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Home My Public Portal About4846 CAMELLIA AVE_Plumbing__ 76A667 17 11-49 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT O. GROUP ZON5/ / N/ / Q/ / / PLUMBE RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION _ ADDRESS to Nd --� BUILDING CITY TEL. No. AD DR E5fi COUNTY / —a LOCALITY LICENSE NO. / EXPIRES NEAREST PERMIT FEES CROSS ST. N TYPE OF FIXTURE OR ITEM FEE OWNER MAIL / �} ' WATER CLOSET(TOILET) @ 0.50. IS ADDRESS BATH TUB @ 0.50 CITY /� TEL. No. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS . LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. JI CERTIFY THAT I POSSESS THE ABOVE VALID LOB LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTIAL ROPERTY DESCRIBED ABOVE. GAS SYSTEM OUTLETS @ 0.50 SIGNATURE OF WATER HEATER @ 0.50 I PERMITTE SLOP SINK @ O.SD INSPECTION RECORD FLOOR SINK @ 0.50 (FLOOR DRAIN @ 0.50 DISHWASHER @ 0.501 1 [EJ�DRINKINGFOUNTAIN @ 0.50 INAL @ 0.50 Q USE SEWER @ 0.50 Z MISCELLANEOUS I [7 0 I I I I �— I I APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING )I �Ai�I�u� (� 1 1 GAS VENT G lest �/I' ICE55POOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER p PERMIT 1.00 GAS TEST , !t)A) �� UTILITY CO. NOTIFIED 1 � ../� 1 / TOTAL FEE 15c� �O I // FINAL 16Nfi61 ICE-BI]I 1/]" � APPLICA ION FOR PLUMBING PER IT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDIrvG i/ // ��L/•/%�� ADDRESS HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET • 2.00 - OWNERll./,aI'�/K MAIL nn LL BATH TUB 2.00 ADDRESS SHOWER 2.00 CITY A TEL. NODS/ ; yyy LAVATORY 2.00 CONTRACTOR OW r �• 1 /� 11F— /F--4 SINK 2.00 ADDRESS ��.x�C�J• / h� / Ctic� DISHWASHER 2.00 CITY �� /� .� 7-v' " TEL. NO. - �2 U U CLOTHES WASHER 2.00 STATEiS//� LIC LICENSE NO. G� CLASS SWIMMING POOL RECEPTOR 2.00 DIST 1-1 NO.G`OUP ONE PR CES D LAWN SPRINKLER SYSTEM 2,00 �' Q� � WATER HEATER ZOg INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 2.00 INSPECTION RECORD a OUTLETS OVER 5 PER SYSTEM .30 O Jz 6/77 /Jo n�Spa. Ste, z Plan check fee S66 Reverse PLUMBING PERMIT ISSUING FEE 5 f_ .%0 r TOTAL FEE .), APPROVALS DATE INSPECTOR R slcvaru RL Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING .�i Address GAS PIPING j, 7 City Tel, No. GAS VENT HOT WATER HEATER STATE ACKNOWLEDGE THAT REE READ THIS APPLICATION AN B ALL THAT THE ABOVE IS CORRECT AND LAWS E COMPLY PLUMBING FIXTURES WITM ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST �d I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AHD/OR UTILITY CO. NOTIFIED LICENSEDAS REQUIRED BY LOS'ANGELES COUNTY AND STATE OF CALIFORNIA 0R THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE 0ES; RI ED R I0 ENTIA PROPERTY. FINAL V SIGNATURE /V / OF PERMITTEE / <� PERMIT VALIDATION PLAN CHECK VALIDATION CK. M.O. Casn CK. M.O: CASH READY FOR FINAL INSPECTMq p, 5 5 D %.5 0 Ay)6 Ove (j 7BA667-CE817 3-59 APPLICATION FOR PLUMBING PERMIT � COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BmLDING TORN A. LAMBIE. County Engineer ADDRESS rl 6 /. CASSATT D. GRIFFIN. Sup I of Building /J LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. J NUMBER FIXTURE OR ITEM OWNER WATER CLOSET [/ ADDRESS / (l e �L 04 BATH TUB SHOWER CITY �✓ TEL NO. LAVATORY CONTRACTOR SINK ADDRESS DISHWASHER CITY TEL NO. CONTRACTOR'S STATE ❑ LAUNDRY TUB REGISTRATION NO. COUNTY ❑ CLOTHES WASHER DISTRIC NO. I GROUP ZONE P CESSED BY s WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL - INSPECTION RECORD ® $1.00 PER ITEM OR FIXTURE APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ Z OO UNDER SLAB WORK , TOTAL FEE ROUGH PLUMBING GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT +. