HomeMy Public PortalAbout5570 ROBINHOOD AVE_Electrical__ 76AC63A-CEe05A 4,72 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS AN, ELES
D%PARTI�ENT OF COUNT�ENGINEER FAE)DRE
UILDI a AND SAFETY DIVISION Sa u.A_
FOR APPLICANT TO FILL IN
OUTLETS NO. KACH FEE
OWNER
S S
RECEPT._ ADDRESS S
MAIL
LIGHT TOTAL FIRST 20
CITY TEL. N0.
SWITCH OVER 20 134, Qs�L1217
PLAN CHECK
LIGHTING 1TOTAL FIRST 20 APPLICANT =
Jy
FIXTURES
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT ', /
RANGE DRYERWTR. HTR. APPLICANT iv
STA. COOK DISP. F.A.U. ADDRESS _
SPACE HTR. AIR COND. CITY TEL, N0.
CLOTHES WASH. D13HWASH. LICENSE NO. CLAS3.C-
FAN OTHER r/ I HERESY ACKNOWLEDGE THAT I HAV[ READ THIS APPLICATION
sir AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY O
MOTORS, TRANSFORMERS MTI NG WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING CJ
IND. HEATERS, ETC, HP. KW. KVA. ELECTRICAL WIRING.
SIZE k TYPE OVER TO
I HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
1 — 10 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY.
10 - EO SIGNATURE
OF PERMITTEE
50 - 100
DISTRICTNO. CLASS ZONE P CE SY
100 - 500 . 05
SIGN, GAS SIGN AND ONE CIRCUIT NOTES:
TUBE, OR
MARQUEE ADDITIONAL' CIRCUITS
SERVICE NOT OVER 600 VOLTS OR 200 AMP
APPROVALS DATE DWECTO"51414.TURE
SERVICEOVER 600 VOLTS OR 200 AMP
TEMP.POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES
TEMP LIGHT OR RECEPT. SYSTEM UNDERSLAB WORK
ROUGH CONDIUT
WIRING
FIXTURES
PERMIT FEE (SUB TOTAL) POWER AUTHORIZED
UTILITY CO. NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT 133UIN0 FEE I 67V
TOTAL FEE -7.� `r
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION (K�. M.0. CASH
389 3 & 7.50 •
75Aa5L-C[a0a 9-84 APPLICATION FOR ELECTIZ&t fR>}VIIT
COUNTY OR LOS ANGELES
DEPARTMENT OR COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRU- 5570 RobinhocNi Rd
JOHN A. LAMBIE, COUNTY ENGINEER TQIIl 1@ 01t
COLO/AN W. JENKINS. SUPT. OF BUILDING LOCALITY P Y
NEAREBT
FORP C 1 CROea 9T.
REC[PT. r7 TOTAL NO, EACH FEE
OUTLETS FIRST 20 12 $-104 FO OWNER
LIGHT MAIL
SWITCH. ��
ADD'L '1O ADDS 5570 Robinhood RD
3 _ OVER 20
LIGHTING TOTALS FIRST 20 2 .10 CITY TEWLF CITY. TEL NO.
FIXTURES 2 ADD'L 10 ELECTRICIANT— IAC•
111 O v R 20
RANG" Cl 0.DRYQS WTR.HT'Ft1. 1.00 ADDREs• 16320 S Fi eora•
aAlls.DISP. RA.COOK CIT„ Gardena TEL NO.
-321-1982
DISHWASHl AUTO.-WASH. lrTATE 196248
SPACE HTRS. STA.AIT.(%HI.MAR.) .50 LICENSE NO.
MOTORG. ovtat NOTOvnt Hs. DIST N . ��rFj NE P BY
0 1 1.00
1 a 1.50 S ON RKORD
a B 2.00 `
O
a iB 2.50
v
oc
Is - 50 3.00 O
50 100 5.00 �J
a
sIGNSI NO'T"""'
MO.LAMPS Z
<tRVICB O-500V-NoT ovnt 2OOA 1.00
SERVICK O-SOOV-OVa 100 A. 1.00
SERVICE OVEFt soov 5.00
MISC.
