HomeMy Public PortalAbout9906 GARIBALDI AVE_Plumbing__ 71A6OY °s 17 11-`O APPLICATION FOR PERMIT
' . DEPARTMENT OF BUILDING AND SAFE'T'Y
COUNTY OF LOS ANGELES PLUMBING i
WILLIAM J. FOX, OHIEF EMOINKER
DIErl-RI -No. 13ROUP ZONE PERMIT NO.
FDR APPLICANT TO FILL IN//�� ? 1 13 O / (,
L
PUMNKR B lvedere Phunbin Go,, REDK BY READY FOR D TE 1 m
FIRUT INwzcrriON
ADDRE� 136 S. Palm Ave. '
■uILDIN 4 C
CITY Alhambra TEL No. AT95025 ADDRESS
nQuw y $0$M 6_ 0_ 2 LguA.LITYTem le City 6
PEHJdIT FEES oR:.E rr. Garibaldi
NUNN" TYP[OF FIXTURE 011 r M FEE OWNER Ra m nd Fort
rier
MAIL
1 WATER OLDUET(TOILET) ! 0.50150 0 ADDRESS
l BATH Tun ! 0. 50 60 pITM TEL Na.
IHQWrR ! 0.60 1 H MR AOKIiOWLiDOE THAT I HAVE READ THIN
LAVATORY (WAHH BASIN) ! 0.60 - 50 A41-1715TION AND STATE THAT THE ABOVE 10 CORRECT
AND AORIZ TO COMPLY WITH ALL COUNTY ORDIMANOEU
KITOHKN MINK ! 0.W50 AND STATE LAWS REOULATIMO PLUMBING.
F OKRTIFY THAT I PCggEUB THE ABOVE VAUD LOU
LAUNDRY TU■ OR TRAY ! 0.60 0 AMOELEU OOUNTY LICENSE, OR I AM THE LEGAL OWNER
OF THE RERIDENITIAL rROPEIITY DESCRISKD ASOVE.
GAJ! BYS"IZ uTLIl7 ! 0.60
■IGMATURE OF A_ LL LtG�nA!f
WATER HATER ! 0.60 PDIMITTEK
■LOr MINK ! O.eO MPECTION RECORD
FLOOR ■INK ! 0.60
FLOOR DRAIN ! O.BD
DIBHWALHER ! 0.60
DRINKING FOUNTAIN ! 0.6a
URINAL
t
HOUAK ■EWER ! CLOD _Z
MIE E 1 &HKOUS
C3
APPROVALS
DATE 1HSPmTOR'f liwt
ROUGH PLUMMINO
BAB PIPINO
MS VENT
OESETOOL ! 1.aO OKIiPOOL
eEPT10 TANK1 /KPTIO TANK
DRAIN ( PIT ( ) ! 1.00 SEWER
PERMIT 1.00 GAS TEST
UTIuTY O0.NOT1FIm C) L
TOTAL FEE • !. 50 0
'�F FINAL
603 M
• ""°W DW 17 11-60 APPLICATION FOR PESNIIT
DEPARTMENT OF BUILDING AND SAFETY PLUMBING
COIIN3Y OFF LOSLOS ANGELES
WILLIAM J. FOX, OHICF [NOIN[[R
D I STR r 0. G R-13 U N E PERMIT NO.
-FOR APPLICANT TO FILL IN
-/ R&M_39RUDY FflR DATE 1 [D
FI NBP7< ION
r
AD DR[SB
■UILDINED Q
DITY TCL ADDRLBB
BOUNTY AVLOCALITY
NEAR[JTI'
PERMIT FEES r - OR CUM a r.
HUME[R TYP[Or FIXTIIRI 13 if mcm OWN[R
MAIL
WAT[R OLOBET(TOILET) ! 0.BO R ADDR[S>t
BATH TU-0 ! 0.60 OITY TKL. No.
SHOWIER ! 0.60 1 H9R[QC71-110LIOC THAT TH[ ANOV[Y ADKNDWLCDa[ THAT I HAVREAD TI■
LAVATORY (WASH BASIN) --a 0.10 AND
AND XTAT1■ OOR
RK13T
AHD AOA[[ TO DOMPLY WITH ALL BOUNTY ORDINANCta
KIT13H[N BINK' ! 0.60 AND STATC LAW/ RIOULATINO FLUM01N0.
t B[RT1FY THAT 1 POSSISB TN[ ABOVC VALID LOS
LAUNDRY TUB CR TRAY ! MED ANO[L[M BOUNTY LIO[NSK, OR I AM THE LZMAL O'WNCR
OF TH[ ROID[NTLAL PR [RTY DCSCRIS[D ADOV[.
