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Home My Public Portal About5013 GOLDEN WEST AVE_Plumbing__ SCO'" AT'°"° "°" �°R"°'W APPLICATION FOR PLUMBING PERMIT ll I hereby afflrmrthaGl have a oeKlficate o} consent to calf Insure, or a cartItIcate of Worktro Compensation Insuanoe, or a certified oopy thereof(Sec.•39DO Lab.C.) c� Z�j COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Polloy No.r Comperry �� . ❑ Certified oopy Is hereby to n". J � - POR APPLk'.AN"r TO FILL IN{PFbfr OR TYPE) EXJ, ADORN IXCertified copy W Mad wtth the oourrt l lx ding Inepsod. LOCAL" fr dnpwr—TL NU188a FIXTURE OR ITEM 0 FEt Appfioant WATEHI(XOSEr gT CERTIF"TE OF BCEMFR PTION OM WORD BATH rue IWST- GOMPENSATiON INSURANCE A (Thts atbH n need not be oomploted the work Lnvotved try the MOWER YAP BOOK asP PARCa0 penutt Is for one hundred dollars($100)or Woba.) LAVATORY I oertlty that In the perlormanoe of the work for whl"this permit MAR- Is Issued; I shall not employ any person In any manner so as to become sub)eot to the Workers'Componsaflon laws. DtSWASHERCTfY TEL NO Date Ap~ CLOTHES WASHER MOR a NOTICE TO APPLICANT: If, atter making this CertlHotto df Exemptibn,you should become subfect to the Workm'Corhpensallon SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith oompty wfth such A DCAEse provhdorrs pr this permit shall be doomed revoked. LAWN SPRINKLER SYSTEM CITY TEL I hereby'#('firmthat IDam Ilcensedunder p oof Chapter 9 WAS HEATER (commencing with Seotlon 7000) of,Dtvlalon 3 of the Business and �LIC8�1 a NO. Profmmlons Code,and my Roane is In full force and effecL OUTLETS OVER GAS � OUTLETS DISTRICT NO. opPROCESSED BY ([ 6 PER SYSTF]t (/G License NumberFINALW L.b.Close DATE alb VALIDATION 9L Coni>rnbtor Data 5 Z F-1i am exempt unser Seo BY ACCT.T - - S.SP.C.for tnMe roe.«, Az Man Ct,t�feeSignature � 3307 1l2■CL5 , PLUMBING PERPAIT ISSUING FEF$ 1 ITEM _ TOTAL FEE TOTAL 112. (35 SINGLE FAMILY HOME OWfEPrBUILDER DECLARATION Name ■CLI I hereby affirm that I am exempt from the ConhAbtors License Law for the following reason (Section 7031.6, Business and Professions Address Code). My Tel.No. 1 11/ 6/92 ❑ I,as owner of the property,win do the work and the apvoturo [7t+1 1 1 1.1 to not Intended or offered for solo (Section 7044, pusineas , 4392 Ali 8'-5& and Profeeslono Codi. CONSTRUCTION LENDING AGENCY I hereby aNirm that there Is R odnstruotlon lending agency for the performance of the work for whloh thle permit is Issued (Sec. 3097, cnr. C.) Lenders Name- Lenders Address, I oerttty that I hevo read this applloatlon and state that the above , Information to oorrecL I agree to comply with all County ordlnanoes and State laws regulating Plumbing, and hereby authorize reproaerttaftvas of this County t4 enter upon the above-mentloned ti pro n SEE REVEME FOR EXPLANATORY LANGUAGE I a—WM of WORKERS'COMPENSATION DECLARATION 7; ) APPLICATION FOR PLUMBING PERMIT I herebyaffirm that I have a CE 81certificate of consent to self ce e�7 z-so insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ,"t ADDRESS is i Gol"I L. Art_ ® Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE 1�d" etLy�� LOCALITY Applicant 6WATER CLOSET Temple City Date � NEAREST BATH TUB CROSS ST. Ae Tunas CERTIFICATE OF EXEMPTION FROM WORKERS' } COMPENSATION INSURANCE ], SHOWER — OWNER Purdy t1 MAIL O (This section need not be completed if the work involved LAVATORY ADDRESS S.lae U by the permit is for one hundred dollars ($100) or less.) 1 SINK w CITY TEL. NO. 286-12 3 _J I certify that in the performance of the work for which this DISHWASHER U. permit is issued, I shall not employ any person in any manner CONTRACTOR JohmWe Plumbi e } so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER ADDRESSccDate Applicant 9125 E. Yeeu>niiDr. Q SWIMMING POOL RECEPTOR CITY Tej��® �y '�a Cr NOTICE TO APPLICANT: If, after making this Certificate of TEL. NO. 5-3�?' ? O Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE [o L LIC. Q. Compensation provisions of the Labor Code, you must forth- LICENSE NO. 279687 C36 CLASS ;� 4 with comply with such provisions or this permit shall be WATER HEATER IW - deemed revoked. GAS SYSTEM OUTLETS DISTRICT ISO. PROCESSED BY _.+ LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL ness and Professions Code, and my license is in full force and 1 Garbage d18 0881 DATE VALIDATION effect. ++�� Water & Gas Piping License Number 4r7687C34ic.Class SpM4 BYNAL Contractor Johmy'$ ?1bgDate 2-2 83 I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer — i PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- (. ' iness and Professions Code). TOTAL FEE L Lic,or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name JOhM 'd Plumbing :service I hereby affirm that I am exempt from the Contractor's Address 9125 E. IAS Fuss Dr. License Law for the following reason (Section 7031.5, Busi- City Temple City Tel.No. 28 24 ¢ r ness and Professions Code): I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 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 C Lender's Address l 1, 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 property for inspection purposes. 2-23-83 Signature of Permittee Date L hereby° °I have Sr °tr1D�n of'consent UNto .elf G�"�ir�o► APRLICA'TIO-N FOR PLUMBING PERMIT insure, or a certificate of Workers'Compensation Insurance•,or a cettif]bd copy thereof(Sec.3600,Lab.C.) LLLJJJ COUNTY OF L_O$ANGELES BUILDING AND SAFETY Poticy No. CoMpany ' Cerltmed copy Is hereby furnished. BUILDING FOR APPLICANT TO FILL FN (PRINT OR TYPE) ADDRESS <. & `��'+•�� ' n Qdrtlfled c6py.is i%m with a county building thrpo�tlon F21LAVATORY FIXTUPIE OR ITEM FEE LOCALITY Te> � (,rit� a WATER CLOSET Date Applicant NEAR TBATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' OWNERCOMPENSATION INSUR4'.NC . SHOWER / Pv.rdp MAft �(T ds sectkm need not be compk9ed if the work tnvotved —r D R ESS by the pemflt Is for one hundred dollfto (1100}of Leas.) SINK CITY TEL.NO.'z��'93 j codify_that In.the performance of the work for which thlsDISHWASHER tr tasdad, I shag not em io any CONTRACTOR Johnny's Plumbi Service .� Pah P Y Y pence in any manner to as to become subject to the Workers' Compensation Lws. CLOTHES WASHEN ADDRESS 9125 Be Las fig$ Dk. Data ' - . Applk wit SWIMMING POOL RECEPTOR NOTI(t�O APPLICANT"If, after making this Certificate of CITY Temple City TEL.NO. 285_ Exemption, you sbogid become aubJpci to the Woriters' LAWN SPRINKLER SYSTEM {� Compeneatlon provisions of the taborode,yLIC. ou must forth- STATE 2f 7w! �+' CLASS SClF`f 4 Z withpompty With such provisions or. tht>i petmtt shall be WATER HEATER LICENSE N ._ 1)I8TRICT O. PROC ED BY deemed revoked, 0A8 SYSTEM OUTLE y. LICENSED CONPRACTOVS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of-Chapter 6 PER SYSTEM- 9 (commencing with Section 7000).of 1Nrklop 3 of the ausi- l Garbage t31 &l r FINAL �•—�� VALIDATION lieu and Profession• Code, and my license if ig full force and `^�� effect. .�s� r' Water s-1,9�!93()L FINAL License Num�b,,eyr,„„,� Ic.Class BY Contractor '"'""'-'''�*B PlbgDate 2-23,83 DI-am exempt from the licensing requirements as I Fm a Plan check fee lipensed archltect or a registeted professional an&O& PLUMBING PERMIT ISSQiNO FEE >$ v acting ifs my profowdo'nal capacity (SQction 7051, Buiv toots and Professions Code). TOTAL FEE LIc.or Rag_No. Date Plan cho*applicant HOME OWNER-BUILpER DECLARATION Name Jannyls Plumb4g 4ecrvice Address 9125 He Las' Tunas $. 'I hereby aMm that I am exempt from the Contractors 'Libense Law for the folloWing reason (Soction,1031.5,r Buri icity Temple City Tai No. 28 ;R 0 0 1,5 A no”and Professions Code): nj, as owner of the property. ant exclusively contracting 1 a•o,o,c,o 5 with Ifcerued contractors to construct the project . (Section 7644,Business and Profeulons Code). !2 0.e JF 2 5 0 - CONSTRUCTION LENDING AQENCY. o a o'5 2'-)0 6, I'hereby afffrm that there is ■ potytruction lending agency for the performance of the work for which this permit is 2 2 3'—8 3 issued(Sec. 3097,Civ.C.). ti L6nder's Nalme L•and6rs Address I certify that I have read this application and state that the above information is correct.I agree to comply vH0 all County ordinances and State lawn regulating plumbing, and hereby SEI{REVERSE FOR EXPLANATORY LANGUAt3$ er authorise tepreaentattves of this County to enter upon the 4bova-mentioned property for inspection purposes. 2-23-83 Signittura of Permittee Date