HomeMy Public PortalAbout5226 DEGAS AVE_Plumbing__ ]dA 66'+-EE#B`'l 10-62
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION aDDRESS
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 226 De as .Ave.
WILLIAM A. JENSEN. SUPT OF BUILDING LOCALITY Temple City
FOR APPLICANT TO FILL IN CHOSSSST. R' ndwick
NUMBER FIXTURE OR ITEM EACH FEE
OWNER Dnal Corp.
2 WATER CLOSET $1.25 2 50 MAIL
1 BATH TUB 1.25 1.25 ADDRESS
SHOWER 1-251 CITY TEL. NO.
7�
2 LAVATORY 1.252 O CONTRACTOR Owen BPOS Plumbing, Inc.
1 SINK 1.25 1.25 ADDRESS 4265 No. Baldwin Ave.
1 DISHWASHER 1.25 1.25 CITY El Monte TEL. NO. 443-0078 -
LAUNDRY TUB 1.25 CONTRACTOR'S STATE 7(]
REGISTRATION NO. 971741 COUNTY ❑
1 CLOTHES WASHER 1.25 1.25 DISTRICT NO. GROUP ZONE �RO ESSED BY
1 WATER HEATER 1.50 1.50 1
1.50 INDUSTRIAL /IL
GAS SYSTEM OUTLETS WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .50 u
INSPECTION RECORD
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APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT S 2 00 UNDER L B-WORK 21, ,
ROUGH PLUMBING
TOTAL FEE 16.25 GAS PIPING (/
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
PND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING. &,J 1 HEREBY CERTIFY THAT I AM PROPERLY REG �p��LICENSED AS REQUIRED BY LOS ANGELES COUNTY / w�l .1CALIFORNIA OR THAT AM TXE LEGAL OWNEfl OF.ANO INTEND TO GAS TE$T 6
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED �� 1
SIGNATURE /
OF PERMITTEE --
FINAL
ALIDATION ROBERT A. WOOD
cK.
M.0. CASH SUPERVISING MECHANICAL�ENG'R
L'1G0 9 3 4 8-� t, R 5 D . 1 6.2 j
WfiW tlh'COMPENSATION cafeDECLARATION
corse APPLICATION
PP ICA TION FOR PLUMBING
SA A OGABI IIrP PERMIT I herebys orfiryn that I'h'ave a certificate of consent to self 76A667A YVI�I�IL YV 0 0tl FOR IFIL�LYYtltlI� 0CI�9 PIG Y'd9C0 II
insure,'r•a certificate of Workers" Compensation Insurance, CE 817(REV. 10/81)
'or a ceriRied.copy thereof (Sec. 3800,, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Pelicy Nd,'J e G40S 3gompany_ PC-0 I IL% S LJQNAXJZ
❑ —
Certified copy is hereby furnished.
❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ILDING /' < $
Certified copy is filed with the county building inspeo- BUADDRESS r 11-7�V�-LO
tion department. � NUMBER FIXTURE OR ITEM @ FEE �
Date 0'4 �QT Applicant n ' J /YIJf a' WATER CLOSET LOCALITY 71—
NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST.
COMPENSATION INSURANCE SHOWER OWNER A 2� G
(This section need not be completed if the work involved by ^MA'I ^� /'� ` S
the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS d-� IJr (I a$ t""'
I certify that in the performance of the work for which This
permit is issued, I shall not employ an person in an manner SINK CITY n TEL. NO.
P P v vP i ILM �r Cf i 4s3
so as to become subject to the Workers'Compensation Lows. DISHWASHER
y'�S ACONTRACTOR
Dote Ia'
_ pplicant r4.J MVI/L CLOTHES WASHER fJ
NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS/Lr J� RS P-l-&—,V6 p
Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR J.TH
Compensation provisions of The Labor Code, you must forth- CITY �� TEL. NO.(,if{l` yS��
with complywith such provisions or this LAWN SPRINKLER SYSTEM
p permit shall be STATE i- OC.LA
deemed revoked. WATER HEATER LICENSE NO. �s 3 J � S Css /3 t
LICENSED CONTRACTORS DECLARATION DISTRICTN ESSED BY
I hereby affirm that I am licensed under provisions of Chapter 9 r GAS SYSTEM 'r 'T OUTLETS
(commencing with Section 7000) of Division 3 of the Business OUTLETS OVER 5 h >
and Professions Code,and my license is in full force and effect. 5 PER SYSTEM a'
DATEFINA�� , 9 � V (DATION O
License Number y`I 3 3 l T Lic. Class 3 If sw
FINAZ O
Contractor Date < BY 1—
El❑ 1 am exempt under Sec. d
` N
B.BP.C. for This reason Plan check fee D
Dat I
PLUMBING PERMIT ISSUING FEE S l 5
Signatur
TOTAL FEE
Plan check applicant ;2 3 5.9. 8 A
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Name #I e e e o e 5
1 hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and I o -.1 &5 0
Professions Code): City Tel. No. o e❑ o,1 [T rj 0 I, as owner of the property, will do the work and the
structure is not intended or offered for sale (Section D 1 ? 04 -8 5
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 issued
(Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
I certify shot I hove read this application and state that the D
above information is correct. I agree to comply with all County
ordinances and Slate laws regulating Plumbing, and hereby
authorize representatives of} is County to enter upon the
above-m boned property r n ection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
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LSi666ture of Fermi a Date