PERMIT ISSU1NO MK 2.00
•UPPULMTNTARY PERMIT IMUMCD Fti 1.00 Z /�
TOTAL FEE lip 6
I HI11KINY AC$U*OVnJMG< THAT I HAVE RLAD THIS APPLICATIONPingloyALS 13ATE 1
m=MKCToptlo IPI
AND IFTAT19 THAT THE AIOV[ IS CORItKCT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDIMA =S AND STATE LAWS REGULATING ,
�tCTWICAL VrMM0. WIRING
I HEREBY .CERTIFY THAT I AY PROPERLY REGISTERED AMD/OR pI�I d
LIC ENDED
Al REQUIRED BY LO■ ANO■L[■ COUNTY AMO STAT[ OP
CALIFORNIA OR THAT I AY THE LEGAL OR R OP ANO INTEND TO
REBID[ IN, T AaOVE D CR [BI IAL PR ■RTY. POWKR
•IGNATURS UTILITY Co.NOTIFI
OF ll_M
Ft NAL
LIDATION JOSEPH C. ROOHAN
(xc-�' MO CASH
U
BPERVIIIIIIING ELECTRICAL ENGINKZM
-680410 . 19 2 0 6:8ON
L'
ob ffIrrn-YA3I COMPENSATION DECLARATION 7� ,ora, APPLICATION FOR ELECTRICAL PERMIT
I rm•thaf I have a cerUflcate of consent to self lneue, CE-806G
` ors of Mbrkers' Gon ponoation Insurance, or a cor-Hed COUNTY OF LOS ANGELES BUILDING AND SAFETY
3800,Lab.C.)
ppl{cy Na Cp7y FOR APPLICANT To FILL INJOB �} !
❑ Certlfled copy le hereby fume d. New fieeidentlal Bldgs 8 Pools EACH NO. FEE f
❑ Corned copy he flied with the oounty building Inspecbm 1 S 2-Family,Sq.Ft $ — S LOCALITY • .
department Mutts-famlfy Sq.Ft NEAREST
CROSS ST.
Ap�lcarrt Reslderdtal $wtmmtrrg Pools OWNER OR
•
FIRM NAME
CERTIF"TE OF EXEMPTION FROM WORKERS' Outlelm RooMAL
COMPENSATION INSURANCE — Lit —t Ff st 20� ADDRESS
(ThLs eectlon nMd not be completed If the work Irrvofved by tfw Total Na qdd � CITY 4 , Tel.Na
pernrR to for one hurKL"W doflare ($100) or We&) PLAN CHECK
I cerdN that In the performance of the work for which this permlt ApPLrAKT
is 6sured, I ehall not employ any person In arty manner so as to
become subject to the VkrkDm'Compenastfon Lew& Ughtirp Flxturee Flat 20 ADDRESS
Total No. Additional GTTY TeL No.
TO ouCANE: tf, After maktnq thistfll
Cerca of Fbced Appliances Not Over 1 HP P�,[r
ptbn,you shld become subject to the Workers'Compensadlon Range— I"ea� W
— DT
provisions of the.Labor Code, you mrmt forbwft comply with such Oven DryerWM— ADDRESS
•
provlelons or this permlt shall be deerned revoked. Top FAU WJ-L CFFY Tel.Nc.yW ffj1
LICENSEDIO
CONTRACTORS DECLARATION Hood Fan Other— d
I hereby afflrm that l am licensed•under provisions of Chapter B Dlep. Room Alr Cond, — REL uAea7� 1-
mnle
(concng with Section 7000) of DW lon 3 of the Buelneas end
Professions Code,and m
my Ilcere Is In fuC=N0.
ll force and effect. Power LerpeIa
Size S TypeHP,
a BY r
License Number 4// � Lb.Ciass pPto 1 KWI� or K144R FINAL
d Q
�f Over 1 to 10 Ind. DATEVkU O
Cate d.
[ Over 10 to 60 In
E] I—
I am exempt under Seo. Over 60 to 100 Ina
B. P.C,for this reason Over 100
k1z IF
Date_ Services,Swbd,MCC A Panelboards , Z
0-200 Amp.Under 800 V
Signature 201 - 1000 Amp.Under 600 V
for Rep.Mal
❑ EpOver 1000 Amp.or Over 600 V
� xemtlon rrt Elect.
