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HomeMy Public PortalAbout5019 DALEVIEW AVE_Plumbing__ '76 A 667.- CE 817 7-69 CITY OF TEMPLE CITY ' -APPLICATION ' FOR PLUMBING PERMIT COUNTY OF LOS ANGELES B50229 ' DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS 5019 Daleview COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY Temple City ' FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER Don B. Matheson WATER CLOSET 1.50 MAIL I BATH TUB 1.50 ADDRESS Same SHOWER 1.50 CITY TEL. NO. LAVATORY '1.50 CONTRACTOR General Installation Co. SINK 1.50 ADDRESS T_ Angeles West Blvd 8-W41- CLOTHES DISHWASHER 1.50 CITY Los Angeles TEL. NO. PL 8-W41 CLOTHES WASHER 1.50 STATE LIC LICENSE NO. C-86 151889 CLASS SWIMMING POOL RECEPTOR 1.50 DISTRICT N/O-/ GROUP ZONE I P OCES D BY LAWN SPRINKLER SYSTEM 2.00 1 WATER HEATER 1.50 1 50 _INDUSTRIAL ✓ y WASTE APPROVAL O GAS SYSTEM . OUTLETS 1.50 INSPECTION RECORD u OUTLTS PERE YSTEMR ..30 Ready for Inspection Now z WATER SOBTENEa Lu N T. Plan check fee 25° of above. See reverse. - . PLUMBING PERMIT ISSUENC FEE S 2 00 TOTAL FEE .APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING - City, GAS VENT Tel. No. HOT WATER HEATER HEREBY ACKNOWLEDGE THAT 1 HAVE RTHIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AN. AGREETO COMPLY PLUMBING FIXTURES WIT. ALL COUNTY_ ORDINANCES.ANO STATE LAWS REGULATING GASTEST PLUM ' PLV BING. I HEREBY CERTIFY THAT 1 AM PROPERLY REG15TERED ANWOR 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 RE5 • TIA�LPR Tr. FINAL SIGNATURE (A/// JACK R. ALLEN, SUPERVISING MECHAWCAL ENG'R. OF PERMITTEE - PERMIT VALIDATION a M.0. CASH PLAN CHECK,VALIDATION. CK. V.0. CASH ' e€ 9 4 .7iOzz�. APR 1 5- D 3.50- feAeeT n 5.50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY LOS ANGELES FO WILLIAM J. FOX. CHIEF ENGINEER FORAPPLICANTLO FILL DISTRICT NO. GROUP ZONE PERMIT NO. PLUMBER �Vi'• 0� , I FOR� ���'� �� �. � /aC_�fy_ RECEIVED BY 'READY DATE ISSUED q////gip, 'FIRST INSPECTION ADDRESS `//.s.��lAiL 14 C •Le Mi'� MS l (//_ CITY t Y //� BUILDING Q�TEL. NO. ADDRESS COUNTY LOCALITY !! (J is LICENSE NO. EXPIRES NEAREST PERFEES CROSS ST. , NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET (TOILET) . 1 0.50. 5 ADDRESS BATHTUB @ 0.50 CITY TEL. NO. SHOWER @ 0.50 I HE 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 AND KITCHEN SINK @. 0.50 STATE LAWS REGULATING PLUMBING. I .CERTIFY THAT 1 POSSESSTHE ABOVE. VALID LOS LAUNDRY TUB OR TRAY @ 0.501 ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER I GAS SYSTEM—OUTLETS @ BO OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. SIGNATURE OF, ��J�/� � IX.ea WATER HEATER @ 0.501 PERMITTER SLOPS INK @ 0.50 INSPECTION RECORD . FLOOR SINK @ 0.501__ FLOOR DRAIN @ 0.501 DISHWASHER' @ O.50I DRINKING FOUNTAIN @ 0.501 I URINAL @ O.5011 J HOUSESEWER @ O.50I 670— Q T Z .MISCELLANEOUS ��ii O 1 O I I APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING fl GAS VENT CESSPOOL @ 1.00 CESSPOOL SEPTIC TANW.' SEPTIC TANK DRAIN ( 1 PIT ( ) @ 1.001 1 SEWER- PERMIT'. 1.00 ' GAS TEST UTILITY CO. NOTIFIED TOTAL FEF. /�� FINAL 7"667 TF S-49® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX. CHIEF ENGINEER F R APPLICA T TO FILL IN DISTRICT NO. GROUP ZONE PERMITNO. r <�-- l A I RECEIVED s�{z PLUMBER - EIVED BY READYFOR DATE ISSUED FIRST INSPECTION / T .ADDRESS � 1 H / — Z�-� / BUILDING / CITY O i I TEL. NO. ADDRESS COUNTY LOCALITY LICENSE NO. [� //� EXPIRES I NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET.(TOILET) ® 0.50 s ADDRESS BATH TUB @ 0.50 CITY TEL. NO. SHOWER .0.50 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ 0.50 STATE LAWS REGULATING PLUMBING. - 1 CERTIFY THAT 1 POSSESS THE AS VE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LI ENSE. OR I AM THE LEGAL OWNER OF THE RESIDENTIAL ROPER TY DESC BED ABOVE- GAS SYSTEM�OUTLETS @ 0.50 SIGNATURE OF WATER HEATER @ 0.50 -P Z&JA SLOP SINK - @ 0.50 1 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR.DRAIN @ 0.50 DISHWASHER ® 0.50 37''/t/ DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 v CGtSPA siJ00 D i-/� lJ HOUSESEWER @ '.0.50 Q MISCELLANEOUS J^41! CJLEi�!.J•GI/T i' P EP �./6�LJ6 rT-oe C�eTc v-a �e� APPROVALS DATE INSPECTOR'S NAME. ROUGHPLUMBING �Ir3 /iG/Y GAS PIPING GAS VENT CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( PIT ( @ I.Do SEWER /J / GAS TEST 3 7 PERMIT . 1.00 _ UTILITY CO. NOTIFIED TOTAL FEE 5 v IBS FINAL 'V '� 'YiAB69 -n 0:50 - APPLICATION FOR PERMIT DEPARTMENT OF-BUILDING AND SAFETY COUNTY OF. LOS'ANGELES P L B I. 4 WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO_ GROUP I ,ZONE :. 'PERMITNO, PLUMBER RECEIVED 1T �:F/LF..,.,exi4. �Gw:.t I RECEIVED BY READY FOR - DATE ISSUED FIRST INSPECTION ADDRESS ///� z��J BUILDING �� f/ ADDRESS CITY iZ"~/ /�//.TL /[ -m TEL.. NO. ./ �y _ COUNTY LOCALITY.. lols Q,t/ pQC.L• LICENSE NO. - EXPIRES -- NEAREST ' PERMIT:FEES ' - . ', caosssT. - . NVMBER ''TYPE OF FIXTURE OR ITEM 'FEE .OWNER' MAIL . . -WATER CLOSET (TOILET) @` 0:50 'S ADDRESS _ BATH TUB @ 0.50 CITY TEL. NO. .+ SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE -THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ 0.501 APPLICATION AND STATE THAT THE ASOVE.IS.CORRECT 'AND 'AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK. @ _O.SOSTATE LAWS REGULATING PLUMBING.,. 1 CERTIFY THAT 1 POSSESS THE, ABOVE VALID LOS _ LAUNDRY-TUBORTRAY @ 0.501_ •ANGELES-COUNTY LICENSE. OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. GAS SYSTEM-OUTLETS @ 0:50 SIGNATURE OF WATER.HEATER @ 0.501 PERMITTEE ///��� .//.Q'!di✓d.C/l SLOP SINK @ o,so INSPECTION RECORD. .FLOORSINK @ 0.501--{I FLOOR DRAIN @ 0.50 IT DISHWASHER @ 0:50. IT DRINKING.FOUNTAIN @ 0.501 I URINAL @. 0.501_1 �f HOUSE SEWER Z_ MISCELLANEOUS'. ' l� - - Q I I . � I 1 APPROVALS . Ag t DATE INSPECTOR'S NAME ROUGH PLUMBING'* _ _GAS' PIPING GAS VENT CESSPOOL '@ 1.00 `� Y CESSPOOLJ/ - SEPTIC TANK: SEPTIC TANK PERMIT .,( ) PIT f ) © 1:001 I .SEWER -.. PERMIT . . ., 100 GAS TEST UT TIN'L TV CO. NOTIFIED TOTAL FEE FAL 'EASE' 17 5-4'® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY n COUNTY OF LOS ANGELES (� WILLIAM J. FOX. CHIEF ENGINEER I FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMITNO. PLUMBER .