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Home My Public Portal About4935 CAMELLIA AVE_Plumbing__ TBABBT -CE#BIT 5/63 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER _ BUDDING AN� SAFETY FIVISION ennRess �� P35 v ' JO N A. LAM IE. COUNTY NGINEER WILLIAM A. JENSEN, SGPT OF BUILDING LOCALITY I FOR APPLICANT TO FILL IN NEARESBCROSS T. NUMBER FIXTURE OR ITEM EACH FEE , OWNER / WATER CLOSET $1.25— MAIL q /� BATH TUB 1.25 ADDRESS CITY TEL. NO. SHOWER 1.25 LAVATORY 125 CONTRACTOR '` T SINK 135 ADDRESS DISHWASHER 1.25 CITY TEL. � ZZ � TSTATE LAUNDRY TUB 135 REGISTRATION NO.1 V COUNTY S CLOTHES WASHER 135 DI CT I q.BOUP I P5OCQS6EO BY WATER HEATER 1.50 J/ (O� C% SYSTEM OUTLETS D_ 1.50 INDUSTRIAL WASTE APPROVAL O OUTLETS OVER 5 PER SYSTEM .>D INSPECTION RECORD pAB 0 z APPROVALS DATE INSPECTOR'SSIGNATURE PERMIT S 21 00 UNDER SLAB WORK ROUGH PLUMBING J /� TOTAL FEE ' 51 qpp GAS PIPING 1 HEREBY THAT THE THAT I CORRECT READ THIS APPLICATION GAS VENT AIT STATE THAT THE ABOVE la CORRECT ANO AGREE E COMPLY wrtH ALL couvir ORDINANCES aDlHAncEs AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES f�r� yy n ( LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST �fJ�W "�� CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROP RTY. UTILITY CO. NOTIFIED SIGNATUREI / L1 ,. ,*'. y OF PERMITTEE !C// FINAL J�g� IP,!SA �w VALIDATION ROBERT X WOOD P T M.0. CASH SUPERVISING MECHANICAL ENG'R LA 6 8.9 3,0lZ2 AW 5 5 D 350-- q 76AG67 CE#817.5.61 TEMPLE CITY APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVLMIONEUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS WILLIAM A. JENSEN, SUPT OF BUILDING LOCALMY FOR APPLICANT TO FILL IN NEAREST ARE T -- " NUMBER FIXTURE OR ITEM OwNER William R walker WATER CLOSET MAIL HATH TUB ADDRESS 4935 SHOWER O1n Temple Citv TEL NO. AT 7-0527 LAVATORY CONTRACTOR SINE ADDRESS 15224 E Arrow DISHWASHER CITY TEL. NO. 1„0CORACTOE . ATE LAUNDRY TUB REGISISTRATION NO. 179226 COUNTY -❑ CLOTHES WASHER D187R1 NO GROUP ZONE P90CSSIwBY WATER HEATER �( O d INDUSTRIA. O GAS SYSTEM WASTE APPROVAL u (� INSPECTION RECORD C O u W a N Z ® QAE $ �� APPROVALS DATE INSPECTORS SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE 3 ' 25 . _ GAS PIPING 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANO STATE THATHATTHE ABOVE ICORRECT AGREE COMPLY GAS VENT WITH ALL COUNTY ORDINANCES AND S. AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM HE LEGAL OWNER F THE ABOVE DESCRIBED RESIDENTIAL O RTY. UTILITY CO. NOTIFIED II SIGNATURE A '� a' OF PERMITTE L-�eI_ /PiI FINAL 77 tf� PK'�`l"!k_A Grp u /VALIDATION ROBERT A. WOOD , ' Crc. M.o. cNSH SUPERVISING MECHANICAL ENG'R q 8't2''6 O G AUG 9 . 5 D 325 Q '76A667 - CE817 5/70 V� y APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER " BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS / COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 1.50 [ MAIL BATH TUB I.50 ADDRESS SHOWER 1.50 CITY ,TEL. NO22, LAVATORY 1.50 CONTRACTOR SINK 1.50 ADDRESS� E DISHWASHER 1.50 CITY TEL. NO. CLOTHES WASHER 1.50 STATE •7 LIC LICENSE NO. �.0 CLASS SWIMMING POOL RECEPTOR 1.50 1 DISTRICT NO. GROUP ZONE 6BED BY LAWN SPRINKLER SYSTEM _ 2.00 Q ,_/ WATER HEATER 1-7-61 [NDUSTR(AL 3 WASTE APPROVAL (o, GAS SYSTEM OUTLETS _1.50 INSPECTION RECORD 'OUTLETS OVER 5 PER SYSTEM .30 y`O, V CL CL N Z Plan check fee 25% of above. See.reverse. .PLUMBING PERMIT ISSUING FEE 8 00 TOTAL FEE' , .APPROVALS DATE INSFECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel. No. HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY .ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF.AND INTEND TO RESIDE IN.THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL b , SIGNATURE 'J OF PERMITTEE LACK R. ALLEN, SUPERVISIN CH ANICAL EN G-R. - . - - -- PERMIT VALIDATION cK. CASH PLAN CHECK VALIDATION CK. MIO. CASH Yy r WORKERS' COMPENSATION DECLARATION 'APPLICATION FOR PLUMBING" PERMIT hereby 6ffirm that I have a certificate of consent to self 20-0026 DPW 6/87 iswre, or a�certificafe of Workers' Compensation Insurance, 76A667A or o.certified copy (hereof (Sec 3800, Lab. C:) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ❑ y" 739�M t �&WFU - Polic No Company Certified copy is hereby furnished. I _ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING- Certified copy i5 filed with the county building inspe<- ADDRESS X tion department. NUMBER FIXTURE OR ITEM C FEE LOCALITY .Date�4 1:2/_-1?, App1icant- - irlyaky If WATER CLOSET NEAREST `1 CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. ' COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by / SHOWER . the permit is for one hundred dollars ($100)or less.) ! LAVATORYQ ADDRESS MAIL I`certify-that in the performance of the work for which this 46- JA permit is issued, I shall not employ any person in any manner SINK CITY r i' TEL. NO. so as to become Subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to. the Workers' CITY. TEL. NO. _67,�.�n Compensation provisions of the Labor Code, you must forth- , c/f?, with comply with such provisions or this permit shall be LAWN SPRINKLER SYSTEM STATE LIC. deemed revoked. - WATER HEATER O LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT No. PROCESSED BY I hereby offirm,thal I am licensed under provisions'of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of:the Business OUTLETS OVER a and Professions Code, and my license is in full force and ffVALIDATION ect. 5 PER SYSTEM FINAL } a [ DATE !/- 1 a License Number�/rCeyjLic. Class _(' O, .rte t FINAL �u Contractor I� Date �' �� BY ❑ I am exempt under Sec. 7 TV .0 B.BP.C. for this reason ® N' Plan check fee z Date: PLUMBING PERMIT ISSUING FEE$ 'Signature , TOTAL FEE Q, SINGLE FAMILY Plan check applicant _ HOME OWNER-BUILDER DECLARATION Nome (hereby affirm that I am exempt from the Contractor s License Address ri_la e i Law for the fallowing reason (Section 7031.5, Business and Professions Code): City Tel. No. ---' ❑ 1, ps.owner of the property, will do the work and the A ITEM" EM" structure is not intended or offered for sale (Section . t.rrit L 7044, Business and Professions Code). - - ' D il,I30 _50 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issuedI: tiFa'.UF ,f}I) (Sec. 3097, Civ. C.). Lender's Name ii t c 10; Lender's Address I certify that I have read this application and state that the - D - i RN C.z.52 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-mened pr erJy, r inspection purpos _ SEE REVERSE FOR EXPLANATORY LANGUAGE Si na ure of Permi ee Date -