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HomeMy Public PortalAbout5813 GOLDEN WEST AVE_Plumbing__ 76A667 E81 E817 A) - 8/75 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING // MAKE CHECKS PAYABLE TO: ADDRESS ' Ka'Zo/ ig T )9 HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY � _^ �` Ci '"i FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST ^ A (� NUMBER FIXTURE OR ITEM @ FEE CROSS ST.OWNER WATER CLOSET u n MAIL BATH TUB ADDRESS SHOWER CITY r TEL. NO. D LAVATORY CONTRACTOR RA SINK ADDRESSf��1 y� V' DISHWASHER CITYA'Si ,^ �+' TEL. NO. CLOTHES WASHER //� SWIMMING POOL RECEPTOR LICENSE NO. 'j 56 Y`f CI ASS `�(f DISTRICT NO. GROUP Z NEgR20�CPVWD BY LAWN SPRINKLER SYSTEM �/ U �/ WATER HEATER INDUSTRIAL C WASTE APPROVAL GAS SYSTEM OUTLETS INSPECTION RECORD OUTLETS OVER 5 PER SYSTEM QJ� l311 E9f 1 � Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE S TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. NO. GAS VENT HOT WATER HEATER I HEREBY.ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE. LAWS REGULATING PLUMBING. GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REOU I RED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT,I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL SI GNA TU RE OF PERMITTEE PE MIT VALIDATION C'JM ,O. CASH PLAN CHECK VALIDATION CK. M.0. CASH 647.50AS 76A667 (CE-ell) - 175 "GERMIT APPLICA)flO FORP�UMB COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING ADDRESS HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 2.00 OWNER (� MAIL BATH TUB 2.00 ADDRESS SHOWER 2.00 CITY TEL. NO. LAVATORY 2.00 CONTRACTOR SINK 2.00 ADDRESS DISHWASHER 2.00 CIT I TEL. NO.yy CLOTHES WASHER 2.00 STATE LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR 2.00 DISTRICT NO.GROUP ZONE PRO ESS D BEY LAWN SPRINKLER SYSTEM 2.00 O fJ 1 WATER HEATER 2.00 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 2.00 INSPECTION RECORD n- O OUTLETS OVER ,30 O 5 PER SYSTEM O F— C� W C1_ C11> Plan check fee See Reverse sb PLUMBING PERMIT ISSUING FEE $ e- TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant � UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALI FORNIA OR THAT I AM TME LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIA% P OPERTY. SIGNATURE � ,meq`` FINAL-v-;) _ vX p OF PERMITTEE //ll � ✓ to. **��"..�(!! 1 PERMIT VALIDATION CK. M.0. CASH PLAN CHECK VALIDATION CK. M.O. CASH C 1263 �p ..cam_ 76DBS-17 10.55 u A667 APPLICATION F ry -L 66� . P T DIVISION OF BUILDING AND SAFET Depoximent of County Engineer County of Los Angeles BUILDING 5813 No. GOldenwest JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS CASSATT D.GRIFFIN, SUPT OF BUILDING Te 1e City y FOR APPLICANT TO FILL IN NEAREST Las Tunas CROSS ST. Li OWNER Lawrence Shuey DISTRISr NO GROUP I ZONE I REA Y FOR INSPECTION MAIL ADDRESS S®tete INDUSTRIAL CITY TEL. NO. WASTE APPROVAL PLUMBER GENERAL INSTALLATION CO. INSPECTION RECORD ADDRESS 6558 Wes? Blvd. CITY L.A. 43 TEL. NO. Peasant 3-2541 LICENSE NO. 787 C-36 151839 NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 $ BATH TUB @ .$1.00 SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $1.00 KITCHEN SINK @ $1.00 DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 GAS SYSTEM @ $1.00 1 WATER SOFTENER 1 00 APPROVALS DATE INSPECTORS SIGNATURE UNDER SLAB WORK PERMIT $ JCOMPLY 0 ROUGH PLUMBING GAS PIPING TOTAL FEE 0 . GAS VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THISN AND STATE THAT THE ABOVE IS CORRECT AND AGRELY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWSG PLUMBING FIXTURES PLUMBING.1HEREBY CERTIFY THAT I AM PROPERLY REGISTOR '- GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AOFCALIFORNIA OR THAT I AM E LEGAL OWNER OVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL PRT SIGNATUREOF PERMITTFINAL n- Fi• .A JOHN A. LAMBIE. COUNTY ENGINEER ALIDATION ROBERT A.WOOD, CHIEF PLBG. INSPECTOR CASH L�'�01 6 6 0 JUi� 2 5 D 3.00 WORKERS' COMPENSATION DECLARATION 76A667APPLICATION FOR PLUMBING PERMIT 76A667 DPW 4/87 I hereby, affirm that I have a certificate of consent to self.in- A sure, or a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) certifiedlcopy thereof (Sec. 3800, Lab. C) Policy No. Company sTA?E k1�� COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS s57/29Certified copy is her furnished. BUILDING FOR APPLICANT TO FILL IN (PRINT OR TYPE) J3 / ���L� Certified copy is iE?