HomeMy Public PortalAbout5053 FRATUS DR_Plumbing__ 7SA667 Des 17 11-50 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY L B I G 1
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
R
FOR APPLICANT TO FILL IN DIST O. GROUP
� 2NE� PERMIT NEI.
PLUMBER CEIVED BY READY FOR DATE ISgUED
FIRST INSPECTION
ADDRESS
°
BUILDING —
�P�
_CITY 4Z/ TEL No 'y e ADDRESS
COUNTY s' /�EXPIRES LOCALITY
LICENSE NO 1/
NEAREST
PERMIT FEES CROSS ST. ,
NUMBER TYPE OF FIXTUREOWNER
DR ITEM FEE
MAIL
20
WATER CLOSET(TOILET) 0.50 $ _ADDRESS
BATH TUB @ 050 CITY TEL O ' 7
SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) @ 050 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ O 50 AND STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ Oso ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
OF THE REHIDEN�A OPE�C AB
SI
GAS SYSTEM OUTLETS @ O 50
SIGNATURE OF�
WATER HEATER @ O SO PERMITTEE y,
SLOP SINK @ O SD INSPECTION RECORD
FLOOR SINK @ 050
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.50
DRINKING FOUNTAIN O 513
URINAL @ 0.50 J
Q
HOUSE SEWER @ O 5O Z
MIS EL EOAUSA, L7
• �V 13
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APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT /���✓
CESSPOOL @ 700 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT I 1 pp GAS TEST
UTILITY CO.NOTIFIED
TOTAL FEE
FINAL
76A667-CE#817 2-66
CITY OF TEMPLE CITY
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES B 26 _9
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS 5053 Fratus
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY Temple City
FOR APPLICANT TO FILL IN NEAREST Rosemead & Lower Azusa
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
OWNER Manual Garreon
WATER CLOSET 31 25 MAIL
BATH SUB 1 25
ADDRESS same
SHOWER 125 CITY TEL NO
LAVATORY 125 CONTRACTOR General Installation Co.
SINE 125 ADDRESS 6558 {Nest Blvd.
DISHWASHER 12S CITY Los Angeles TEL NO PL 3-2541
STATE LAUNDRY TUB 125 LICENSE NO C+-36 151839_ CLASS
CLOTHES WASHER 1 25 DISTRICT NO� GRO TOE PRO B
WATER HEATER 1 50
i
GAS SYSTEM—OUTLETS— 50 INDUSTRIAL OUTLETS WASTE APPROVAL p
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD v
l WATER SOFTENER1 ,50 Ready for Inspection Now
W
t/J
Z
APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT 3 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE 3 50 GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED REFTIAI�PROP TY UTILITY CO NOTIFIED
SIGNATURE G`/yam
OF PERMITTEE
FINAL
VALIDATION JACA R. ALLEN
cK M o CASH SUPERVISING MECHANICAL ENG'R
9 G 8 2 6 D D 3 .5 0 �.
?I
WORKERS'COI have a TION DECLARATION CE $1 A APPLICATION FOR PLUMBING PERMIT
I hereby affirm that I have a certificate of consent to self ce e» Iz-sol
insure, or a certificate of Workers'Compensation Insurance,or
a cer fled copy th eof(Sec 3800,Lab C)
$a f� COUNTY OF LOS ANGELESWING AND SAFETY
Policy No Company �r�^^"�1 l
D Certified copy is hereby furnished .� —.,(wry FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDINGPic
ADDRESS J
2`�ertified copy is filed with ttbe ounty building inspection NUMBER FIXTURE OR ITEM • FEE
Dated%-i1G ` `tti WATER CLOSET LOCALITY J� I
63�pphcant NEAREST 1 /
BATH TUB CROSS ST
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE SHOWER OWNER
MAIL
(This section need not be completed if the work involved , LAVATORY ADDRESS Sd 3i
by the permit is for one hundred dollars ($100) or less) - }
SINK CITY �� !� t r TEL NO-) .71�/ 0
I certify that in the performance of the work for which this DISHWASHER CONTRACTOR U
permit is issued, I shall not employ any person in any manner F�vL�� _
so as to become subject to the Workers' Compensation Laws CLOTHES WASHER
Date Applicant ADDRESS 1 �4` ✓ 0
SWIMMING POOL RECEPTOR CITY�k)e U TEL NO ( 3� w
NOTICE TO APPLICANT If, after making this Certificate of
Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC Cn
Compensation provisions of the Labor Code, you must forth- WATER HEATER LICENSE NO-�-(� � I CLAS / Z
with comply with such provisions or this permit shall be
deemed revoked GAS SYSTEM OUTLETS ���� P�CESSE BY
LICENSED CONTRACTORS DECLARATION OUTLETS OVER 01
I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM
9 (commencing with Section 7000) of Division 3 of the Busi- FINAL
ness and Professions Code, and my license is in full force and DATEt1 w Y�VALIDATION.-
effect A-m� " ��' '�
FINAL `
License NumberLie Class�/� BY
ContractorDate
lam exempt from the licensing requirements as I am a Plan check fee
licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$
acting in my professional capacity (Section 7051, Bus-
iness and Professions Code) TOTAL FEE
Lie 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 w Tel No 3 ^ 3;7 6 1 A
ness and Professions Code)
I, as owner of the property, am exclusively contracting # 0`0010 0 5
with licensed contractors to construct the project 2 y 2 5
(Secti0 on 7044, Business and Professions Code) 0
CONSTRUCTION LENDING AGENCY 0101:-12 Q 5 O 5
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is 04231-82
issued(Sec 3097,Civ C)
Lender's Name
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 proferty for inspection purposes
APt
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