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HomeMy Public PortalAbout5938 BURTON AVE_Plumbing__ 76AG67 CE#8175-61' APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING ND ASAFETY DIVISION PBUILDING JOHN A. LAMBIADDRESS WILLIAM A. JENSEN, SUPT OF BUILDING E, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN CROSS TT. NUMBER FIXTURE OR ITEM OWNER WATER CLOSET MAIL BATH TUB ADDRESS. �/ - L'/U v CITY TEL NO. O �/ SHOWER CONTRACTOS M LAVATORY ADDRES102,02 SIN% DISHWASHER CITY TEL. NOCONTRACT 's J � TA LAUNDRY TUB REGISTRATION NO. //� cL- COIINTY CLOTHES WASHER DISTRICT NO. GRTOU�P` ZONE P SEED BY WATER HEATER Ji �_ I ��[4�ZL(.. O INDUSTRIAL GAS SYSTEM WASTE APPROVAL V INSPECTION HECORD C O V W d Z o SAO PER ITEM OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2100 UNDER SLAB WORK TOTAL FEE ROUGH PLUMBING LalGAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE REAP THIS APPLICATION AND STATE THAT THE ABOVE 19 CORRECT ANO AGREE TO COMPLY GAS VENT O WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATERn-am'q '- G PLUMBING. - V 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AMO/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THA h�E�L AL OWNER OF THE ABOVE - DESCRIBED RESIDE IAL P P TY. UTILITY CO. NOTIFIED SIGNATURE Stu OF PERMITTE FINAL VALIDATION ROBERT A. WOOD crc. M.0. CASH SUPERVISING MECHANICAL ENG'R j}C10 7 7 8% JM26 5 A 3501 �. vattGs�-c��Lisz r APPLICATION FOR PLUMBING PERMIT 1 • COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, CcmiT En oar ADDRESS S! CASSATT D. GRIFFIN. Sup I el Building LOCALITY FOR APPLICANT TO FILL. IN NEAREST CROSS ST. NUMBER FIXTURE FIXTURE OR ITEM / WATER CLOSET OWNER rS . C O— O MAIL BATH TUB ADDRESS 3 SHOWER CITY j �\TEI. NO. T LAVATORY CONTRACTOR ©W yL Q r" SINK ADDRESS DISHWASHER CITY TEL NO. LAUNDRY TUB CONTRACTOR'S STATE ❑ REGISTRATION NO. COUNTY Q. CLOTHES WASHER DISTRICT NO: GROUP ZONE I READY FOR INSPECTION WATER HEATER / GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD - f P/9 .' i h'-23—.s� TOP OvT rFs ? EQvO w/ L U R/i✓ �/r 4YJ < APPROVALS $1.00 PER ITEMDATE INSPECTOR'S SIGNATURE CT5 OR FDURE - - f✓J UNDER��'L$BWSORK PERMIT $ 00 ROUGH PLUMBING TOTALFEE A GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 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 IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REOUI RED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITYCO. NOTIFIED DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE OF PERM ITTEE S,y II Yq� l ��p� FINAL ROBERTA.WOOD. ®' VALIDATION SUPERVISING MECHANICAL ENG'R CK. M.0. CASH { 2 1 3 2.9% JAN 26 5 A 0 0 5.0 0 A l� WORKERS'COMPENSATION DECLARATION - - APPLICATION I�®Y'lP IL�Itl�1�10C1'LY PERMIT I FerebyJ�- "Fvm that I have o certificateof consent to self In �6A66�A PW 4/87 n surev'or a certificat6 of Workers'Compensation.lnsurance,.or a 'CE 817(REV. 8/86)' ,ul certified copy thereof (Sec. 3800 Lab. C.) - - Pololhcy 457 Company'7Annh1i L Ind .COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS r`Certified copy is hereby furnished, ., 4Ltl4-J'I FOR APPLICANT TO FILL IN (PRINT ORTYPE} BUILDING Certified copy is filed with the county building inspection ADDRESS 5938 North Burton NUMBER FIXTURE OR ITEM FEE department @ . .. ., LOCALITY San Gabriel, CA Date S�77/_w,�RQ Applicant WATER,CLOSET.