Loading...
HomeMy Public PortalAbout9064 BROADWAY_Plumbing__ -SAESTy,;2B;TaBE TEMPLE CITY 4 '7 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS C WILLIAM A. JENSEN. SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN Geo ESST. J NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET S1.25 MAIL _ BATH TUB 1.25 ADDRESS (� CITY TEL. NO d SHOWER 1.25 LAVATORY 1,25 CONTRACTOR SINK 1,25 ( ADDRESS DISHWASHER 1.25 J CITY TEL. LAUNDRY TUB 1,25 CO*TRACTOR'S STATE ❑ REGISTRATION NO. COUMY ❑ CLOTHES WASHER 1.25 DIST NO. GROUP ZONE P OCE 'BY WATER HEATER 1.50 CAS SYSTEM OUTLETS 1.50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .00 INSPECTION RECORD d O v m O - u W a N Z DA APPROVALS DATE INSPECTOR'SSI NIITITHE UNDER�6LB9WORK / PERMIT S 2 00 hA ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ TH 15 APPLICATION AN STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULA, NG HOT WATER HEATER PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF.AND INTEND TO RESIDE IN, THE ABOVE DESCRIBED RESIDENT L P PERTr. UTILITY CO. NOTIFIED /1 SIGNATURE OF PERM ITTE �- FINAL VALIDATION ROBERT A. WOOD CK. M.O, cnsH SUPERVISING MECHANICAL ENG'R Lfl' 235612 WIR21 5 D 5.7 i"' 76 66".CE#81 7�'5/63 APPLICATION FOR . PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER _ BUILDING AND SAFETY DIVISION BUILDING h JOHN A. LAM IE. COUNTY ENGINEER ADDRESS D L fOa- 1U n. WILLIAM A. JENSEN. SUPT OF BUILDING -� LOCALITY e FOR APPLICANT TO FILL IN NEARESxS CR CAR T. NUMBER FIXTURE OR ITEM EACH FEE OWNER I O WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS SHOWER 1.25 CITY TEL. NO. LAVATORY.iy��V� L.P� 1.25 n- CONTRACTOR D Y SINE ,/�'7/I �„� 1.25 'ADDRE&4 J/LIV N C G' DISHWASHER 1.25 "CITY /� TEL. NO. YVV �6 p LAUNDRY TUB 1,25 CONTRACTO 'S STATE REGISTRATION NO. (o .Z COUNTY CLOTHES WASHER 1.25 DISTRIC aND�/ GROU ZONE PROCESSED BY _ WATER HEATER 1.50 � } GAS SYSTEM OUTLETS IAl D_ 1.50 —� WASTEINDUSTAPP WASTE APPROVAL O OUTLETS OVER 5 PER SYSTEM .SO V INSPECTION RECORD z 0 I-A d N Z APPROVALS DATE INSPECTORB SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK C ROUGH PLUMBING TOTAL FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS PLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY OR OINANGES AND STATE LAWS REGULATING HOT WATER HEATER PLO MOING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED .../OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE EGAL OWNER OF.AND INTEND O RESIDE IN,THE ABOVE CRIB ESIDENTIAL ROPERTY. UTILITY CO. NOTIFIED SIGNATURE OF PERMITTEE 62 -FINAL VALIDATION ROBERT A. WOOD cK. M.0. CASH SUPERVISING MECHANICAL ENG'R L1:D 8 85 8�, I-MY 14 5 D 7,225- 4 ' COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY- WILLIAM 1: FOX, County Engineer FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE �ER� T NO. PLUMBER ��� RECS VED�BY READY FOR UUD L7�J FIRST INSPECTION //� 1 y ADDRESS a�/1l!�5'lellBUILDING �� 01TY /// ,..n/�C�jy/ TEL No./��. 17 ADDRESS COUNTY LOCALITY //,/J'✓`�(i(%(.,,/ LICENSE NO. EXPIRES 67 NEARE5T� PERMIT FEES CR055 fiT. [JJ /rt NUM©ER TYPE OF FIXTURE OR ITEM FEE OWNER �iV MAIL X WATER CLOSET(TOILET) @ 0.50 $ J ADDRESS .Y �J BATHTUB @ 0.50 CITY / '�j , — /TEL. No 17 SHOWER @ O.SO I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE 1'0 COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. -- 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. GAS SYSTEM—OUTLETS ® 0.50 SIGNATURE OF WATER HEATER @ 0.50 PERMITTEE SLOP SINK @ D.So INSPECTION RECORD _ FLOOR SINK ® O.SD FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN ® 0.50 URINAL ® 0.50 _ Q HOUSE SEWER ® 0.50 Z_ MISCELLANEOUS ❑ APPROVALS DATE INSP CTOR'.R NAME ROUGH PLUMBING ryl!lC] S_ -"P SAL._, GAS PIPING GAS VENT CESSPOOL @ 1,00 CESSPOOL SEPTIC TANK• SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT t.Oo GAS TEST Q� UTILITY CO. NOTIFIED _ 9 TOTAL FEE .� FINAL 76AG6: DBS#17 6-52 7GA667-CE817 6-60 APPLICATION FOR PLUMBING PERMIT ' COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING e 6 �- JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS WILLIAM A. JENSEN, SUPT OF BUI LDiHG 1.. . _ LOCALITY '• FOR APPLICANT TO FILL IN NEAREST CROSS Si. NUMBER FIXTURE OR ITEM OWNER _ WATER CLOSET MAIL BATH TUB ADDRESS - CITY �j /7 TEL. NO. SHOWER LAVATORY CONTRACTOR S SINK ADDRESS 2 2 ,��� p' DISHWASHER CITY CONSTRATION 1 l t� �y CO A7 LAUNDRY 7U8 REGISTRATION NO. / / J� CLOTHES WASHER DISTRICT NO. GROUP Z NE EBBED BY WATER HEATER S Q rs L GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD a O V O V 0.