESIDENTIAL PROPERTY. Over 50 to 100 Incl. PERMITEE Over 100 SIGNATUREel I_ Services DISTRICT NO. P SE BY 0-200 Amp. Under 600 V c o O 201 -1000 Amp. Under 600'V APPROVALS DATE INSP TOR'S Over 1000 Amp.or Over 600 V SI ATURE TEMP.POWER POLE '• Temp.Power Pole&Appurtenances UN:DERSLAB WORK Sign with One Branch Circuit ROUGH CONDUIT Additional Sign Branch Circuits (Other) WIRING FIXTURES o POWER AUTHORIZED PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL PERMIT ISSUING FEE TOTAL FEE NOTES "n " CASH PERMIT VALIDATION CK. M.O. CA POLICY HOLDER: -77 � 0 C-JAN 18 -2 .0 2 1.2 0 e POLICY NUMBER. 3 7.5-/ r 76AS63-CESOO 7-50 APPLICATION FOR ELECTRIC .PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D..GRIFFIN, SUPT OF BUILDING LOCALITY FGARBAGE OR APPLICANT TO FILL IN NEAREST PERMU FEES CROSS ST 1 T E M NUMBER: EACH FEE OWNER- 0 WNER i RECEPT. • SW. • $.1O $ / ADDRESS FIXTUR �f 10 iJ CITI( TEL. NOf S CLO. DRYERS ELECTRICIAN ER HEATERS .SO ADDRESS HTRS. DISHWASHERS CITY L. NO SPOSERS / Auro.- / STATE �g STA. COOKING UNITS / .25 LICENSE NO. MOTORS: OVER — I/a 2$ INC. H.P. DISTRICT O. G P zON PROCESSED BY O � . I/z— 2 .$0 2— $ 1.00 MSPE=ON RECORD $— 1$ 1.$0 a 1$- SO 2.$0 $0—200 $.00 SIGNS: NO. TRANS. NO. LAMPS SERVICE 0-600V 1.00 SERVICE OVER 600V $.00 MISC. WIRING PERMIT 1.00 FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .SO TOTAL FEE S AM APPROVALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APIALICXTION DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY "• CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING _ ELECTRICAL WIRING. WIRING 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES C LINTY AND STATE OF FIXTURES CALIFORNIA OR THAT AM THE L AL N O THE. ABOVE `d DESCRIBED.RESIDENTI P ERTY. POWER If SIGNATURE UTILITY CO.NOTIFIED ` OF PERMITTEE FINAL / ON ARTHUR C. VETT, SUPERVISING ELECTRICAL ENGINEER C MO CASH � 1 - 1-4 OR DEC 24- 2 A 9.5'0 WORKERS'COMPENSATION DECLARATION C-503 to/et APPLICATION FOR ELECTRICAL PERMIT I hereby affirm that I have a certificate of consent to self insure, CE-506G or a certificate of Workers' Compensation Insurance, or a certified COUNTY OF LOS ANGELES BUILDING AND SAFETY copy thereof(Sec 38000.Lab.C.) r _ PGlicy No. 4-9011/a0mpany- `�,,r 72 Fe /V'4) FOR APPLICANT TO FILL IN JOB r '/ 0 Certified copy is hereby furnished. New Residential Bldgs.&Pools EACH NO. FEE ADDRESS G 0 g: /!/#,'O 1 &2-Family,Sq.Ft. $ — $ LOCALITY 19 Certified copy is filed with the county building inspection NEAREST dFpa�tme / 4 �7 Multi-family Sq.Ft. CROSS ST Date !O// Applicant f' Cei,ft 6" `) Residential Swimming Pools OWNER OR FIRM NAME CERTIFICATE OF EXEMPTION FROM WORKERS' Outlets:Rec 'f g Li ht!�&Sw.