SINGLE FAMILY / Temp.Power Pole 8 Appurtenances
HOME OWNER-BUILDER D TION Sign with One Branch CV=h
I hereby afftrm that I am exempt from " Ccnt wtor'e License Law
for the foUowlnp reason(Sec#on 703'1.6, Business and Proteesions Addborial Sign Branoh Clrouke
Clods):
/ Misc.Conduits S Conduors
❑ I,as owner of the propefly,will do the work end the struchae ct(See Complete Fee Schedule) —
fe not fnterded or ott(arsd for sale (Section 7044, Bu0eea
and Profasafona c/,ode). ► ;@73.Q-0 A
COfJSTNUCTION LENDING AGENCY #i°'O °,°.° 2
I hereby afftrm that Is a construction lending agency for the
perfomianc8 of U-o work for which this permft Is lured(Sec.3097, PERMfI"FEE (Sub-Total) I o - 37.50
Cts. C.). ,o ° 3 7,5 0S
PLAN CHECKING FEE
p
a . 622-87
PERMfT ISSUING FEE Address
that I have read this application and ate that the above TOZ4L FEE
le oonoci I agree to comply with all County ordirancee
and State lawe re4uietinq Electrical wiring, and hereby autlr r
representatives of thb County to enter upon the aboye-mentloned
fDr.tr pu
SEE REVERSE FOR EXPLANATORY LANGUAGE
tl 1l
Signature of Parmtttee betd
COUNTY OF LOS ANGELES TEMPLE CITY 0 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0804040011
AU`ZIN3 AND SAFETY / LAND DEVELOPMENT TH24PLE CITY CA 91780
PHONE: (626) 285-0488 ETT:
LEAL ID: FEES PAID BUILDING ADDRESS: _ -
TR: 16957 LT: 91 5570 ROBINHOOD AV
FEE DESCRIPTION: QUA??'=: UOM: AM47UNP: TEND CA 917002718
A95ES90R I2&'OIUQL=ON NDFIDER: NEAREST CROSS STREFiT: BCKM ..
8586-018-013 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 OLID: B3 LOCALITY: TE24PLE CITY, C
Ol OUTLETS-L(3P,SW,RECP 40.00 OUT 66.00
T2UdgT: O2 LIQHTIM FIMTVRES 23.00 LAT 43.05 ISSUED ON: PROCESSED BY: PLAN BY: EMPIRES ON:
H2 RES ORBO DISP LT 3HP 1.00 DIS 10.95 04/04/08 SR 10/01/08
H3 RES DISITYASHR LT 3HP 1.00 DIS 10.95
OWNER: TEL. NO: H4 RFS RANGE HDS LT 3HP 1.00 HOO 10.95 FINAL DATE BY: CODE:
►ANO PAUL P;CHUU FA.II4AN VIVIAN (626) 582-8422- H5 RES WASH MACH LT 3HP 1.00 WAS 10.95
5570 ROBINHOOD AV H7 RES EXHAUST FANS 2.00 EM 21.90 Imel —7-y
TENP 917802718 LB 200 AMP PANELS, MCC 2.00 PAN 77.70 DEJUIRIPTION OF WORK
TOTAL FEES 180.20 ELECTR-ICAL FOR ADDITION, RLDEL AND UPGRADE SERVICE PANEL
TO 200 AMP
APPLICANT: TEL. NO:
WANG (626) 582-8422-
5570 ROBINHOOD AV. SPECIAL CONDITIONS:
TEMPLE CITY CA 91780
CONPRAClOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
T 4 A CONSTRUCTION CO. (626) 757-3442-
306 N. ELIZABETH AVE LIC. NO TEMIKRARY POWER POLE
MONTEREY PARK, CA 91780 852143 B
UNDERGROUND CONDUIT
AA.CEITECT OR ENGIN=R: TEL. NO: UFER GROUND
SHTH, PAUL (626) 641-7533-
359 ROSEMEAD BLVD LIC. NO: ROUGH COST
PASADENA, CJS. 91107 66283
ROUGH WIRTTAG '
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
UTILITY COMPANY NOTIFIED
` REPORT ID: DPR265 ROUTE TO: BS0508