> Fl ° OR F T em $ APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2100 UNDER SLAB WORK TOTAL FEE ROUGH PLUMBING GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS ORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY OROINA 9 ND ST L REGULATING PLUMBING. HOT WATER HEATER 1 HEREBY CER T A R IS RE D/OR PLUMBING FIXTURES LICENSED AS REOUIR S C N T OF GAS TEST CALIFORNIA OR TNA VE DESCRIBED RESIDE CEA T UTILITY CO.NOTIFIED ^ SIGNATVRE � GF PERMITT FINAL ®r ALIDATION ROBERT A. WOOD, U.0. OMNI SUPERVISING MECHANICAL ENG'R ✓ �F�o 9 0 7 8 JU-N 2 3 5 0 3.0 0 M WORKERS'COMPENSATION DECLARATION APPLICATION P®p ICA TION FOR PLUMBING MBING PERMIT 20-0026 DPW 4/90 P'i Ir IL ir.i'Y II CI 6.1�1H7 1�1 /H9 C . hereby, affirm ate o have a certificate of consent to Self r a 76A667A ^ sure,or a certificate of Workers'Compensation Insurance,ora �ILfll certified copy thereof.(Sec.3000, Lab. C.) Policy No. Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS � , Certified copy tt hereby furnished. - ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy isfiled with the county building inspection _ ADDRESS q6J� F�a.•j /vyy} (�", department. NUMBER FIXTURE OR ITEM @ FEE / LOCALITY ,`m GC G!)' C I/ &c) Date Applicant WATER CLOSET(TOILET)' .NEAREST, CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. SV L qW A4 COMPENSATION INSURANCE SHOWER OWNERLOvvPVrF L DMA/R4 67_7— (This section need not be completed if the work involved by MAIL the permit Is for one hundred dollars ($100)or leas.) / LAVATORY - ADDRESS qQ F /LpAl 1) I certify that in the performance of the work for which this per- mit is issued; I shall not employ any person in any manner so SINK CITY7—r.W,,�Ljr G TEL. NO 8 �rz5-.t as to become subject to the Workers'Compensation Laws, DISHWASHER S 6 S-3_CL CONTRACTORHLRmJ�w m/RI Z Date_ / Applicant L7 f'/�/H7 A+'� FJT��S CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESSSWIMMING POOL RECEPTOR emotion,you should become subject to the Workers'Compeh- cation ruch provisions of the or this Code,you must forthwith L TEL.NO. Q P ycomp'- LAWN SPRINKLER SYSTEMS CITY � � � z leydwith such provisions or This permit shall be deemed revok- - STATE _ LIC. WATER HEATER LICENSE NO. I t/�Q CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO `/, PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect. HOSE BIB DATE License Number /L{/D s Lic Class�y]_ O p Contractor (� FINAL 5 fl_ I/L`�/l h'1/9c✓R Am/�asbote 6___3- 76 BY ACCT. cc 00 C I am exempt under Sec 3303 9L70 U B.BP.C. for this reason NU L�7/DLdYrCS ��G. LU ,_ _ Plan check fee I ITEMS H Dat PLUMBING PERMIT ISSUING FEE$ �' � D Z Signal rep .-o .>„- �.,�,,.--/ T17TAL. 91_ 70 — TOTAL FEE a SINGLE FAMILY CHECK 91.70CHANGE .00 HOME OWNER-BUILDERDECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Nome - Law for the following reason (Section 7031.5, Business and Professions Code): - Address 0000-0001 5/ 3/96 I, as owner of the property, will do the work and the City Tel. No. 6203 1 AM10:20, structure is not intended or offered for sale(Section 7044, Business and Professions Code). D -. CONSTRUCTION LENDING AGENCY 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 Nome Lender's Address I certify that I have read this application and state that the D above information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the ybo e-mentioned or erty for inspection purposes. / SEE-REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date APPLICATION O;m that COMPENSATION DECLARATION APPLICATIOI�N POR. PLUMBING' PERMIT 20-0026 DPW</87 7cerHiierd,c.Fp,,y1hereof fiim that have a cerUhtate of consent.to self in- 76A667A rtificole of Workers'Compensation'Insurance,oraCE BI](REV. B/86)(Sec3800, Lab. Gj COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ComponyPy y furnished.d copy is fi ed w BUILDINGd<o is.hereb 1 FOR APPLICANT TO FILL IN(PRINT OR TYPE) ;. 