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Home My Public Portal About5826 CAMELLIA AVE_Plumbing__ °vx AJ.IOATION FOR ]PLUMBING PERMIT . DIVISION OF BUILDING AND .SAMY Depcntm�toR.l. w�.J. FOX, CouNTv �Nawme DUI 1INo ` oDEaB CASSATT D. GR1ItF1[f, •LI*'T OF IlUILd UI• ' �. LOCALITY FOR CAN1�yw. TO I= IN NEAREA'TCROSS 2T. r, F,cl NE D18TRIC�J" q. oROUp _ 1fE BIADY FOR Ilu►lICT10■ bR .J / O INDUSTRIAL 9T E LN�O.. / W ' PLU 15 IR INSPE ON H1=15 } ADD E88 ' CITYTEL_NO. . LICEN x NUM�[lt TYPK OF FIxT'U(li 811 ITW FILE , WATER CLOSET (TOLLLeT) S DATH,I UG - SHOWER LAVATORY (WASH BASIN) KITCHEN SINK DISHWA8HER LAUNDRY TUE OR TRAY i CLOTH"WASHER .. I I , TOTAL NO. 0.80 APPROVAM DATE INSPECTOR'$$IGNATURE GA9 6Y8TEM OLCfLETB 0 1.00 WATER HEATER 0. 1 O, Q NDE12 SLAB WORK PERMIT Cb ROUGHPLUMBING s � - GAB PIPING - TOTAL PEE- GAS VENT I H EBY AQKNQWL16GE THAT 1 HAV READ THIS APPLICATION HOT WATER HKATER I ANd $PAYE T}61.T THE ABQVE IS.CORRECT AAD AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMMNG FIXTURES PLUMBING. I HEREBY CERTIFY THAT 1 AY PROPERLY REGISTERED. AND/OR AS TEST' LICENSED AS REQUIRED BY $ ANGELES- COUNTY AND STATE QP CALIFORNIA OR THAT I THE LS-GAL NER 0 THE Y 1LLTYO.NOTIFIED PESCRI135D RESIDENTIAL P SIGNATURE OF PF;RMITTEE FINAL, W1u.JAM J. SOX, CQuNTY ENomnmR VALIDkTTON R.A.WOOD,CHIS PLpo. IN"K=R 'COO 0 6 7 MV 16 3 2.0 0 n . 76Affl7-QM7121% TEMPLE C27Y APPLICATION FOR PLUMBING PERMIT � _ �fflw.l D BUMDMG ]� UNTY IINKXeQi, tumor rmcl *cc4u . FM APM= TO F= 29 . NEAMM Cam=e't. Numigm FIXTURE OR ITER b ` } rt cLov= n59may, >eam raa anna�e r' r! ®owast moi ` MEMO= c T=- >K>rxmff Tm . 7 7 COUN" CLO=WARM DISTRICTNO. GROUP I ZONE Ep&Y WAffi=MM _ 4� QU stern[ BEIDUHTWAL WAPPROVAL RCMM=ON RECO» APPROVALS PATS. INSPIECTDE'E a1GnATURE PEPJWIT ; 21()o UNDER 9LAL WORK TOTAL uROUGH PLUYHINC; 6A8 PIPING I MWXY ACLIIo*LLDGI TRAT 1 aA ILAD TAIL AM.ICATIL' /11�D Sun TRAT THI AWa If CDtitlQ AID A� TO COITLT OAS VEENT ■�TH ALL COUATT OQD11ANcii AID !'PAIL LAn RimL✓1TFRG FLD7e1110. HOT WATER HEATER `�..�, 1 HILLIIT CIQTIFi '�'HA7 1 AM PIMPII1.T AaW VQ PLUMBING FIXTURES WCL111ID AL LLQUIQID Jf LOS ARMIES CDUfT'/ /11D S& RF GAS TEST CAL FFpppp��IIA OQ i 1Pa LLIAL as. OE TaL ADOYR DlfCxlbtp QL1TD UTILITY CO.NOTIFI® if I QNATU7SE OF pwmin 1pFINAL �► VAMATIO�ROBERT A 00 Q Ill.p, 6�ro SUPaRVIisIN0 M ICAL ENG'R Ao315 J "16 5 0 325- 4 7&"67A ICX 017W-I J/" APPLICATION FOR PLUMBING PERMIT BUILDING SAFETY DIVLSION FOR APPLICANT TO FILL IN(P%NT OR TYPE) BUILDING DRESS 5826 CAMELLIA AVE. NUMBER F)XTURE OR ITEM O FEE WATER CLOSET LOCALITY TEMPLE CITY N BATH TUB GR=ST. SHOWER OWNER STROBEHN GEORGE LAVATORY ADDRESS SAME SINK arY TEMPLE CITY TEL No. 287-0098 DISHWASHER CONTRACTOR TRANE RCC CLOTHES WASHER ADDRESS 2034 N. PECK RD. SWIMMING POOL RECEPTOR CITY S0. EL MONTE TEL No. 579-7982 LAWN S$MNKL$t SYSTEM WATER HEATER STATE LIC NO. 265094 CLASS C-20 1 GAS SYSTEM 1 OUTLETS 3 OO 7NO. -� �]�1E \ & `1 O 5 WASTE APPROVAL V INSPECTION RECORD Plan check fee PLUMBING PERMIT