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER LORCERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES S REQUIRED BY LOSANGELES gUNTY ANDSTATEOF GAS TEST THAT 1 AAt'THE LEG WNER OF THE ABOVE RESIDENTIA R iY. UTILITY CO.NOTIFIED E ,,j, �] pp"�ITTE FINAL /p Q/ K,"�Fe lash ®P. VALIDATION ROBERT A. WOOD. cK. U.0. CASH SUPERVISING MECHANICAL ENO'R LACp'I5 9 7 3`2 FEB 3 5 A 3.0 0 COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer �.�.DIVISION OF BUILDING & SAFETY L I N " WILLIAM J. FOX, County Engineer wff FOR APPLICANT TO FILL IN DIS RIC.hNO. GROLJP ZONE PE . PLUMBER RECEI-VED/uABYn READY�XjDR DATE I9HUED FIR5T I NBPEFCTION ADDRESS /- / ADDREBUILD'SS NO CITY TEL No. d COUNTY LOCALITY LICENSE NO. EXPIRES NEAREST PERMIT FEES clzass ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNry�ER / I d.l/ / MAIL WATER CLOSET (TOILET) Q 0.50 G p AD DR EBB q�� //�� {{ /• p BATHTUB Q 0.50 /y CITY 791rt/i[YL!<� fJiLeJ TEL. NO. .- SHOWER Q 0.50 'R5 0//.�, 1 HEREBY ACKNOWLEDOE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) Q 0.50 ,@,y APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK Q 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOB LAUNDRY TUB OR TRAY Q 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. GAB SYSTEM-OUTLETS Q 0.50 / /J Q A SIGNATURE OF WATER HEATER Q 0.50 PERM ITTEEEEAl-A" SLOP SINK Q 0.50 INSPECTION'RECORD FLOOR SINK Q 0.50 FLOOR DRAIN DISHWASHER DRINKING FOUNTAIN Q 0.50 7 /� w i Q' �. 1 T 1Z h�.� %l✓6A�1- I 1 URINAL Q 0.50 Q HOUSE SEWER Q 0.50 Z MISCELLANEOUS L7 APPROVALS DATE I!.fIP`1E.T.R'9 NAME ROUGH PLUMBING IG - GAS PIPING GAS VENT CESSPOOL Q 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) Q 1.00 SEWER PERMIT 1.00 GAS TEST TOTAL FEE R �0 O UTILY CO. NOTIFIED _ "�" FINAITL 76.1667 DBS# 17 6-52 WORKER'S COMPENSATION DECLARATION 20-[)Q26 DPW 9189 ''-7 hlJ I hereby affirm that I have a certificate of consent to self insure, 76A667A APPLICATION FOR PLUMBING PERMIT or a certificate 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.❑ BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) 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 WORKERSBATH TUB CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed If the work involved by the SHOWER MAP BOOK PAGE PARCEL permit is for one hundred dollars(5700)or less.) OWNER I certify that in the performance at the work for which this permit LAVATORY is issued. I shall not employ any person in any manner s0 as to SINK MAIL ADDRESS become subject to the Workers'Compensation Laws. DISWASHER CITY TEL,NO, Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of CONTRACTOR Exemption, you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Cotle, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM } LICENSED CONTRACTORS DECLARATION CITY TEL.NO. d I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER (commencing with Section 7000) of Division 3 of the Business and GAS SYSTEM OUTLETS SCENSE NO. CLASS U Professions Code.and my license is in full force and effect. W OUTLETS OVER DISTRICT NO. PROCESSED BY J 5 PER SYSTEM ly License Number Lic.Class } DATE VALIDATION a Contractor _Date cc ❑ I am exempt under Sec. FINAL CL FIBY d B-BP.C.for this reason 2 Plan check fee ' F Dale: Signature PLUMBING PERMIT ISSUING FEE$ ❑ TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Address Code): City Tel. No. I, as owner of the properly,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 representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE South" of P.rm)a,s nae. yJOLRKER'S COMPENSATION DECLARATION 20-0026 9169 76A66]A APPLICATION FOR PLUMBING PERMIT u 6A66 .f herrUy a}fcm that I have a certificate of consent to self insure, , or a certificate 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. /ri FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS ELLIA department NUMBER FIXTURE OR ITEM @ FEE LOCALITY (qW 44 Dale Applicant 3 WATER CLOSET CNEAREST ROSS ST. /eW ��O CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the work Involved by the Z SHOWER r/ MAP BOOK PAGE PARCEL permit Is for one hundred dollars($100)or less.) ,�'/C OWNER I certify that in the performance of the work for which this permit LAVATORY is issued, I shall not employ any person in any manner so as toll//`` MAIL �," SINK' S- �aJ LK1. •p0 ADORESS' y /CO / become subject to the Workers' Compensation Laws. DISWASHER, CITY 'J TEL.NO: Date —�� Applicant J CLOTHES WASHER , NOTICE TO APPLICANT: If, after making this Certificate of CONTRACTOR gs Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM - LICENSED CONTRACTORS DECLARATION CITY TEL.NO. I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER . 150 d (commencing with Section 7000) of Division 3 of the Business and STATE ' LIC. O Professions Code.and my license is in full force and effect. GAS SYSTEM OUTLETS 1&_4 s LICENSE NO, GLASS V OUTLETS OVER DISTRICTNO.OPROrr CESSEO BY O S PER SYSTEM License Number Lic.Class ~ ti S ! r FINAL VALIDATIONw Contractor Data DATE Q.fn EJI am exempt under Sec. FINAL I ? I BV B.BP.C.for this reason Data: � 8_c�� Plan check fee D ?I .: _ Signature PLUMBING PERMIT ISSUING FEE$ rt7 �jt ❑ TOTAL FEE SINGLE FAMILY Plan check applicant TOTAL 319 - 95 HOMEOWNER-BUILDER DECLARATION Name _ - - ik:H .i: . I hereby affirm that I am exempt from the Contractor's License Law - r.C! for the following reason (Section 7031.5, Business and Professions Address CHANGE •�I� Code): 94 City Tel. No. I,as owner of the property,will tlo the work and the structure is not intended or offered for sale (Section 7044, Business 111300-1300 1 11! and Professions Code). - D 2477 i AM c'tll r• 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 1 have read this application and state that the above D information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize repts ntafives of this Count to anter upon the above-mentioned p(o rty to inspection sa SEE REVERSE FOR EXPLANATORY LANGUAGE //_f Signature 6f nittee�� V 2allb COUNTY OF LOS ANGELES i'ti•iri_E CITY n fSL�c PLUMBING PERMIT -DEPAP.TMEHT•OF PUBLIC WORKS w 97111 LAS TUNAS PL 0508 040956000,5 BUILDING AND SAFETY / LAND DEVEI-DPPf F;T -.1i'iPLE CITY CA 91780 PHONE:' 626) 285-0488EXT: LEGAL ID - ---T � .FEES — r _�—i ADDRESS: ' TR: 14467 LT S9 4 AM.EL LIA AV FEE DESCRIPTION QUANTITY UOK: AMOUNT: TFb. A 91 804240 ASSESSOR INFO MitT!a @J+B.R: —_.--- _ - - -.NEAREST CROSS STREET: LOWER A7L h - 8589-,016-009 - 01 PERMIT ISSUANCE FF,E 27.75- HOMA PAC 597 GRID: A5 LOCALITY: TEMPLE CITY _ - ____ 07 BATHTUBS/SPDWERS 4.00 FIX 64.80 _ TENANT - -- 11 CLOTHESWAS�EP(S1 1.00 =IX - `16.20- ]SSUED-O- 2L,C'tSSED BY: LA6 Bt . c'P.IBES ON: f: -. 17 FLOOR DRAI!:(S) 2.00 FIX 32.40 09/16,104 J - 03!-5/OS 25 LAVATORIES(SIHKS 4.00 FIX - 64.80 - OWNER: I L NIi "9 ROOF DRA!N(S) 1.00 FIX 16.20 FINAL D0.1c SHRUBAR VICTOR E - (626) 235-002V 45 WATER Clvidl/UHINAL 3.00 riX 48.60 4846 CAMELLIA AV - 47 WATER HEAT (S) 1.00 ;I!l 16.20 TEMP 917804240' 51 LOW PRS GAS 5 01-11 LET 1.00 SYS 16.20 UESCRIPT "N OF W08K- --- TOTAL FEES 3.^,3.15 PLUMBING FSR ADGa ii ON/REMODEL - APPLICANT:- TEL- HO: SAME AS OWNER SPECIAL C;�iu�T1UNS: s i CONTRACTOR: APPROVALS �- DATE .IaVI?. 7R-al GhAI URE SAME AS OWNER - - - .. - - ' LIC. NC L o - (WATER Sr4VIC ITrC ---T I . PLASTIC `/6 Yin I,-..... -_- _... '- , '4 -ROI.ir: , •tib L, __-- NO: - 2I .GAS a- r,p_ _— ., i- -_- HOT 1 . PLUMPI4G -- ' AWN SPRiR -- GAS Tc`-;- "- - - UTILITY TUIPA,il NOTIFIED - -�--- ' .. .. - CWJ GRAY WATER SYSi Ef• - - - REPORT ID: DPR263 ROUTE 1'0: 650508