(TOILET) NEAREST - CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB - CROSS SL Hermosa • - _ COMPENSATIONINSURANCE SHOWER - OWNER Bohden KOSt1V (This section need not be completed if the'work involved by MAIL the permit is for one hundred dollars ($100)or leis.); - LAVATORY' ADDRESS 5938 North Burton Icertify that in the performance of the work for which;his per _ 'mit is issued;I,shall not employ any person in any manner So - SINK, CITY -San Gabriel TEL N0.286-7970 as to become subject to the Work Cornpensation Laws. DISHWASHER _ CONTRACTOR A 'Date Applicant ` CLOTHES WASHER ADDRESS NOTICE TO APPLICANT.'If,'ofter a ing.this Certificate'of-Ex- _ - 1 350 E. I as rl'1 ms Dr.: emption,you Should become•su j6ct to the Workers'Compen- SWIMMING POOL RECEPTOR sation provisions of the labor'C de, you must forthwith comp- LAWN SPRINKLER SYSTEM . CITY .San Gabriel TEL No 286-1141 lywith such;provisions or this permit shall be'deemed revak- STATE LIC �+ ed. _WATER HEATER LICENSE NO.221751 CLASSG-20 LICENSED CONTRACTORS DECLARATION D15TRICT NO, SED BY Q_� ' I hereby affirm that I am licensed under provisions of Chapter one GAS SYSTEM One OUTLETS ©_ v ' 9(commencing with Section 7000)of Division of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- - SPER SYSTEM FINAL 'VALI N Y feet DATE License Number 771751 Lic. Class_ C-7Q G FINAL U ContmctcrBrVant Hta R A/( Date A�( Date-5/22/8__ .-" BY O n H am exempt.under Sec: - Z4:-''L .W �c '- 'B ap:G. f- is reason _ 41alon check fee - ,' D U) Date: ' t PLUMBING PERMIT ISSUING FEE$ ,Signatur - TOTAL FEE - x SINGLE FAM �/E OWNER-BUILDE ECLARATION - Plan check'appli<a nt p' 5 I hereby affirm that I am exempt om the Contractor's License Name - ,sf' ' Law for the following reason (Section 703.1:5,• Business and tfT.CT.v Professions Code): Address 1 - 1'350 E. TaS 'ILiMS Drive "a3l07 :" .._ 16.5.0 O I' as owner of the property, wilkdo jhe_work and the Gty Sart Gabriel Tel. No. 28(_1141 _ 1 IT06 structure is not intended or offereci sale'(Section 7044, 1 - •. Business and Professions.Code). D TOTAL 16 . 50 CO Ca- CONSTRUCTION LENDING AGENCY t' - 'CHECK 16.50 I hereby affirm that there is construction lending agency for - ' - .u0 the performance of the work for which this permit is_issued _ 4ntun7G nn1n7G (Sec. 3097,Civ. C,). Lender's Name - UODO-0001 6/ 589 Lender's Address ' - 3784 1 PML:18 I certify'that I have read this application and state that the above information is correct. I agree to.,comply'with all County D , or nces a11taawsregulatingPlumbing,.and herebylitho( eves of 'this County to enter upon thea ov erty for inspection purposes. - - /22!$� e SEE REVERSE FOR.EXPLANATORY LANGUAGE /Sig 46ture Cf Perini -Dote - T i-,/ Y nF tOS ANGELES TEMPLE Coi'i 4 0=6o PERMIT DEPAl" 04C,91160021 I :,� F PUBLIC WORKS 9701 LAS TUNAS BUILuING AND 511,E€iTY f LAND DEVELOPMENT TEMPLE CITY LA v1780 PHONE: (62^) 2E5-9488 EXT: EC;L 10: ITR: 51123 LT 101 5938 BURTCN AV N DESCRIPTION: "Gur SCAB CA Yl i2oVi ;)UA.'JTI'Y: UOM: NEAREST CRCSS -"R�ET: LAS TUNAS 153It6-014-060 101 PERMIT ISSUANCE FEE -i5 THOMAS Pr,Gl'; 556 -RID: G3 _CCAll-,': S-%N GABRIEL :07 BATHTUBS/SHOWERS 2.00 FIX 2.40 i y 21 HOSE BIBB(S) 2.00 FIX �;.40 _ISSUED_ONPROCZSMFB7PLAN BY `5 LAVATORIES/SINKS 1.00 FIX 16. 0 109/'3/04 JG 03/2'105 (411 i4-ITER CLOSET/URIN.'U- 1.00 FIY. 20 TOTAL FEES LEDAVID (626) 679-6353'.' SUR ON AV ,,,/52:1130 'I�I rLIN OF 1",11K PLUAING OR NEW 'PT;�RC-OM —TEL. NC. N r, (626) 285-79-1- t6l` - MIS310N ; C�00N_Djff-c,�,F SAN .A9RH:L CXA"a�i1726 �_W 'CON�nA6i Ont IFL. 'iWAI FAK '(INSfRUCTION (626,1 2.S'6--9'31- I - 611 ', MISSION RD. LIC. i I Un_ur_p _%4G WORK-- SAN ]AGRIEL, CA 91,77(1, 53613" R I 1 J EF__SE­RV-CE 'T PLAS11C YIN MAL Y W61x. sAm ,626) 1�53 ". 4T,4 ��T, :AB1.1-� NG: ALHAMBPA, ,A 91801 ------- ---- AWN—so k i-C ES GAS (UTILITY_C0VPANT7_,,__ fl' !GRAY-WATER SYSlnf____l__ (REPORT ID: DPR263 ROUTE TO: BS050E