HomeMy Public PortalAbout5925 CAMELLIA AVE_Plumbing__ 78AA97 DIM 17 11-90 APP CATION FOR PERMIT
DEPARTMENT OF NG AND
sAFETY
COUNTY OF IDS ANGELES
WILLIAM J. FOX, CHIEF NOIN[¢R PLUMBING i
R APPLICANT TL7 FILL IN i/J
rLUMB[R ME E nr READY FOR DATE IMiUID
FIRST INSPECTION
ADD R IAN 496
�o J
7l BUILDING!
OITY TEL N AJYDRER — 7
COUNTY
1 C=kLITy y�
NEAREST
PERMIT FEES QRDSS rr. /
MUMRDI TYPE OF FDCPURI OR Ff[M Fr[ OWNER
MAIL �
WATER OLDS T(TOILET) ! COD 0 ADDRIMM
MATH TIJo ! 0.60 OITY� TLL No.
III HCWER ! D.SO
1 H ADKNQWLrA [ THAT 1 HAVE HK
AD RD TRI■
LAVATORY (WASH BASIN) ! EL no APP LI OAT H AND MTATE THAT THE ABOVE 12 CORR[OT
AND AMR[E TO COMPLY WITH ALL ODUNTY ORDINANOM
KIT13HER MINK ! 0.150 AND STATE LAWS REGULATING PLUMOING.
1 CERTIFY THAT t POSSESS THE "WE VALID LOS
LAUMDRY TUE OR TRAY ! D.EO ANGELA OD LIO[NSr. OR 1 AM TH[ t m•� OWNOi
OF THE Rd1 PROPE RIOrD ASSVE.
GAS wnmm r1UTLET7 ! C.EO
OISNATURE OF
WATER HEATrR ! EL so P�2M1
■LOP MINK ! D.ISO INSPECTION RECORD
FLDDR MINK ! 0.So
FLOOR DRAIN ! SED
DINHWASHER ! 0.612
DRINKING FOUKTAIN ! O.EO
UIHNAL ! aEO J
HOUSE M[WrR ! SEC Z
MIOQELLANEOUS 0
Q'
APPROVALS
DATr 1N!lT.GTOR'S MAIs
ROUGH PLUMBING
OAS PIPING
OAS VENT
[EMPOOL ! 1.'CD CKROPOOL
MEPTIC TANKS M[PTIO TANK
DRAIN ( ) PIT ( ) ! 1.00 BEmR
PERMIT 1.012 M" TEET
TOTAL FEE UTILITY CO.NOTIFIED
FIHArL
"Kwy APPLICATION FOR PERBUT
DEPARTMENT OF BUILDING AND SAFETY PLUMBING
���g'
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIKF ENGINEER
FOR APPLICANT TO FILL IN DISTRI5 NO. GROUP ZONE PERMIT NO.
J/ S /3
R Belvedere Plumbina4 Co. RLCKIVLD SY READY FOR DATE ISGU®
FIRST INSPECTION
[A7DDRL88 136 S. Palm Ave.
SS
CITY Alhambra TEL- o. AIo J2
BUILDING ble --Qve:-
c,.
COUNTY IC $p$j�f 6/30 51 LOCAL,
NKARKUT Tem .le Cit
ENIZ O. IRHS r7�,�,,,
����..pp������ CROSS HT. T�j'T�s 111.11aS l
MUY�[R TYPK OFF PgXrTI111R OR� ,SEE OWNER ?h. Prinzio
0 MAIL
WATER CLODKT TOILET 0.50 ADDREDD NJ
BATH TUE 0.60 CITY TEL NO
SHOWIER O.DO 1 HR®Y ACKNOWLEDGL THAT I HAVE READ THIS �`
LAVATORY (WASH CABS Y O.EO APFLI CATION AND STATE THAT THE ADOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTORDINANCES AND f
KITCHEN SINK a0.60i noSTATE LAWS REGULATING PLUMBING.
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY a 0.50 1. 00 ANGELES COUNTY LICIENSIL OR I AM THE LEGAL OWNER
2. OF THK RK61D[NTIAL PROPERTY DESCRIBED ABOVE.
GAD OUTI�TS 0.60 ESBE.SIGNATURK OF
WATERHKATER 0.60 1 no PERMITTi¢ cla � •�•�•�
' SLOP LINK 0.SO INSPECTION RECORD
FLOOR SINK 0.150
FLOOR DRAIN 0.50
DISHWASHER 0.60
DRINKING FOUNTAIN 0.60 -
URINAL 0.60 _ J
HOUSE SEWER 0.60 -714 G
MISCELLAN000S (�
� � a
'+ _ O
Nr
/ n v
L
- � C
APPROVALS
DATE INS"CTOR'e N/1Ht
ROUGH PLUMBING
GAS PIPING `
GAB VENT L -
CESSPOOL 1.00 CESSPOOL
DTIC TANK] SRPM C TANK
DRAIN ( ) PIT ( ) e 1.00 SEWER r
PERMIT . 1.00 4M TEST
UTILITY CO. NOTIFIED
— 77a
TOTAL FEEf f`
FINAL
50 M
TeAPPLICATION POR PLUMBING PERMIT ;1
rs a»17"t,
BUIMING AND SAFETY DIVISION
Dop=tment of Co=t= Eagineer
Co&mt7 of " Angolea .5 �-
JOHN A.LAMBIE,COUNTY ENGINEER
CASSATTa.ORIFFIN',HurTof BuiL.Drro
LOCAL
FOR TO FILL IN NEARESTCROSS BT.