/ 'led with the county buildin spection ADDRESS .J I-IV Fr�CJi - department. I L NUMBER FIXTURE OR ITEM @ FEE _ ,� � !f II ' m LOCALITY P� 17g0 Date Applicant / WATER CLOSET(TOILET) Ute NEAREST n _ nn " L/7-5 ' L)/U`T.rj CERTIFICATE OF EXEMPTION FROM BATH TUB WO KERS'' J Uv CROSS 5T. COMPENSATION INSURANCE SHOWER OWNERs�A� UM���E uwm C 0 (This section need not be completed.if the-work involved by MAIL the permit is for one hundred dollars ($100)or'less.) , LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK mit is issued, i shall not employ any person in any mannerCITY TEL. NO so Z*36 6711 as to become.subject to,the:Workers Compensation Laws., DISHWASHER CONTRACTOR �� ` CONTRACTOR i1j� Date Applicant CLOTHES WASHER ADDRESS 77��,,//�� T NOTICE TO.APPLICANT If,'after making this Certificate of Ex- c 7L�7� OOL�T/ U SWIMMING POOL RECEPTOR p emption, you should become subject to the Workers'Compen- CITY ���� C TEL. NCt'�g �0 safion provisions of the Labor Code,you must forthwith comp LAWN SPRINKLER SYSTEM71 ..Jy with such provisions or this permit shall be deemed revok- STATE LIC ed. / WATER HEATER /_ '(�� LICENSE NO. 7 CLASS {� LICENSED CONTRACTORS DECLARATION DISTRICT NO, OR4SSID BY I hefeby affirm that I,am.licensed under provisions of Chapter / GAS SYSTEM OUTLETS 2 OV �1 9(commencing with Section 7000)of Division 3-of the Business OUTLETS OVER' 06 and Professions Code, and my license is in full force and ef- 5 PER SYSTEM 1. 1FINAL IL VALI T N >_ fect. 7 Lic..Class DAT License Numb r O A Contracto DatA4z;, O a- �1 I am exempt-under Sec. LU B.&P.C.-for this reason ► -Plan check fee g Dote: PLUMBING PERMIT ISSUING FEE $ �p Signature TOTAL FEE (� SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License, Name Ste. �QJ Law for the following reason (Section.7031.5, Business and ir•r- s 1 Professions Code): Address 30 10^ Q6 L/e • E 7 Cit AWAOM/7 CA f/ Tel. N06 "/I �i I, as owner of the property, will do the work and the Y �© structure isnot intended or offered for sale(Section 7044; Business and Professions Code). -"^ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a constructionlending agency for 41335 1 lhe,'performonce of the work for which this permit is issued (Sec..:3097',�Civ. C.). r:` t 5( L- Lender's Name Lender's Address I certify that I have read this application and state that,the A'1 9'49 above information is correct. I agree to comply with all County ordinances and Stat laws regulating Plumbing, and hereby authorize repres tives of this County to enter upon the ab v -me io roperty for inspection purposes: SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o ermittee 1 / Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1404030014 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS, 1 ITR: 6561 LT: 468 I I 5813 GOLDEN WEST AV 1 I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917802204 I (ASSESSOR INFORMATION NUMBER: 1 1 . NEAREST CROSS STREET: LAS TUNAS 18587-024-003 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY CAI 1 .107 BATHTUBS/SHOWERS 1.00 FIX 16.20 1 (TENANT: 125 LAVATORIES/SINKS 1.00 FIX 16.20 (ISSUED ON: PROCESSED BY: PLAN BY: 1 145 WATER CLOSET/URINAL 1.00 FIX 16.20 104/03/14 SR I TOTAL FEES 76.40 1 10WNER: TEL. NO: I IF TIOIIL„DATE FI BY: CODE: BEN 15813 GOLDEN WEST AV (TEMP 917802204 1 1ItSCRI7PTION F WORK 1 1 I IBATHTUB/SHOWER, LAVATORIE AA WATER CLOSET I I I 1 (APPLICANT: TEL. NO: 1 I ' ITO, LANH V (626) 309-9623- 1 I 14841 TEMPLE CITY BL 1 ISPECIAL CONDITIONS: 1 ITEMPLE CITY CA 91780 I I I I I I I ICONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE 1 1ALAN SERVICE CO. (626) 309-9623- 1 1 14841 TEMPLE CITY BLVD LIC. NO 1 (UNDER SLAB WORK ITEMPLE CITY CA 91780 648308 1 1 IWATER SERVICE I IPLASTIC Y/N METAL Y/N ( I (ARCHITECT OR ENGINEER: TEL. NO: 1 I I - TROUGH PLUMBING 1 LIC. NO: IGAS PIPING I I I I IGAS VENT 1 i I I I IHOT WATER HEATER 1 I I I IPLUMBING FIXTURES 1 I I I ILAWN SPRINKLERS I I I I IGAS TEST I I I I I (UTILITY COMPANY NOTIFIEDI I I I ICWV I I I IGRAY WATER SYSTEM I I I I I I I I I I I I I I I I I I I* ADDITIONAL DATA ON FILE I I 1 I REPORT ID: DPR263 ROUTE T0: BS0508 1 I I I I I