The URL can be used to link to this page

Home My Public Portal About4948 BALDWIN AVE_Plumbing__ (2) 76A667 CE817 8 58 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A LAMBIE CountF Eng�neer ADDRESS CASSATT D GRIFFIN Sup t of Buildmg + .a.._ LOCALITY FOR APPLICANT TO FILL IN NEABEST CROSS ST NUMBER FIXTURE OR ITEM OWNER WATER CLOSET MAIL BATH TUB ADDRESS SHOWER CITY TEL NO LAVATORY CONTRACTOR SINS ADDRESS DISHWASHER CITY 5 TEL NO 3 6 CONTRACTOR S ..��jj STATE LAUNDRY TUB REGISTRATION NO 3w/� COUNTY ❑ CLOTHES WASHER DISTRICT GR U Z NE PROCESSED BY WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD APPROVALS OB PFIXCI�UREE $ I �� DATE INSPECTOR S SIGNATURE UNDER SLAB WORK PERMIT $ 2100 ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED DESCRIBED RESIDENTIAL PROPERTY SIGNATURE &k&k XS OF PERMITTEE < L FINAL ROBERT A WOOD OF VALIDATION SUPERVISING MECHANICAL ENG R CK 61 m O CASH 3 0 2 0- 'SEF 2 5 A 30 0 :* 4�V i _\ i 76AC67Cr"E 817B) 9/75 APPLICATION FOR PLUMBING PERMIT BUILDING AND SAF Y DIVISION FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING < NUMBER FIXTURE OR ITEM @ FEE ADDRESS 4948 Baldwin Avenue WATER CLOSET LOCALITY Temple City NEAREST BATH TUB CROSS ST SHOWER OAINER Mrs. Sue Anderson MAIL LAVATORY ADDRESS 4948 Babdwin SINK CITY Temple City TEL NO 444-0714 DISHWASHER CONTRACTOR Bryant Heat & Air Cond Inc CLOTHES WASHER ADDRESS 1350 E. Las Tunas Drive SWIMMING POOL RECEPTOR LAWN SPRINKLER SYSTEM CITYSan Gabriel )6 TEL NO 286-1141 1 STATEWATER HEATER LICENSE NO 221751 CILASS C20 a_ O l GAS SYSTEM OUTLETS 3 00 DISTR�I/�7J,NO GROUP Z E PRO ESSED BY 0 1 CD OUTLETS OVER Y v U U 5 PER SYSTEM INDUSTRIAL LU WASTE APPROVAL a INSPECTION RECORD Z Plan check fee PLUMBING PERMIT ISSUING FEE $ TOTAL FEE 1 7150 Plan check applicant Name APPROVALS DATE INSPECTOR S SIGNATURE UNDER SLAB WORK Address ROUGH PLUMBING City Tel NO GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER L CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURESS REQUIRED Y LOS ANGELES COUNTY AND STATE OF GAS TESTOR THAT I A THE LEGAL OWNER OF AND I�jTENDEABOVE ESC IBED RESIDENTIAL PROPERTY/ UTILITY CO NOTIFIED E( T T E AL PLAW'0RK'Z9MG0MPeN9AT16N PERMIT VALIDATION cK M D CASH POLICY HOLDER - 1 8 2 WG 12, 5 D 7.5 POLICY NUMBER 0 2-v 3yS-a (0 3 5�'- 67 WORKERS'COMPENSATION DECLARATION 76A667A I hereby affirm that I have a certificate of consent to self ce $17 (2-80) APPLICATION FOR PLUMBING PERMIT insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No ° r 37ompany Went Anari onn y Certified copy is hereby furnished.! FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING7 a ADDRESS 4 �1l dv'l i y\I'@ Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE department. LOCALITY D jI —1 f1 Appli 43xiar&: P J WATER CLOSET NEAREST BATH TUB CROSS ST. tl CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE is SHOWER OWNER (� LAVATORY MAIL W ID Light- (This section need not be completed if the work involved „ ADDRESS 4948 Baldwin Av"e J by the permit is for one hundred dollars ($100) or less.) CITY Temple C ��L/� SINK �? City L.wy�9LFTE —U f L4 u' I certify that in the performance of the work for which this DISHWASHER } permit is issued, I shall not employ any person in any manner CONTRACTOR Aveso as to become subject to the Workers' Compensation Laws. •.� CLOTHES WASHER ADDRESS 263I Lee A � Date Applicant �r SWIMMING POOL RECEPTOR NOTICE TO APPLICANT: If, after making this Certificate of CITY TEL. NO, CL Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE` Monte El LIC. 3 W Compensation provisions of the Labor Code, you must forth- WATER HEATER LICENSE NO. 0 CLASS4783 with comply with such provisions or this permit shall be deemed revoked. DISTRICT NO. PROCESSED BY GAS SYSTEM OUTLETS LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL VALIDATION ness and Professions Code, and my license is in full force and DATE effect. f` FINAL License Number Lic.Class BY Universa11-13';'30 Contractor Date I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section 7031.5, Busi- City Tel. No. ness and Professions Code): `; • • ♦ • • ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project �' • • (Section 7044, Business and Professions Code). ' • t • 1 (: if n CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is` issued(Sec. 3097,Civ.C.). Lender's Name Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the ab4-mentionedproperty for inspection purposes. Signature,6f Permittee Date ti WORKERS'COMPENSATION DECLARATION. zaaesrw I hereby affirm that I have a' certificate of consent'to self' ce 8'17.(Z-8 oj APPLICATION FOR PLUMBING PERMIT insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.) COUNTY OF,LOS ANGELES BUILDING AND SAFETY Policy NoWC 5C)093ompany WAcf Amari can El Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING 4hI7�aldwin Ave 14 Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE ADDRESS D department, LOCALITY Dal[el�� lic iyeo a a'pp ver aI Plbs WATER CLOSET A NEAREST BATHTUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER �+� OWNER (This section need not be completed if the work involved LAVATORY MAIL ADDRESS 4948 Baldwin Ave a �D by the permit is for one hundred dollars ($100) or less.) / SINK ()� CITY Temple City TE L.444-0714 O0 I certify that in the performance of the work for which this DISHWASHER 'c permit is issued, I shall not employ any person in any manner CONTRACTORUniversal P m O so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER ADDRESS 2631 Lee Ave w Date Applicant SWIMMING POOL RECEPTOR 13- NOTICE TO APPLICANT: If, after making this Certificate of CITY TEL. NO. to Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE SO El Monte o LIC. :575 34 M Compensation provisions of the Labor Code, you must forth- WATER HEATER LICENSE NO. 306678 CLASS 788 with comply with such provisions or this permit shall be deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. O SSED.B / LICENSED CONTRACTORS DECLARATION OUTLETS OVER �C �G I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINALell � VALIDATION ness and Professions Code, and my license is in full force and DATE t i effect. �f FINAL License Number Lic,Class BY r' inivers� 11- Con ractor Date I am exempt from the licensing requirements as I am a Plan check fee L/— d�`�• Cl / �J S licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ 06 acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE 60 Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that 'I am exempt from the Contractor's Address License Law for the following reason (Section.7031.5, Busi- City Tel.No. 3 0 9,9 A ness and Professions Code): D1, as owner of the property, am exclusively contracting 0 0.0 0 o 5 with licensed contractors to construct the project (Section 7044, Business and Professions Code). 2 0 0 1 6 0 0 CONSTRUCTION LENDING AGENCY 0 0 0 1 6. 0 0 csa I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is 1 1.2 4—8 0 issued(Sec. 3097,Civ.C.). Lender's Name Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the abo mentioned property for inspection purposes. Sign atur Per tttee Date