� � DIgTRICT NO. GROt U�� ZONE atiwT►of IuIacT1o�
IL
AADDREM .
INDUSTRIAL
CITY N WASTE APPROVAL ��ya�
PL >reraR ' j LNSPF�C,TION Rf=RD
ADDRASS J
C[TY TEL NO
UCI4V136 NO. S 9 e-
HT7riDilt TYlQ Or FTJCTU]ts OR r rm P=
WATER CL)SIXT (TOILET) •1.00
]BATH TUB 41.00
SHOWN Q X1.00 '
LAVATORY (WASH BASIN) ;1.00
K17CHICN SINK Q 1.00
DIHHWAEH$R 1.00
LAUNDRY TUB OR TRAY @ 1.00
CLOTH W Q 1.00
WATER HEATIKK .00
GAS SY m 111,0.0
APPROVALS
DATA IHEPECTOR'E SISRATURR
UNDNR QLAJ?WORK
PERyfT # 00 ROUGH PLUMBING
G"PIPING
TOTAL FEE
__ TRA
READ vNx-r
ION
A114 STA YTHAT THS ABQVX Lg CORRECT AND AQRSB TOPLICOTHLB MPLY HOT TKR H. ATS
WITH HSIREPL COUITCT OYDINAN ARD STATE LAWS REaULATIIIG
PLUNBIRS, PLUMBINGG FIXTURES
'
1 MASHY CERTIFT THAT 1 AN pttOPTDLL REy 8TYBSD /l��1I11D/OR GAS TEAT
LI QED N RIi ODUM BT LOe AILGEI$6 jOIfTT AILD STATE OF
CALI�ORI1(A OR THAT I At THE 130AL OWIM OF THE WYE UTILITY CO.NOTIFIB37
MCRIBED REZ1 WOP
SIGNATURN
OF PE•1WITTFINAL
jr ROBERT A_W004
JOHN A. LAMBIE,COUNTY ENGINEER ,.gVAMATION SUPERVISING NUCI-LANICALEING'R
L 0. CASE
f ' 3 9 0 0Z-- OCT30 3 2.00 �
WORKER'S COA]PEN8ATfON DECLARATION 20-0028 DRY 9/0e
Ilhersby affirm fiat I have a oerUfloate of consent to so[f Insure, 7&M"A APPLICATION FOR PLUMBING PERMIT
or a oertlfloatp of Workdre Compensation InsueWnoe, o('i cerflfied
copy-therecf(8eo.8800 lab.C.)
_ COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV.
Certified copy Is hereby rumfahed
FOR APPIJ(.ANr TO FR1!1(PfIWT OR TYPE) SUILDN(i
❑ Certified copy to f ed with the Canty brdlding Inepecfbn ADIORM o•L� G�/�
department NUMBER FIXTURE OR nEw • FEF LOCALM
Dais Appk-rt WATER CLOSET f T
CEFTTIFiCATE OF D03iPTION FROM WORMCA088
BArHl TUB
COMPENSATION NSURANCE
f (This section need not be oomp{sbd H the work ImWvsd by the r SHOWER MAP BOOK PAGE �� PAACB
psrraft N for one Irawdred dollare('$100)or{ass.) r LAVATORY
A4 90- Xol
I osrttfy that In the performance of the work for which this permit MALL
Is Issued, I shall not employ any person In any manner so as to 84 NK A
become subject to the Workers'Compensation Laws.
DfSWASHSi
Dam APplictuk CLOTHES WASHER
NOTICE TO APPLICANT: If, after making this Certificate of com ri'LAC-1-011
Exemption,you should become*ub)eot to the Workers'Compensation OWLQ M POOL RECEPTOR
provisions of the Labor Code, you must f xthwith comply with such ADDRESS
provisions cr tufa permit shall be deemed revgked. LAWN BPFCNCLE R BYeTEM
LICENSED CONTRACTORS DECLARATION C17Y TFL NO.
I hereby affirm that I am licensed under provisions of Chapter to WATER HEATER
(commencing with BectloDivi
n 7000) of sion 8 of the Business and STATE
Professions Code,and my Roense Is In full force and effeoL GA8.818TEfa OUTLETS LICBtBE NO.
OUTLETS OVER Dl8TF1rCT
5 PER SYSTEM
L kxwm tb unber L kL Clow72.7
DR"''LTE MK—VALJ T
Contractor Date v
❑ I am exempt under Sec. RNAL TOTAL
� f 2_-�f�5_
B-BP.C.for this reason C�Ck{r ,i• 1,
fee
�:
DPian checkl � �l � C .00
PLUMBING PERMIT ISSUING FEE i 0
TOTAL FEE 'Z 000D-ODO
❑ Plan oheoik appbcant , 1 �1�7/94
S[N%3LE FAAULY X71 1 �12:,}1
ROME OWNER-BUILDER DECLARATION Name
I herebyflinLi
an that I am exempt ftom the Contractor's cense Law
for the following reason (Section 7091.6, Bualnsss,and Professions Address
Cade):
Ctty Ta.No.
as owner of the property,w01 do the work and the struohire
la
not Intended or offered for sale(Section 7044, Business 1
and Profaeelons Code). ►
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a apnstructlon lending agency for the r
performance of the work for whloh this peanut to Issued (800. 3097, /
Ctv.C.)
Lenders Name
Landers Address
I certify that I have read this appllcatlon and state that the above
Informatlon Is correct. I agree to oomply with all County ordinances
and State laws regulating plumbing, and hereby authorize
rep roseritatives of this County to enter upon the above-mentioned
property for Inspection purposes. l SEE FOR D(PLAMTORY I-A.WUAGE
81Qnattf ro