0.60
■IRNATIIRI OF_r
WATER H[ATXR O MOD P[RMII'l'C[ -
BLOP BINK ! 0.60 INSPECTION,RECORD
FLOOR OINK ! 0.6O
0 ^
FLOOR DRAIN ! 0.60
DIBHWABHCR ! m." M Cr d-
DRINKINO FOUNTAIN ! 0.60
URINAL ! 0.60
MIBO[LLAN[OUO - C3
0
APPROVALS
DAT[ INNOME=X'■ MA 49
ROUGH PLUMNINO
OAS PIPING
OAS V[NT
DKE"OOL ! 1.00 0 CJ DIEBBPODL tea-9-
B[PTID TANKz ■[FT10 TANK
DRAIN ( ) PIT ( ) ! 1.00 B[WER
PERMIT 1.DO UL TFMT
UTILITY D0.NOTIFIED
TOTAL FEE
FINAL !!
[
hereby affirm Rs'COMhEave 4r c r"ccatoLof c�droent�to"If ��:1(_-1.) APPLICATION FOR PLUMBING PERMIT
hipm, ■ catiHcatepf Workers'Compensation Insurance,or
a certifted.copy-thereof(Sec.3600,Lab.C.)
Y, COUNTY OF LOS ANG S SAFETY
,p6ay No. —Company
Ca tInbo copy is hereby tumlahed. FOR APPLICANT TO FILL IN (PAINT OA TYPE) BUILDING ff '
C4rfit4d o6py is ftlhd with the cou4ty building inspection NUMBER FIXTURE OR ITEAA • ADDFIIE88 /
department. LOCALITY
15ate Applicant WATER CLOSET A EST
BATT 1 TOB CROSS ST. A.)/✓
OI�RTIFICATE OF EXFMPTION FRO14 WORKERS'
COMPENSATION INSURANCE SHOWEx1
MAI L
cmis We don need not bo completed if the w0$ to Weed z , 9 LAVATOfIY ADDR
by the pem3it is for-Qm hundred dollars ($100) or law)
SINK L
CITY TBI-.. NO.
— C7
I certify that In the perfornlagcb of the work for which thL DISHWASHER +
perrpft In issued, I esll not employ 4ny paUon In any manner CONTRACTOR
Ir
to as t ecomc subject to the tion IAwa. CLOTHES WASHER A1DbRES.S 0
Data j'd Applicant swwmmo POOL RECEPTOR /
NOTICE TO APPLICANT.-It, after making this Certificate of CITY TEL. NO.33fs—
Exemption, you should become subject to the Workers' LAWN 8PRINKLER$YSTEM4
T '
Compensation provisions of the Labor Code, you must forth- ATEA LFCN.8E . � 5CLASS
WATER H
with comply with such provialons or this permit sball be �
deemed revoked DIST T NO. P CES$FQ BY
GAS SYSTEM f).UtLfT8
LICENSED CONTRACTORS DECLARATION ' OUTLETS OVER
I hereby affirm that Vern llcehsed-linder provUl6as of Chapter 6 PER SYSTEM
9 (commencing with Secttop 7000) of Division Yof the Buti- FINAL
nen and Profaaiom Oode, apd my license is to full force and DATE
effect.
3� FINAL
License Njimber,1)??03' Lic.Claw BY
Contractor Data
I am exempt from the licensing requtrements as lam a Pler>check fee ¢�
licensed architedt or ■ rdgistered profesalonal engineer PLUMBING PERMIT ISSUING FE-E$
lctrnt In my profeaionaj Capacity-(Section 7051, Bus-
igen and Profeadons.Co4a). TOTAL FEE
Lic.or Reg.Na. Date Plan check■ppltcant
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm that I am exempt from the Contractor's Addredw
License Law for the following reason (Secilon,7031.5, Bust- Ctty Tel.No.
ness wd hrofaslona Coda): 2.3 2&8 A
I, as owner of the property, am exclusively contracting
with 4beh4ed contractors to construct the project # o 0 0 0 0 5
($action 7044,Business and Profesgigns Code).
2003 .1,00
CONSTRUCTION LENDING AGENCY o 0 0 Tj Q Q
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is 2037.80
issued(Sec.3097,Civ.C.).
Ladder's-Mame
Lender's Addrer
I certify that i have read thta 1ppilcatio0 and state that the
above information is correct.I agree to comply with all County
ordinances and State laws regulating Plumbing-, and hereby SEE REVERSE FOR EXPLANATORY LANGUA{j
authorlxe repraen rjnty to enter upon the
above-meDtIptied f ins n p
Signature of Permlitee