HomeMy Public PortalAbout10133 BOGUE ST_Plumbing__ ysAear +y �-ag APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBINU
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. I GROUP ZONE PERMIT NO.
)
PLUMBER VALLEY BOULEVARD PLUMBING CO. RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS
900 EAST VALLEY BLVD.
ROSEMEAD BUILDING '10%3
CITY TEL. NO. AT• 2"2119 ADDRESS
L.OUNT E No. 93M EXPIRES 6.30- -S*1 LOCALITY
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET (TOILET) Q 0.50 15 ,��v ADDRES
BATH TUB Q 0.50( is-Z3 CITY EL. NO. a
SHOWER Q O 50 I I HEREBY A NOWLEDGE THAT 1 HAVE READ THIS
1 LAVATORY (WASH BASIN) Q 0.50 IAPPLICATION AN STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING PLUMBING.
KITCHEN SINK Q 0.50 -� 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY Q O Sol ANGELES COUNTY LICENSE. OR i AM THE LEGALO�W/Ny/E�/1�'
OF THE RESIDENTIAL -PERTY DESCRIBED ABOVE.
%!'LI'
GAS SYSTEM OUTLETS Q 0.50
SIGNATURE OF
WATER HEA R Q O 50 I PERMITT _
1 SLOP SINK Q o.5o I INSPECTION RECORD
FLOOR SINK Q 0.50 1
FLOOR DRAIN Q 0.'501
DISHWASHER Q 0.501
DRINKING FOUNTAIN Q O 501
IURINAL Q 0.501 •J
IHOUSESEWER Q 0.501 1 Q
MISCELLANEOUS 1 I U•
o
I—I
I
APPROVALS
1 I DATE INSPECTOR'S NAME
1 1 ROUGH PLUMBING
1 _
1 1 GAS PIPING «r Z
1v '✓
GAS VENT � /G
CESSPOOL Q 1.00 I I CESSPOOL
SEPTIC TANK: 11 SEPTIC TANK
DRAIN ( ) PIT ( ) a 1 00I 1 SEWER
PERMIT . I 1.00 GAS TEST � f�c�i���. ' 3-a+�
v
I UTILITY CO. NOTIFIED -
TOTAL FEEI lo 6
FINAL
DEPARTMENT OF COUNTY ENGINEER L g '
NG
DIVISION OF BUILDING AND SAFETY �,)/-? � PERMIT APPLICATION
��COIINTY OF LOS ANGELES a BUILDING A�•
�D /31;+5 1AM J: FOX, COUNTY ENGINEER ,ADDRESS A e c u� w 1)
FOR APPLICANT TO FILL IN LOCALITYNEAREST
BUILDING //�� CROSS ST. f/�' t� ���
ADDRESS � T /30�(y P-
�- 1 DISTRICT-NO.� GROUP ZONE PERMIT N0.
LOCALITY )'1-- . Q
NEAREST /
CROSS ST. RECEIVED BY Ready for Inspection DATE ISSUED
O W N E R / /C 2 S/`-INI+ 4 0 f `�/ ��✓�� F�® ����
MAIL INDUSTRIAL
ADDRESS S� )ryl 't_ //�� WASTE APPROVAL
CITY TEL.NO./JU ?C12-57 INSPECTION RECORD
1 r
PLUMBER S-`
ADDRESS
CITY TEL.N0.
❑STATE
LICENSE NO. n COUNTY J
PERMIT FEES z
•IUMSER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET(TOILET) @ 0.80
O
BATH TUB @ 0.80
SHOWER @ 0.80
LAVATORY(WASH BASIN) @ 0.80
KITCHEN SINK @ 0.80
LAUNDRY TUB OR TRAY @ 0.80 A\11
�� `tI' } ,
SLOP SINK @ 0.80 l
t�. n �(/ ,� ` •.
FLOORSINK @ 0.80 { I1 r^
FLOOR DRAIN @ 0.80 O 0`� A Ov
DISHWASHER @ 0.80 sAv ro A .01
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80 l
GAS SYSTEM..............OUTLETS @ 1.00 W
WATER HEATER @ 1.00
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDERSLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE y� C® GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL(PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE � .. n A n I�(� .�_
OF PERMITTEE-.�.A/��.J---...-. `k""^-'—��
FINAL
76A667 DSS 17 Cdb 12-53 D
�,,� WORKERS'•COMPENSATION DECLARATION
IT;ereb , if
firm that-I 1-1 --,20-6026 certificate of copse it td'self m_ ,20-0026 DPW 4,87, ._APPLICATION.. FOR PLUMBING: PERMIT.
y ., -76A667A '
r "hyo a chff'Workers'Compensation Insurance,or a CE 817(REV 8Y86 )
tie co�yicate o
,tfiereof"(Sec 3800,,Lab C )
,COUNTY,OF LOS ANGELES DEPT. OF PUBLIC'WORKS.