ISSUING FEE$ 7 00 TOTAL FEE 10 00 Plan check applkant APPROVALS DATE WSAECTOR'S SIGMATURS Name lJ<JDERSLAB WORK Addretu ROUGH PLUM84NG City Tel.No. GAS PIPING J FMMDY ACK OWLI!DGC THAT I HAVE READ THIS AHL.ICAnom AND STATE GAS VENT THAT THE ADOW B COWECT AND AGREE TO COWPLY WITH ALL Ckx)!nY OFD DiAXCES AND STATE LAWS REOLJLATT G PLUMBING. HOT WATER HEATER I HEREBY cmriFy THAT I AM PROPERLY FIYGIST RED AND/Olt LK:EXM ASV BING FIXTURES REWDLED BY LOS•RM ES CWKTY AJO STATE OF CAUPORNIA OR TFLAT I AM THETEST LPGAL OWNER OF,AND WrOW TO MtDE IM THS ADOVT DESCRIBED RESIDENTIAL ppoPvtrY. 4-2 {^,� TYCO. TIPPED {S IONATU RE /�./Y — OFPERMfTTeB fr�� '� L ATION f— /I-I - N PERMIT VALIDATION �_ M-O. CASH POLICY HOLDER: .0 5 lSWR 13 5 0 1 O.O O e. POLICY 'NUMBER: 4 wbRIERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT {� DECLARATIONL1 I heseb,, afflern tFMi I*ave a certificate of consent to self 76A667A I1.sure, of a certificate of Workers'Compensation InsurarIce, CE 817(RFV. 10/81) or a ceftlfled cow thereof(Sec. 380(), Lab. C. COUNTY Of LOS ANGELES BUILDING AND SAFETY Policy No. 'Company ❑ • 'Certified copy Is hereby fumishe i. FOR Al'PDGaNT TO FILL IN(PRINT OR TYPE) BU F1 Certified � Certified copy Is filed with the county building Inspec- ADS tion department. NUMB82 FIXTURE OR ITEM FES LOCALITY / Date Appligont WATER CLOSET ,UMAJL CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE SHOWER CMTs section need not be completed IF tfse work Involved bythe permit Is for one hundred dollars (=100)or Tess.) LAVATORY r, I certify that In the performance of the work for which this SJ NX TEL. Permit Is laued, I shall not employ Person In any manner so as to become subject to the W ens Compe t n L DISHWASHER COIJTRA Date A�II CLOTHES WASHER r ADDS NOTICE TO APPLICANT: I£, or makl Is Certificate of SWVAAAJNG POOL Exemption, you should become su to the Worker' � / TELNO Compensation provisions of the Labo e, you must forth- LAWN SPRIWLER SYSTEM with comply with such provisions or this permit .shall be STATE LIC. deemed revoked. WATER HEATER LIBJSE NO. CLASS 'LICENSED CONTRACTORS DECLARATION BY I hereby affirm that f am licensed under provisions of Chapter 9 OAS SYSTEM OUTLETS 1 i l/sX+ (commencing with Section 7000) of Dlvtslon 3 of the BusinessOUTLETS pyo and ProF Ions Code,and my license Fs to full force and effect. 5 PER SY5fEhk FINAL VAL! ATION , License Number, Llc. Class o FI 8. Contractor Date BY ❑ I am exempt under Sec. O B.BP.C. for this reasoh 0 Plan check fee Date: cn PLUMBING PERMIT ISSUING FEE; C�Q Z Signature TOTAL FET: Plan check applicant 24965 A SINGLE FAMILY HOME OWNER,AUILDER DECLARATION Name # o o_ o 0 0 5 1 hereby affirm that I am exempt from the Contractors License Law for the following reason (Section 7031.5, Business and 'fess I o o 2 a 5 0 Profess gns Code): City Tel. No. o 0 0 2 0 5 LTi LC! I, as owner of the property, will do the work and the struc'Ture Is not Intertaed or offered for sale (Sectionlopy� 7044, Business and Professions Code) 7.Q 7 . 