HomeMy Public PortalAbout5220 BARELA AVE_Plumbing__r
7GAG'G7A ICE 877131,-477
APPLIC TION FOR PLUMBING PERMIT
DING AND SAFETY DIVISION
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FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM FEE ADDRESS 5220 Barela Temple Cit
WATER CLOSET LOCALITY
BATH TUB NEAREST
CROSS,ST.
SHOWER OWNER Mr. & Mrs. Don Cardella
LAVATORY MAIL ADDRESS 5220 BaA
SINK CITY Temple Cit TEL.N.O. 285_3807
DISHWASHER CONTRACTOR AAA Conditioned Air Inc.
CLOTHES WASHER
ADDRESS 10160 Valley .
SWIMMING POOL RECEPTOR
CITY El Monte • TEL.NO.-579.-.1800
LAWN SPRINKLER SYSTEM
STATE LIC.WATER HEATER LICENSE No. 293529 CLASS C-2O
GAS SYSTEM OUTLETS. DISTRICT NO: GROUP ZONE PRO SED
5�OPi C)
50 PER SYSTTEM INDUSTRIAL v
WASTE APPROVAL C
INSPECTION RECORD v
W
Z
Plan check fee.
PLUMBING PERMIT ISSUING FEE S
TOTALFEE
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 AND STATE GAS VENT '
LA
TTHE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
STATE LAWS REGULATING PLUMBING: HOT WATER HEATER
I HEREBY CERT, THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
UIRED BY LOSAN LES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TESTAL OWNER OF,AN INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL sPERTY. UTILITY CO.NOTIFIED
NATUREF PERMITT _ FINAL S)1 i • • 7•(,.//i` (iL(�/7,(�v� �. ,�
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION• 4;& CK. M.O. CASH tU
7 i O Q •
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_ �O O O UT :I:.
CH
CDP 102 7-72.
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A. PPLICAVON FOR PLUMBING ' ERWT
CITY OF
DEPARTMENT OF COMMUNITY DEVELOPMENT FNEAREST
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BUILDING AND SAFETY SECTION S 5220 Barela Ave.
Y
FOR APPLICANT TO FILL IN (PRINT OR-TYPE) T.
NUMB R FIXTURE OR ITEM @, FEE
WATER CLOSET 1 co MAIL
OWNER
BATH TUB 1,
ADDRESS_ 5220 Barela.•Ave.
SHOWER "p",
CITYTEL:,NO, e
LAVATORY 1 75 CONTRACTOR Univessal Plumbing
SINK 1- ++' ADD RESS26 1 Lee-Ave. .
DISHWASHER 1.7 CITY p Vontp TEL. NO. _
CLOTHES WASHER ' S STATE LICENSE NO. 31601$ ' Lass 036020 :
SWIMMING POOL RECEPTOR 1,75
DI CT NO. GRO.IIP ZONE R ESs, :Y
LAWN SPRINKLER SYSTEM 1, 5 * 4,
WATER HEATER 1.75 (910 INDUSTRIAL.'
_ WASTE APPROVAL
GAS SYSTEM OUTLETS 1, 69 INSPECTION RECORD
OUTLETS OVER r;0 -ry n
5 PER SYSTEM 3 / ,a our OK
Plan check fee See reverse. F'
PLUMBING PERMIT ISSUING FEE- $ 00
y
TOTAL FEE ,APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant,- _ UNDER SLAB WORK 7 sf�9. bj�CLtCitf�'�
Name ROUGH'PLUMBINGjT
%}p
-...I
Address GAS PIPING
City Tel. No. 13AS VENT
HOT WATER HEATER
. I HEREBY ACKNOWLEDGE THAT I HAVE READ.!THIS APP.L•I= ,
CATION AND.STATE THAT THE ABOVE IS CORRECT AND AGREE TO PLUMBING FIXTURES
COMPLY WITH ALL.CITY ORDINANCES AND STATE LAWS.REGU- GAS TESTS
LATING PLUMBING. I
I -HEREBY CERTIFY•THAT I A PROPERLY REGISTERED AND UTILITY CO:NOTIFIED f '
OR LICENSED AS REQUIRED'BY ANGELES COUNTY AND STATE
OF CALIFORNIA OR THAT I A Hf LEGAL OWNER OF, AND IN-
TEND TO RESIDE IN THE A E DESCR DRESID ENTIAL PROP- (-_70,
am %1/1� .`
PROP-
ERTY. FINALI• / / O C Je
SIGNATURE t
OF PERMITTEE
O •' N q ;
• • • hb
PLAN HECK V��IDATION O , ; L�_
O` N' N.
�7 O O •
�O O O
PERMIT VALIDATION CH;
WORKERS'COMPENSATION DECLARATION CrE 817w APPLICATION z
-P-L�M B I N G PERMIT
I hereby affirm that I have certificate of consent to self ce a» (z-so)
inSuri�, si4rcgrtificate of Workers'Compensation Insurance,or
a certified coot'thereof(Sec.3800,Lab.C.) T
I :i
II K`�, COUNTY OF LOS ANGEL UILDING AND SAFETY
Policy,No. Company
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING `�
❑
Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE �L7
ADDRESS
department. WATER CLOSET LOCALITY
Date Applicant NEAREST
BATH TUB CROSS ST.
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE SHOWER OWNER
(This section need not be completed if the work involved LAVATORY MAIL
P ADDRESS.
by the permit is for one hundred dollars ($100) or less.) SINK
CITY TEL.NO �fjfy (�
uv
I certify that in the performance of the work for which this DISHWASHER p
permit is issued, I shall not employ'any person in any manner 2 CONTRACT®R
so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER
ADDRESS U
Date Applicant az
SWIMMING POOL RECEPTORW
NOTICE TO APPLICANT: If, after making this Certificate of CITY TEL.NO. 0.
Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. z
Compensation provisions of the Labor Code, you must forth- LICENSE NO. CLASS
with comply with such provisions or this permit shall be WATER HEATER
deemed revoked. DISTRICT NO. PR, ESSED BY
GAS SYSTEM OUTLETS �c s
LICENSED CONTRACTORS DECLARATION OUTLETS OVER
I hereby affirm that I am licensed under provisions of Chapter # 5 PER SYSTEM
9 (commencing with Section 7000) of Division 3 of the Busi- FINAL VALIDATION
ness and Professions Code, and my license is in full force and DATE
effect.
FINAL
License Number Lie.Class BY
Contractor Date
I am exempt from the licensing requirements as I am a Plan check fee
licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$
acting in my professional capacity (Section 7051, Bus-
iness and Professions Code).
TOTAL FEE r
Lie.or Reg.No. Date Plan check applicant
HOME OWNER-BUILDER DECLARATION Name ,' �L �i ,
I hereby affirm that I am exempt from the Contractor's Address G.. L
License Law for the followingreason Section.7031.5, Busi- 2 6 8 a
( City (3j � �l✓ T.I.
ness and Professions Code): # 0 0 0 0 o 5
i, as owner of the property, am exclusively contracting ' '
with licensed contractors to construct the project 2 0 0 1 6,00
(Section 7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY 0 0 0 1 0 0 6_
I hereby affirm that there is a construction lending agency 0. •1 6—80
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
aut rize represent 'ves of this County to enter upon the
ove- ent' ned p op rty for ins tion purposes.
Slarl
re of Perhtittee Date