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Home My Public Portal About6138 GOLDEN WEST AVE_Plumbing__ 76A667 - CE817.5/70 TEMPLE CITY APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES B 7727 DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FNEAREST 6138 Goldenwest JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS. SUPT. OF BUILDING Temple City FOR APPLICANT TO FILL IN (PR NT OR TYPE) . NUMBER FIXTURE OR ITEM EACH FEE OWNER J. Noetzel WATER CLOSET 1.50 MAIL BATH TUB 1.50 ADDRESS Same SHOWER 1.50 CITY TEL. NO. LAVATORY 1.50 CONTRACTOR GENERAL INSTALLATION CO. SINK 1.50 ADDRESS 6558 WEST BLVD. DISHWASHER 1.50 CITY Los Angeles TEL. xo. PL 3-2541 CLOTHES WASHER 1.50 STATE LIC LICENSE NO. C 36 151839 CLAS SWIMMING POOL RECEPTOR 1.50 DISTRICT NQ. GI$O:LIP E PROC9ASED BY LAWN SPRINKLER SYSTEM 2.00 � ,�. •--' WATER HEATER 1.50 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD OUTLETS OVER 5 PER SYSTEM .30 Ready P for Inspection Now 1 'WATER SOFTENER 1 75 Ub Plan check fee 25% of above. See reverse. Soo PLUMBING PERMIT ISSUING FEE .$ TOTAL FEE 1 4 175 APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel. No. 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 GAS TEST PLUMBING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF , CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN, THE ABOVE DESCRIBED RES TI/�1�PR0 Y. FINAL - r - -- SIGNATURE C ' JACK R. ALLEN, SUPERVISI HANK AL ENG'R. OF PERMITTEE PERMIT VALIDATION C M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH r 76 A 667—CE 817.4-68 APPLICATION FOR PLUMBt G PERM u COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE WATER CLOSET 1.50 OWNER 14AIL ,-7 BATH TUB 1.50 ADD SHOWER 1.50 CITY �rTEL. NO. ,— ,/ LAVATORY1.50 CONTRACT R SINK 1.50 ADDRESS DISHWASHER 1.50 CITY iyi TEL. N CLOTHES WASHER 1.50 STATELIC LICENSE NO.lie CLASS SWIMMING POOL RECEPTOR 1.50 DISTRICT dtapP ZONE . P BY LAWN SPRINKLER SYSTEM 2.00 •' 0 WATER HEATER 1.50 , INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.50 .INSPEC/TIO ECO I� OUTLETS OVER L 6 l 5 PER SYSTEM .30 l�J E&1 N Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City. Tel. No. 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 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 CALIFORNIA OR THAT I A THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DE RI ED RESID TIAL OP Y. / .' �/ FINAL V✓ SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL R. OF PERMITTE PERMIT VALIDATION CK. M.0. CASH PLAN CHECK VALIDATION CK. M.O. CASH 1 r�2 0 4 2 SEP29 5 Q 3.50- 76 A 667 -'CE 817 7-69 APPLICATION FOR PLUMBING PERM, COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADDRESS 6138 Golden West JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY Temple City FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST - CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE WATER CLOSET 1.50 3 OWNER Dick Bowen � - MAIL BATH TUB 1.50 '- ADDRESS 1620 Melanie Lane SHOWER 1.50 CITY Arcadia TEL. NO. LAVATORY 1.50 Z1 CONTRACTOR Owen Bros. Plumbing, Ince SINK 1.50 ADDRESS 4265 No. Baldwin Ave. DISHWASHER 1.50 Jr� CITY El Monte 917831 TEL. NO. 443-0078 CLOTHES WASHER 1.50 STATE LIC LICENSE NO. 231 741 CLASS C 36 SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE PROCESS BY LAWN SPRINKLER SYSTEM 2.00 -WATER HEATER 1.50 Q INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.50Q INSP TI RECOV , u OUTLETS OVER 30 5 PER SYSTEM v _ b Lu Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE 10 APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLU I Address: GAS PIPING GAS VENT City. Tel_ No. 14Y I HOT WATER HEATER ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ALATHAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES COUNTY ORDINANCES AND STATE .LAWS REGULATING GAS TEST - CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED S REQUIRED BY LOS ANGELES COUNTY AND STATE OF OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO HE ABO DEGCRIB ED RESIDENTIAL PROPERTY. FINAL E .TACK R. ALLEN, SUPERVISIN CHANICAL EN-G'R. ITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH WORKERS'COMPENSATION DECLARATION APPLICAT0ON FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) or a certified coy thereof (Sec. 3800, Lab. C. COUNTY OF LOS ANGELES /� �� BUILDING AND SAFETY O�CX958588CPA cy C Aetna Casualty & Surety o. ompany Certified copy is hereby furnished. ® FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS 6138 N. Golden West Ave. tion department. SERVAMATIC SOLAR NUMBER FIXTURE OR ITEM @ FEE LOCALITY Temple City Date_ 92/83 Applicant SYSTEMS, INC. WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER NOETZEL JOHN & ARY (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS SAFE I certify that in the performance of the work for which this 286-9165 permit is'issued, I shall not employ any person in any manner SINK CITY TEL. NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR, SERVAMATIC SOLAR SYSTEMS Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS 20290 E. Carrey Road Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL. NO. p p LAWN SPRINKLER SYSTEM Walnut, 17 '5957433 with comply with such provisions or this permit shall be deemed revoked. 1 WATER HEATER solar 20 100 LICENSE NO. 390645 CLASS C36 SC44 LICENSED CONTRACTORS DECLARATION DISTRICT NO. PRgICESSED BY 01 I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VALIDATION O License Number 390645 Lic. Class C36 SC44 DATE �� 7 SERVALi iATIC SOLAR SYSTEMS 9/2/83 FINAL Contractor DateBY ❑ I am exempt under Sec. B.&P.C. for This reason Plan check fee ',:�-• � ,. 1 5% A Date: PLUMBING PERMIT ISSUING FEE$ Signature 10 50 '; c> o n o o 5 TOTAL FEE 30 50 Plan check applicant SINGLE FAMILY •2 c: o 3 Q --0 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License c_)C,Address `,0 C_z Law for the following reason (Section 7031.5, Business and ' Professions Code): (j 3 G O 1 3_ p City ' Tel. No. �, ,, ❑ 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). 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 NONE 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 ob ve-menti ned property for insp coon purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE /2 83 ignature of Permittee Date