1 - ith the county building inspection ADDRESS 9010 department. .. _ NUMBER FIXTURE OR ITEM @ FEE - - - - - LOCALITY yPLE C/7'Y . Date- � ' Applicant � - WATER CLOSET(TOILET) ® I � NEAREST ' CERTIFICATE OF EXEMPTIOMFROM WORKERS' BATH TUB 4`S�otcwL 1ldY►AA , CROSS ST, S'UL 7/At* — - - COMPENSATION-INSURANCE SHOWER' OWNER: 1-1, U0V e_ (This section need not be completed If the work involved by [ MALL the permit Is for one hundred dollars ($100) or less.) / LAVATORY - - a' d ADDRESS T ala q�OgflN I certify that in the performance of the work for which this per- SINK CITV e� .� TEL"NO. L mii is issued, shall not employ any person' any manner so - 2/44 CC C s a�S Y7� !� / y as tobecomesubject to'the Workers' Compensation Laws. DISHWASHER CONTRACTOR 0,10J� /,�,'1 QttJAIC BUIG I�C� - Date � -Applicantl.t'"^`'•��"q •- CLOTHES WASHER ADDRESS NOTICE , y APPLICANT: o a subject to this Certificate of Ex- SWIMMING POOL RECEPTOR - sation r you shouldth ecome subject to the.Workthwith mpen- CITY TEL NO. cation.provisions of the Labor Code, you must forthwith comp- LAWN.SPRINKLER SYSTEM ly with such provisions or this permit shall'be deemed.revok- STATE LIC ed. - - WATER (/HEATER' O L �L LICENSE NO. CLASS / LICENSED CONTRACTORS DECLARATION DISTRICT NO. P CESSED Y I hereby affirm that am licensed under provisions Of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3o the Business OUTLETS OVER - 5-16W . fed Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL V DATION d DATE License Number Lic.'Class - ^ U - FIN 2 Contractor Date BY O OI am exempt"under Sec - W a B 8P.'C. for this reason- Plan check fee - I _ D Z t Date: - - PLUMBING PERMIT ISSUING FEE S Signature roTAL FEE 0 5 7.3 A SINGLE FAMILY - HOME OWNER-BUILDER DECLARATION Plan check applicant 5 . T I hereby affirm that am exempt from the Contractor's.License Name5'0 Law for the following reason (Section 7031.5, Business and - Professions roCode): _ Address 3 4.5 0 5 TYI"I, ad owner of the property, will,do rhe work and the Gty Tel. O9' O'� 8 Yyy-'"LLL structure is not intended or offered for sale(Seaton 7044, - . Business and Professions Code).ir CONSTRUCTION LENDING,AGENCY - - - I hereby affirm'that there is a construction'lending agency for the performance of Ihe,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 ,D ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. 9_/,Tq , SEE REVERSE FOR EXPLANATORY LANGUAGE '§ignature of Permittee r -Dote - . . WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT 2 I.hereby, affirm that I have a certificate of consent to self 76A667A 20-0016 DPW 4/90 sure,or a certificate of Workers'Compensation Insurance,ora a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS 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 ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant y WATER CLOSET(TOILET) r f / NEAREST - CERTIFICATE OF EXEMPTION FROM WORKERS' / BATH TUB t CROSS ST. COMPENSATION INSURANCE OWNER SHOWER (This section need not be completed if the work Involved by r MAIL 4 the permit is for one hundred dollars($100) or loss.) J LAVATORY ADDRESS' I certify that in the performance of the work for which this per- SINK CITY TEL. NO. mit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date- Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY - TEL. NO. sation provisions of the Labor Code, you must forthwith comp; LAWN SPRINKLER SYSTEMS iy with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER - LICENSE NO, CLASS LICENSED CONTRACTORS DECLARATION DISTRICT-NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the BusinessOUTLETS OVER - t l" c"'� y fed Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION U HOSE BIB DATE License Number Lic. Class W J FINAL ¢ U. Contractor Date BY ❑ I am exempt under Sec. B.BP.C. for this reason •-r / l Plan check fee , I p�.E�'� Date: - PLUMBING PERMIT ISSUING FEE-$ , �s W Signature )r�•{s i. f„T SINGLE FAMILY .$ _ 7 ~ TOTAL FEE �5 x ViV_bi� HOME OWNER-BUILDER DECLARATION Plan check applicant 9.1s I hereby affirm that I am exempt from the Contractor's License Name � Low for the following reason (Section 7031.5, Business and Professions Code): Address Utl�u3-C+Q!7i �f 5! I, as owner of the property, will do the work and the City Tel. No. ���9 1 - in°e structure is not intended or offered for sale(Section 7044, Business and Professions Code). Poo.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 lop, - above information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby - authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE'REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date