( ./ y RECEIVED BY READY FOR DATE ISSUED FIRST INSPECT[ S ADDRESS �A T' A /�_./ .1 n.L A...N �� BUILDING CITY I //9� TEL. NO. ADDRESS COMM LOCALITY NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER ,-1 MAIL WATER CLOSET (TOILET) @ 0.50 S ADDRESS BATH TUB @ 0.50 CITY TEL. NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) Q 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK Q 0.50 STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY (CENSE, OR 1 A THE LEGA OWNER OF THE RESIDENTI PROPERTY DES RIBE ABOV GAS SYSTEM OUTLETS Q 0.50 SIGNATURE OF WATER HEATER Q 0.50 PERMiTTE SLOPSINK @ 0.50INSPEC ON RECORD FLOOR SINK @ 0.50 Z FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 - 6 - I '� » �I���'%f.G 71 DRINKING FOUNTAIN Q 0.501 ` URINAL @ 0.50 HOUSE SEW ER @ 0.50 MISCELLANEOUS 0 I APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL Q 1,00 CESSPOOL SEPTIC TANK: SEPTIC TANK I DRAIN ( PIT ( ) Q 1.00 SEWER PERMIT . 1.00 GAS TEST TOTAL FEE S �.. UTILITY CO. NOTIFIED L v.e0 FINAL r WORKERS'COMPENSATION DECLARATION 76AG67A I hereby affirm that I have acertificate of consent to self ceen (z-ao) .APPLICATION FOR PLUMBING PERMIT insure, or a certificate of Workers'Compensation Insurance,or - a certified copy thereof(Sec. 3800 Lab. C. — COUNTY OF OS ANGELES BUILDf G AND SAFETY Policy No. Company s C. FT\ 1 — Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING — ADDRESS Lql Certified copy is filed with the c u 1 uilding inspection NUMBER FIXTURE OR ITEM O FEE LOCA LITV L YYY WATER CLOSET Dated arJ ' .Applicant •� NE qq EST BATH TUB CROSS ST. CERTIFICATE OF EXE iON FROM WORKE S' Q COMPENSATION INSURANCE SHOWER OWNER 1C � � MAIL ,(This section need not be completed if the work involved LAVATORY ADDRESS } by the permit is for CITY TEL. NO one hundred dollars ($100) or less.) SINK ���rrr� �0 I certify that in the performance of the work for which this DISHWASHERPTCxi permit is issued, Fshall not employ any person in any manner CONTRACTOR lJ l/liG 0 so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER %1 /i ' V ADDRESS 0 (l Date Applicant _ a SWIMMING POOL RECE PTO NOTICE TO APPLICANT: If, after making this Certificate of CITY 13, TEL.NO. W Exemption, you should become subject to the Workers' LAWN SPRINKLER SVST M STATE � . qqR(p Z Compensation provisions of the Labor Code, you must forth- WATER HEATER /� LICENSE NOrJp4l —(.. CLA with comply with.such provisions or this permit shall be C deemed revoked. DISTRICT NO. CESS D B/)Y GAS SYSTEM LETS- yy ��/J LICENSED CONTRACTORS DECLARATION OUTLETS OVEA I hereby affirm that I am licensed under provisions of Chapter 5 PER SVST FINAL VALIDA ION 9 (commencing with Section 7000) is Division 3u ll the Busi- and DATE S-2 J�'� r ness and Professions Code, and my license is in full farce and effect. `y pp`` rx/ /� 1�1aKA / ' ,3(a FINAL , /►��'fffr-�m�^e''n�sey�Nru{m�b�e(.'Ll 8,� / /�yrL(i1c.Class�ll BY ' COn�I ttcl(P y/11��I1lA..•1./ktl le I am exempt from the licensing requirements as I am a Plan CheeFree licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE / 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 .`� Y40 q�q p with licensed contractors to construct the project ' (Section 7044, Business and Professions Code). - #'eta e o e rj CONSTRUCTION LENDING AGENCY ,. - ,. 2'e•�o .1 2 rJ 0 I hereby affirm that there is a construction lending agency - for the performance of the work for which this permit is a e e 1 2,50 issued (Sec. 3097,Civ.C.). ' Lender's Name 0 5,24-82 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the 'above-mentioned lffa perry for inspection purposes. 1 ig ature of Permittee Date