— MAIL COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by the First 20 Total No. Additional CITY �� 4 C Tel.No. permit is for one hundred dollars($100)or less.) PIAN 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'Compensation Laws. Lighting FixturesFirst 20 ADDRESS Total No. Z Additional CITY Tel.No. Date Applicant Fixed Appliances Not Over 1 HP NOTICE TO APPLICANT: If, after makingthis Certificate of PERMIT Exemption,you should become subject 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 -ie +Al ,s provisions or this permit shall be deemed revoked. Top — FAU _ W.H. '- CITY (/i AIA- 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 31 Clas. -C`= (commencing with Section 7000)of Division 3 of the Business and REG.NUMBER Professions Code,and my license is in full force and effect. Power Apparatus&Large Appliances DISTRICT i PRO SED 4%,t ,,// r / ,_/ Size&Type HP,KW,KVA,or KVAR V 0 License Number 3117g] Lic.Class c�, e'� Up to 1 Incl. FINAL 0 /' �/ �_7' f ��/�� Over 1 to 10 Incl. DATE VALIDATION � Contractor l� LCh .7 to , ; �m ). ,Over 10 to 50 Incl. ❑ FINAL V I am exempt under Sec. Over 50 to 100 Inc. BY W Over 100 B&P.C.for this reason 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 L I hereby affirm that I am exempt from the Contractor's License Law j a for the following reason(Section 7031.5,Business and Professions Additional Sign Branch Circuits Code): 3307 ECT IS as owner of the property,will do the work and the structure Misc.Conduits&Conductors 1 1 r TC!'.:. is not intended or offered for sale (Section 7044, Business Other(See Complete Fee Schedule) _ and Professions Code). ® !0TAL2-0.20 CONSTRUCTION LENDING AGENCY CHECK 20.20 1 hereby affirm that there is a construction lending agency for the Vit_ performance of the work for which this permit is issued(Sec.3097, PERMIT FEE (Sub-Total) CHANGE ,CC! Civ.C.). PLAN CHECKING FEE Lender's Name n Q!])jr-031121 71 9/910PERMIT ISSUING FEE �l' Lender's Address �+V In /) 1,723 1 AN 3926 1 certify that I have read this application and state that the above TOTAL FEE p( 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 pro e y for inspection purposes. 79 , SEE REVERSE FOR EXPLANATORY LANGUAGE Sfanature Of Permittee Date ' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1307150018 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: ITR: 21704 LT: 2 I I 5409 ROBINHOOD AV IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917802730 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: OLIVE 18586-023-002 1A1 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY CAI I IG1 OUTLETS-LGT,SW,RECP 3.00 OUT 6.00 1 1 ITT: IG2 LIGHTING FIXTURES 3.00 LGT 6.00 ISSUED ON: PROCESSED BY: PLAN BY: I 1H2 RES GRBG DISP LT 3HP 1.00 DIS 11.00 107/15/13 SR I I IH3 RES DISHWASHR LT 3HP 1.00 DIS 11.00 1 1 (OWNER: TEL. NO: 1H4 RES RANGE HDS LT 3HP 1.00 HOO 11.00 Fp ITE FI HY: CODE: I IF33ANGW NORMAN AVE (626) 862-6488- i TOTAL FEES 72.80 IARCADIA CA 91006 I IDESCRIPTIO OF WORK 1 IREPLACE DISH RANGE HOOD, GARBAGE DISPOSAL, 3 LIGHTS IFIXTURES33 OUTLETS (APPLICANT: TEL. NO: I SAME AS OWNER [SPECIAL CONDITIONS: I I I ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER - I LIC. NO i (TEMPORARY POWER POLE I I I UNDERGROUND CONDUIT I I I (ARCHITECT OR ENGINEER: TEL. NO: I I _ 1 IUFER GROUND I I I LIC. NO: i IROUGH CONDUIT I I (ROUGH WIRING I I I MAIN WATER LINE 1 I 1 PLASTIC YIN METAL YIN 1 I I (UTILITY COMPANY NOTIFIED( I 1 I I I I I I I I I I I I I I I I I I I 1 I I I I I 1 I I I I I I I I IREPORT ID: DPR265 ROUTE TO: BS0508 I I I I I I I I I