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Home My Public Portal About9855 FLAHERTY ST_Plumbing__ D.B.S.17 2SM BETS 1-48 - APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ' COUNTY OF LOS ANGELES PLUMBING WIA.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETEd� p -t� 7, _ CESSPOOL SEPTIC TANK READY FOR HEATER RECEIVED BY DATE ISSUED � FIRST INSPECTION ,- AS- MISCE LANEOUS �Kf`i APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY C NAME d ✓ o- 3.- '3J ADOJOSRES N m ADDRESS LOCALITY a � .�.�� L c�/9 NEAREST A CITY ��A/ YJ` I�EL Y d � CROSS ST. COUNTY �a v � CERT.NO. EXPIRES(9 v !D L`Z.'\ m NAME LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL /� NORTH O ADDRESS,//�6�"5'%�Tf Od�4f /q �1�yN ',y CITY ��R�"' '+'� TEL.NodHv d `7 I AM THE LEGAL P069@SSOR-CF THE ABOVE LOB ANGELES COUNTY CERTIE7C4TE t�OF QUALIFICATION. PLUMBER - I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. N OWNER CORRECTIONS SOUTH DESCRIPTION.OF WORK a z_ BATH TUB FURNACE O Q' 19HOWER DISHWASHER -LAVATORY REFRIGERATOR .KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS _WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME —_WATER HEATER DENTAL LAVATORY ROUGH PLUMBING -METER--Z—GAS SODA FOUNTAINOUTL GAS PIPING �+ _z GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK I I CESSPOOI SEPTIC TANK SEWER I UTILITY CO.NOTIFIED / TOTAL FEE �p--- FINAL ( f 7GA667 17 5-49 ® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO ILL IN DISTRICT NO. GROUP ZONE ERMIT NO. '7' 4- d lea � o' PLUMBER RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS dl J /& /0-/0- U 9- BUILDING t V z CITY TEL. NO. ADDRESS COUNTY LOCALITY LICENSE NO. EXPIRES NEAREST PERMIT FEES CROSS ST. al - NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER c MAIL WATER CLOSET (TOILET) @ 0.50 $ ADDRESS BATH TUB @ 0.50 CITY TEL. NO. SHOWER r@ 0.50 1 HEREBY ACKNOWLEDGE THAT I 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 STATE LAWS REGULATING PLUMBING. KITCHEN SINK @ 0.50 I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTIAL yyy,PPP OPERTY DESCR >D ABOVE. GAS SYSTEM OUTLETS Q 0.50 SIGNATURE OF PERMITTEE��- WATER HEATER @ 0.50 SLOP SINK Q 0.50 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50I DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50I J HOUSESEWER @ 0.50I - Q Z MISCELLANEOUS U' lY O I I I APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1.00 I� f CESSPOOL SEPTIC TANK: I �- SEPTIC TANK I I DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT 1.00 GAS TEST I UTILITY CO. NOTIFIED ., TOTAL FEE w ,�' v FINAL Cl i y 78A 667 -CE#817 70-62 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 98 5 L. Flaherty St. WILLIAM A. JENSEN, SUPT OF BUILDING 4 CROSS LOCALITY Temple City FOR APPLICANT TO FILL IN NEAARESST, Golden west NUMBER FIXTURE OR ITEM EACH FEE OWNER Will. P. Behrrnan WATER CLOSET $1.25 MAIL p BATH TUB 1.25 ADDRESS $ E. Flaherty SHOWER 1.25 CITY Temple City TEL. NO. At 6 5002 LAVATORY 1.25 CONTRACTOR Pacific Installers SINK 1.25 ADDRESS 10920 E. Grand DISHWASHER 1.25 CITY Temple City TEL. NO. 143 6905 CONTRACTOR'S p STATE $] LAUNDRY TUB 1.25 REGISTRATION NO. 211898 COUNTY ❑ CLOTHES WASHER 1.25 DISTRICT 77i OUP ZONE PROCESSED BY WATER HEATER lace 1>1t40 �O O '4 GAS SYSTEM OUTLETS 1.50 INDUSTRIAL WASTE APPROVAL 0 OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD u @C Lae CL Vf APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE 50 GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER �q ,� may: PLUMBING. _ _ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES V I LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST I CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL P oPERTY. UTILITY CO. NOTIFIED � SIGNATURE OF PERMITTEE C FINAL '-)/// � �. ALIDATION ROBERT . WOODS"' cK. ' M.O. CASH SUPERVISING MECHANICAL ENG'R 2 3 5 V 3.5 r WORKER'S COMPENSATION a certificate of consent to 76A666DPW9/89 APPLICATION FOR PLUMBING PERMIT 76A667A I hereby,affirm that I have a certificate of consent to self insure, or•a certificate of Worker's Compensation Insurance, or a certified copy thereof(Secy 3800 Lab.C.) Policy No. 112Q762-L2 Company 57 a fD . COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV. ❑ Certified copy is hereby furnished. BUILDING El APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified copy is filed with the county building inspection department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant ( WATER CLOSET NEAREST OF CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB I CROSS ST. p COMPENSATION INSURANCE ASSESSOR MAP BOOK � p 5 PAGf��5 PARCELf/� Fi (This section need not be completed if the work involved by the SHOWER permit is for one hundred dollars($100)or less.) ' OWNER LAVATORY I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as toSINK MAIL ADDRESS become subject to the Workers'Compensation Laws. DISWASHER CITY TEL.NO. Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of CONTRACTOR TNf•1c� �'V Exemption,you should become subject to the Workers' Compensation SWIMMING POOL RECEPTOR i provisions of the Labor Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM 41 LICENSED CONTRACTORS DECLARATION CITY ` �,QQ� TEL.NO. �S3 I hereby affirm that I am licensed under provisions of Chapter 9 ' WATER HEATER C7n`�STATE LIC 0 (commencing with Section 7000) of Division 3 of the Business and ' GAS SYSTEM OUTLETS LICENSE NO. J Z �ir> CLASS V Professions Code, and my license is in full force and effect. OUTLETS.OVER DISTRICT NO. v PROCESSED BY 5 PER SYSTEM �� (/ �-• ,.G �� License Number 52,7)12 5 Lic.Class 0 FINAL VALIDATION LU ,, � ��,,�� lCL1 1J7T�y .I DATE Contractor�1+iDate Zyca ❑ I am exempt under Sec. BY AL B.&P.C.for this reason Date: Plan check fee , PLUMBING PERMIT ISSUING FEE$ Signature ❑ TOTAL`FEE Plan check applicant ;•.- SINGLE FAMILYt•'.I HOME OWNER-BUILDER DECLARATION Name - 9"vc; I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Address rt__. Code): ! i r F�. El City Tel.No. ;-) - f 5 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). , - '• a f! 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.) 9/222`/92 Lender's Name + 5 f4 i (f { may:, f i o/% 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 ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature ofermittee Dater