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Home My Public Portal About9462 DAINES DR_Plumbing__ P. 8/68 - 7 AIBP SCA I`7I®IIS FOR PLUMBNG ' PERW COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS b 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 z �` �/I BATH TUB � 1.50 �ADDRESS .C.J"a SHOWER 1.50 CITY TEL. NO. LAVATORY 1.50 CONTRACTORX�_ SINK 1.50 ADDRESS��3 DISHWASHER 1.50 __ CITY TEL. NO. CLOTHES WASHER 1.50 STATELIC LICENSE NO. Q g CLASS 'SWfMAlItNG POOL RECEPTOR 1.50 DIS.�T�{I C�Nj�._ GR Z P O ¢5 LAWN SPRINKLER SYSTEM 2.00 O WATER HEATER 1.50 INDUSTRIAL v WASTE APPROVAL z GAS-SYSTEM OUTLETS 1.50 0 INSPECTION RECORD I-. ' OUTLETS OVER v 5 PER SYSTEM •30 � C/) Z Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEF, 5 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan Check applicant - UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel. No. HOT WATER HEATER IHEREBY ACKNOWLEDGE THAT 1 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. I HEREBY CERTIFY THAT 1 AM PROPERLYREGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PRO TY. FINAL , SIGNATURE JACK R. ALLEN, SU ERVISING MECHANICAL ENG'R. - OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDAT6A CK. M.O. CASH '; ; 9,-.8 y j3- APR 2 2 5 D 3.5 0 76 A 667,- CE 817 7-69 �� COUNTY OF LOS ANGELES M DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY 1 FOR APPLICANT TO FILL IN (PR NT OR TYPE) CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER =- WATER CLOSET 1.50 MAIL - .BATH TUB 1.50 ADDRESS q462-- P •. SHOWER 1.50 CITY _ f e TEL. NO. ' LAVATORY 1.50 CONTRACTOR j SINK 1.50 ADDRESS DISHWASHER - 1.50 CITY - TEL. NO.. CLOTHES WASHER 1.50 STATE.. LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE PRO-E B£-D BY LAWN SPRINKLER SYSTEM 2.00 `� -! ` �'�,�' _ if I WATER HEATER 1.50 .1 INDUSTRWASTE APPROVAL 0 GAS SYSTEM OUTLETS 1.50 1 � INSPECTION RECORD u OUTLETS OVER 5 PER SYSTEM .30 - z - O Lu' • G. Z, Plan check fee 257. of above. See reverse. , PLUMBING PERMIT ISSUING FEE 8 2 100 TOTAL FEE (_ ✓ �� APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant - UNDER SLAB WORK Name ROUGH PLUMBING Address a GAS PIPING d 7-7,41 `,f GAS VENT v 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. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED - o LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND'STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,.AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL SIGNATURE JACK R. ALLEN, SU ER WISING CH ANICAL ENG'R. OF PERMITTEE ,. PERMIT VALIDATIION �. M.O. CASH PLAN.CIIECK VALIDATION CK. M.O. CASH �, n,7 3:3 gti OCT 2 6 3.5 O APPLICATION FOR PLUMBING G ERM COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY G FOR APPLICANT TO FILL IN NEASESTCROT. LO NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.25 MAIL 1 BATH TUB 1.25 ADDRESS % CITY TEL NO. SHOWER 1.25 LAVATORY 1.25 CONTRACTOR SING 1.25 ADDRESS DISHWASHER 1.25 CITY L. NO. LAUNDRY TUB 1.25 CONTRACTOR'S STATE 1:1 REGISTRATION NO. COUNTY ❑ o to CLOTHES WASHER 1.25DISTRICT NO. FGIROUP ZONE P OCESSED BY WATER HEATER 1.50 0 /e— g GAS SYSTEM OUTLETS 1.50 INDUSTRIAL a WASTE APPROVAL Q OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD f;-------------- U !�1(/'? �VJI�✓ �rri? ? it ^:fi=Y O�r �'4':- .I,1 0 W � . N Z 3 % APPROVALS l DATE INSPECTOR'S SIGNATURE PERMIT t 2 00 UNDER SLAB WORK\ ROUGH PLUMBING TOTAL FEE ' :S 0 GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT �, AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 1\ R WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER �� ✓y �'%'�' f+,;'t�/ PLUMBING. I 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 AM THE LEGAL OWNER OF,' INTEND TO f x.. RESIDE IN,THE ABOV SCRIBED RESIDENTIA O RTY UTILITY CO. NOTIFIED It SIGNATURE 1 OF PERMITTEE a ;.r.... FINAL VAIf LIDATION ROBERT ROBERT A. WOOD C!, M.O. CASH SUPERVISING MECHANICAL ENG'R L,`ll�0 4 7 2 3 OCT 9 5 D 3.5 0. V WORKERS'COMPENSATIONDECLARATION A AP�LICQTV®N FOR PLUMBING PERMIT I hereby"affirm that I have a• certificate of consent to self CEce Slati(2-SO) insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS NGEL BUIL AFETY Policy No.w.5999 3ompany. Wt---,t- Amer 7 o an Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ® -I�rtified co is filed with_the count building NUMBER FIXTURE OR ITEM O FEE ADDRESS copy y g inspection department. WATER CLOSET LOCALITY Dater-7C-R - pplicanfTni,Te'rS81 P1I-)g — NEAREST BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER BYeazeal (This section need not be completed if the work involved ILAVATORY MAIL ADDRESS Q462 paimps Dr, by the permit is for one hundred dollars ($100) or less.) SINK } CITY Temple City • TEL. NO, 0- I certify that in the performance of the work for which thisDISHWASHER OU permit is issued, I shall not employ any person in any manner CONTRACTOR so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER ADDRESS Q Date ApplicantSWIMMING POOL RECEPTOR, F- NOTICE NOTICE TO APPLICANT: If, after making this Certificate of CITY So EL Monte TEL. NO. 575-34 t1 Exemption, you should'become subject to the Workers' LAWNSPRINKLER SYSTEM STATE OpGG C LIC. Cn o0 O Compensation provisions of the Labor Code, you must forth- LICENSE NO.3U6678 CLASS 4 Z with comply with such provisions or this permit shall be WATER HEATER ' O _ deemed revoked. GAS SYSTEM OUTLETS ^ DISTRICT NO. E ED•BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER d`' I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL / VALIDATION ness and Professions Code, and my license is in full force and DATE / l effect. License Number��8Lic.Class FINAL BY 4— Contrac�PYG bgate 10-29-80 I am exempt from the licensing requirements as I am a Plan check fee .licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ -70 acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE ®"lob Lic,or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby''affirm that I am exempt from the Contractor's /address License Law for the following reason (Section.7031.5, Busi- City' Tel.No. ness and Professions Code): I, as owner of the property, am exclusively contracting with licensed contractors to construct the project � )_ (Section 7044, Business and Professions Code). . 228 6.6 A CONSTRUCTION LENDING AGENCY # a '0 0 0 0 5- I hereby affirm that there is a construction lending agency ' ' for the performance of the work for which this permit is 2 0 0 1 0.0 0 issued(Sec. 3097,Civ.C.). o 0 0 0 0 Lender's Name CE Lender's Address I certify that I have read this application and state that the V above information is correct.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon th^ abo inentioned property for inspection purposes. Signature of Permittee 1 Date