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Home My Public Portal About5212 ARDEN DR_Plumbing__ OBABBT -CE#817 12-84 CITY OF TEMPLE CITY 8391 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING 5212 N. Alden JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY Temple Cit FOR APPLICANT TO FILL IN CROSSSST. Hwy & Valley Blvd. NUMBER FIXTURE OR ITEM EACH FEE OWNER C. Hobbiltzell WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS Same CITY TEL. NO. SHOWER 1.25 LAVATORY 1.25 CONTRACTOR General Installation Co. SINK 1.25 ADDRESS 6558 West Blvd. DISHWASHER 1.25 CITY . Los Angeles TEL. NO. PL 3-2541 LAUNDRY 'PUB 1.25 REGISTRATION NO. Ci-36 151839 787 COUNTY STATE I CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE BY WATER HEATER 1.50 GAS SYSTEM OUTLETS 1.50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD 1 Water softener 1j 50 Ready for Inspection Now � e� W 9L co z APPROVALS DATE--� INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 2 ou O ROUGH PLUMBING j TOTAL FEE GAS PIPING I. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT I AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ,t WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER '! PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED REST IA ROP Y. UTILITY CO. NOTIFIED �\ SIGNATURES//� -�'/�^ OF PERMITTEE FINAL ® I911 LIDATION ROBERT A WOOD CK. M.O. CASH SUPERVISING MECHANICAL ENG'R LA 0u6657u%0'1 OCT20 5 0 3450N 76,067 17 a-SO 1 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. rS __j _ i— ill PLUMBER6Y� �Y/o-r✓ /J�'�� LJ�_ RECEIVED BY READY FOR DATE ISSUED /nq /,E ,v� FIRST INSPECTION B IADDRESS/'001�"/// [G 1310 :r( G Z-' 1� In —/( —'r' `� / I'I vim/ •"✓ TEL. OG to if b/ BUILDING �c, ,Y / ��r/Qf� CITY ADDRESS d� 1 COUNTY ` LOCALITY `j�L /T LICENSE NO. EXPIRES NEAREST PERMIT FEES CROSS Sr j` NUMBER TYPE OF FIXTURE OR ITEM FEE OW NEz///t//s/4 y( MAIL WATER CLOSET (TOILET) @ 0.501$ ADDRESS —1( e I BATH TUB @ 0.50I CITY / (iC JL(G/i(�/ ' I TEL. NO. J SHOWER @ 0.501 1 HEREBY ACKNOWLEDGE THAT I HIAVE READ THIS LAVATORY (WASH BASIN) @ 0.501 L APPLICATION AND STATE THAT THE ABOVE 11 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING P ING. KITCHEN SINK @ 0.50 '� 1 CERTIFY THAT 1 SS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.501 �D ANGELES COUNTY E. O 1 AM THE LEGAL OWNER OF THE RESIDENT L PROP DESCRIBED ABOVE. O I GAS SYSTEM OUTLETS @ 0.50 SIGNATURE OF A I WATER HEATER @ 0.501 PERMITT SLOP SINK @ 0-501 I NSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 I DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL @ 0.501 I J HOUSE SEWER @ 0.501 I Q _Z MISCELLANEOUS I I � I� 0 APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING P, 4- GAS GAS PIPING GAS VENT CESSPOOL @ 1.00 I CESSPOOL SEPTIC TANK: 1 SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00SEWER PERMIT . . I 1.00 GAS TEST I 1 UTILITY CO.LITYTIFIEp�� ''`�`�"�`�� f TOTAL FEE I $ FINAL ION WORKER'S I ve'a certificate of consent to 76A626DPW9/89 APPLICATION FOR PLUMBING PERMIT 76A667A I hereby affirm :hat I have'a certificate of consent to self insure, or a ceYtificate of'Worker's Compensation Insurance, or a certified copy thereof(Sec'.3800 Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV. Policy No. Company ❑ Certified copy is hereby furnished. El Certified APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM �@ FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. ' COMPENSATION INSURANCE IASSESSOR (This section need not be completed if the work involved by the SHOWER MAP BOOK PAGE PARCEL permit is for one hundred dollars($100)or less.) LAVATORY OWNER ��, I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as toSINK MAIL / /� become subject to the Workers'Compensation Laws. ADDRESS DISWASHER CITY T ,dG TEL.NO. Date Applicant CLOTHES WASHER CONTRACTOR NOTICE TO APPLICANT: If, after making this Certificate of eGL',e! Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM ; LICENSED CONTRACTORS DECLARATION TEL.NO. I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER CL (commencing with Section 7000) of Division 3 of the Business and STATE LICA Professions Code, and my license is in full force and effect. GAS SYSTEM OUTLETS 41NsF NO;' G. S (� OUTLETS OVER DISTRICT NO. PIS$*BY o 5 PER SYSTEM - •- - .- License Number Lic.Class �^ FINAL - VALIDAITIQ�iCplt; LU DATE r �.� � Contractor Date ❑ FINAL TOTAL - _ I am exempt under Sec. BY.._;: CHECK .6Cr B.&P.C.for this reason Date: Plan check fee _... - _ __.... ...._..... Signature PLUMBING PERMIT ISSUING FEE$ ❑ TOTAL FEE 3, SINGLE FAMILY i 1w1t�r�4fg Plan check applicant _ " 1 7b AM10:111 _ HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law r for the fo3jowing reason (Section 7031.5, Business and Professions Address Code): City Tel. No. I, as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business and Professions Code). , 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 ordinances and State laws regulating Plumbing, and hereby authorize repres.p,ntalives of this County to, nter upon the above-mentioned pro er r' ct' n ur ses SEE REVERSE FOR EXPLANATORY LANGUAGE /1zy 9 z._ Signature of ermittee Date