8 f3 CONSTRUCTION LENDING AGENCY I hwpby affirm that there Is a constryction lending agency for the performance of the work for which this permit Is Issued (Sec. 3097, Civ. C..). Lender's Name Lenders Address I certify that I have read this application and state thot the ► above Information Is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize repr4entatives of this County to enter upon the a -meptloned property for I pectlon purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 'L-1`19-y-a re WORKERS'COMPENSATICINDEClARA'nON APPLICATIONFOR PLUMBING PERMIT I hereby affirm That I have a certificate of bbnsentio }elf _ 7dyq t Insure, or a certificate of Workers'Compe n Infura�ficd, CE 817(REVr10/B1) tifie pythereof Sec. ' Lab. COUNTY OF LOS ANGELES �i`- BUILDING AND SAFETY doff s�- ❑ Certified copy la hereby fumished. FOR APPLKANT TO RLL IN(PRINT OR TYPE) BUILDING NG copy Is filed with the county building Inspec- ADORfSS s ❑ C A-A4f_L L./ Ar tlon department. FIXTURE OR ITEM Q FIS LOCALITY-- Date Appligant WATER CLOSET C CERTIpCATE OF E CEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE OWNERf3 (This section need not be completedNUMBER If the work Invahred by SHOWER the permit Is for one hvndrpd dollar($100)or lees.) LAVATORY AADDDRR I certify that In the lswnot empere of the work for which this SINK permit to c ed, I shall not employ any person In any manner CITY Ta- to as to become subject to the Workers'Compensation Laws. DISHWASHER �y�n� I I ' e—4_17�_ Dan AMllcanf CLOTHES WASHER •_"_ J��V ADDRf55 NOTICE TO APPLICANT: If, after making this Certificate of D Exemption, you should become subject to the Workers' SWLMMING POOL RECEPTOR Compensation provisions of the Lhbor Code, you must forth- C>TY G� LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STS deemed revoked. WATER HEATER liCENSEU CONTRACTORS DECLARATION MMICT NO. PRqtESSM BY I hereby afflrm that I am licensed under provisions of Chapter 9 GAS SYSTEM OlmElS (commencing with Section 7000) of Division 3 of the Business OUTLETSOVl3; �� } and Profeesl Code,and my license Is In full force and effect. 5 PER SYSTEM FINAL �jp � `�G DATE V_ ALIDATFON u License /u�m/ CFasfAGIy♦' Y p� I trl Dal�f" FINAL O r ❑ �D7 /3 a I am exempt under Sec. aA Z B.BP.C_ for this reason Plan check fee Date: PLUMBING PERMTT ISSUING FEE_ � [j . Signature -r 0 83 S A TOTAL FES Q t,° ooaoo5 Plan check applicant SINGLE FAMILY 3 0-50 HOME OWNER-BUILDER bECLARATION Name ti 3 0,'J I hereby affirm that I am exempt from the Contractors License Address 0 0 , 0 0 Law for the following reason (Section 7031.5, Business and 0430-84 Professions Code): City Ter. No. ❑ I, as owner of the property, 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 [trued (Sec. 3097, CIv. C.). Lender's Name Lenders dress I certify that I have rood 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 20 -7 this County to enter upon the above-m Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE �,- pho fu Permittee Date