Policy tgo. Company
Certified copy is hereby furnished
FOR APPLICANT TO FILL IN PRINT OR BUILDING ,,/�
Certified copy is filed with the county building.ins'pection ( ) ADDRESS 0�3 �� ST. f"v 4 2.
NUMBER' "FIXTURE OR ITEM- FEE v
department t_ r �° LOCALITY
WATER CLOSET(TOILET)
Date Applicant NEAREST
CERTIFICATE OF EXEMPTION^FROM WORKERS'I BATH TUB CROSS,ST
COMPENSATION INSURANCE ' �/� OWNER- w�y„�
SHOWER V
(This section-need not be.completed-if the work involved by
MAIL
the permitis.fer.one'hundied'dollars ($100) or less:)'• �' LAVATORY ADDRESS "[{.f ,!}�t'r q �icgfy�
I certify that',.the'performance of lhe`work for which this per-
SINK
mit is'issued, I shall not employ anyperson',in any manner,so CITY TEL NO
as-to become sublect to the Workers'Compensation Laws DISHWASHER
CONTRACTOR 00jr4U�Z ,
Date ) Applicant CLOTHES WASHER ADDRESS Tff� �j.�M1r"*S A(iD r�7
NOTICE TO.APPLICANT.,If, after making'this,Certi,ficate of Ex SWIMMING=POOL RECEPTOR _
einptiorn;y`ou should become subject to the Workers'Compen- CITY• TEL NO .
sation Prov)s"Jons of'the Cobor.�Code;'you must-forihwilH!comp; 'LAWN SPRINKLER SYSTEM •`5• "
ly with such provisjons or,this permit sholl'be5deemed-revok- STATE UC
ed,. WATER-HEATER" - LICENSE NO CLASS
:'LIGENSED•CQNTRACTORS DECLARATION - _ DISTRICT NO L.PROCESSED.BY,
I hereby affirm that'1 am licensed under provisions'of Chapter GAS SYSTEM - OUTLETS
9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER
and PPofessions Code, and my license is in;full.force and ef= 5'PER SYSTEM FINALI/ VALIDATION
e
ttt DATE'. / (J
License Number 'Lic .Clos's 'O
w FINA �• U
Contractor Date ' O
U
I arr exempt under SLUec
^, B.&P•C for this reason N
Plan check fee
�.
Date PLUMBING PERMIT ISSUING FEE$ 1060
` Signature
,TOTAL FEE
SINGLE FAMILY _ 3
HOME OWNER-BUILDER DECLARATION Plan check applicant WA�f 5
i USN— �N.
I hereby affi?rn,that I am exempt from'the Contractor's License as Name ANT
Law for the"following reason (Section 7031 5, Business and
Professions Code t
Address'jip�3�'S'. WbtNUC�rN`(tl!V (L�. ,3307 1 io.0
� 1, ds owner';of,'the property, ,,will do the work^and the ; City, WJ LAJw el No. ?fes � 1 ITEMS
.structure isnot intended or offered fo'sale(Section 7044,
Busme'ss`and Professions Code) `' T��TAL •' 2�-m 50
' 7� `'
`,:CONSTRUCTION LENDING-'AGENCY'_; °. GIE�.Y�- ., r �8.5`I
I.hereby affirm`that there i"s a construction lending agency forGRANGE t, �` ' `,•eUI�- :'
the performance of the work for which,this permit is issued
(Sec ;3097,;Gv, C-)d= : ma��'yy �f�R(,�;�YYii 9/ 9 ii�.t G
Lender's Name , - ` .� .-•• - o '• 0Dbb—tJI.►i!I 7�19A7
Cerider's Address 5773 1 W8:29
I certify that l have read"this dpplicatfion and.state that the " ','•°i :' ;
above information is correct- I agree to comply-with,all County ,
ordinances and State I'aws.regulating Plumbing, and..hereby' f
authorize -representatives of this County to enter upon•the -
above-mentioned property for,!nspection purposes. - _
SEE REVERSE FOR EXPLANATORY-LANGUAGE- =
gnature Permittee `Date