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HomeMy Public PortalAbout10062 GREEN ST_Plumbing__' DM°°' APPLICATION FOR PLUMBING PERMIT 1 h DIVISION OF BUILDING AND 8A 'ETY D.pam.at of County Engh-w County of Los Angels ISUILDIN01 4 JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS CASSATT D.GRIFFIN,Hu P'T of BUILDING LOCA fTY FOR APPLICANT TO FILL IN NEAREST CROSS OWNER DI81'RIGT O. GROUP ZON$ I RlADT FOR I115►[CTION WAIL A-DDRESS .S� Now DD ` 1 U�TRIAL 1 ry ZA87'F1 APPROVAL p�y+�� ���y� PLUMBER GENEM BIW A"TION CO• ++�4K�+�+++,ON•SWORD ADDRK" 6868 West'6Fvd. CITY LA, 43 TSL NO. PLAOKMt 3-2341 UCEN819 NO. 787 C-36 151839 NUYDR TYF=OF FIXTUR=OR ITEM F[i WATXR CLOSET (TOILET) Q fl.04O 19ATH TUB a 1111.00 sxoWlKR 1.00 LAVATORY (WASH BASIN) a IF1.00 KrrCHELN SINK 1.00 DISHWASHER 1.00 LAUNDRY TUB OR TRAY 41.0.0 CLOTHES WASHER @ $1.00 WATLR HATER 1.00 GAS SYSTXM 1.00 1 WATER 50frENI!R AU 00 APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK $ 00 ROUGH PLUMBING GAS PIPING �TPERNIT OTAL FEE 00 GAR VWgt 1 HEICBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HbT WATEt HEATER WITH ALL COURTY ORDIXANCFA AND STATE LAWS REGULATING PLUMBING FIXTURES PLUMBING. . I HEREBY CERTIFY THAT I A■ PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELEB COgkTY AND STATE OF CALIFOR111A OR FRAT I AY��'�����}}}}iiiiE }3G OWLISH OF THE ABOVE UTILITY CO.NOTIFIED _ DESCRIBED REBIDtiHTIAL 1 � SIGNATURE y ` OF PERMITTEE FINAL JOHN A_ LAMBIE. CoUNTY ENGINEER AI.IDATION ROBERT A.WOOD, CHIEF PLEIG. INsP¢crOR aL ■.•. CAIR 6 44 7 MAY 14 5 A 3.0 0 � 76A667 -CE#617 2-62 EA c + • APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS JBY WILLIAM A. JENSEN, SUPT OF BUILDINGLOCALITY FOR APPLICANT TO FILL IN NEARESTCROSS ST. NUMBER FIXTURE OR ITEM EACH FEE/ OWNERWATER CLOSET $1.25MAIL BATH TUB 1.25 ADDRESS SHOWER 1 25 CITY TEL. NO. LAVATORY 1.25 CONTRACTOR SINK 1.25 ADDRESSDISHWASHER 1,25 CITY TEL. NO. LAUNDRY 'fUB 1.25 CONTRACTOR'S S STAREGISTRATION NO. 1J �Ol� COUNTCLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PRO SSE WATER HEATER 1.50 `'� GAS SYSTEMOUTLETS 1.50 INDUSTRIAL Jf WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD 4' r €�J sa. eek ', APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ Q 00 UNDER SLAB WORK —> G TOTAL FEE ROUGH PLUMBING `T��-4- 73 GAS PIPING 1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER LESDE CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURESS REQUIRED BY LOS ANGELES COUNTY AND STATE OF OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST HE ABOVE CRIBED RESIDENTIAL PROPERTYUTILITY CO. NOTIFIED E !/ITTE /v FINAL VCK. ALIDATION ROBERT A. WOOD M.J. CASH SUPERVISING MECHANICAL ENG'R 5./ 5,y ; WORKERS'COMPENSATION DECIARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 20-0026 DPW 8/87 Insure, or a certificate of Work" Compensation Insurance, 78AS87A or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No.-Company Company Certified copy Is hereby fumished. FOR APPLK1+Nf TO RLL IN(PRINT OR TYPE) b1JILDiNG Certlfied copy Is filed with the county building Inspec- ADWESS tion department. NUMBER FIXTURE C)♦2 ITEM Q PES LOCALITY Date Appilcant WATER CLOSET 4AREST CERTIFICATE OF EXEMPT10N FROM WORKERS' BATH TUB CROSS ST COMPI NSATION INSURANCE SHOWER OWNS (Thiss*efforr roved not be completed If the worte rk Ioly"by the pwmtf Is for one hundred dollars.($100)or 6".) LAVATORY AMAILZESS I certlfy that In the performanc,* of the work for which this r permit Is Isaupd, I shall not empI any Person In any manner SINX CITY TEL, / so as to become aublect to the W ers compensation Laws. DISF WAMER OOtJTRA,CTOR' r Date 3,13 R 2 A�ppllcant CLOTHES WASHER NOTfCE TO APPLICANT: If, after klhg this Certificate of ADORi•ES Exemptloh, you should becom blett to thr Worker' SW NA dNG POOL RECEPTOR Oompenaatlon provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM C'Y Z10 with comply with such provisions,or this permit shall be STATE LIC, deemed revoked. WATER +EATER UCENSE NO. �f 3CAM _j LICENSED CONTRACTORS DECLARAT}ON DISTRICT PROCESSED BY I hereby afthat ftrm I am licensed urider provlslora of Chapter 9 C SYSTEM OUTLETS (coL/ OVER and Pro r�clnqesslo with Section 7000) of Division 3 of t6r d effect. a t. OPER S TEM / VALIDATION and Prof*ssioro Code,and�c.rrr Is in full force and effect. 3 PER SYSTEM �� License Number It qg�2-��� ,��,I1c. Class_ Contractor F�SiI� 3 l Q Z 8-FIYlA1 © I am exempt under Sec. B.BRC. for this reasonPlanchock fee Dat*: PLUMBING PERMrr ISSUING Fes; sIgrwtu TOTAL FEE Plan check appllccint 73 7 •�1] SINGLE FAMILY �� HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Conttactoes Ltcans* Address T17TIL ;�9 30 Law foc the foHowing reason (Section 7031.5, Business and Professions Cod*): City Tel. No. 5ry• a I, as owner of the property, will do the work and the structure Is not rntended or offered for sale (Section , .00 7041, Business and Professions God*). CONSTRUCTION LENDING AGENCYHfl1 3/13/52 I hereby affirm that then Is a construction lending agency for the performaoN of the work for which this permit Is Issued 27'r2 1 N1 912 (S*c. 3097, CIv. C.} Lenders Name Lender's Address I c*rtlfy that I k�avo toad this application and state that the ► above Information Is correct. I agree to comply with all County orcilhances and State laws re94lciting Plumbing, and F4reby authorize reprelentatives of this County to enW upon the above-mentloned'property for Inspection purposes. f!i RQNlRs! FOR EXPLANATORY LAf+1aUAG! Signature Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY 0 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TURAS PL 0508 04(}6070013 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: --7EE9'PAID BUILDING AJJVKL��: ON FILE 10062 GREEN ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803331 NEAREST CROSS STREET: BALDWIN 8585-O07-029 01 PERMIT ISSUANCE FEE 27.75 THCMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY 47 WATER HEATER(S) 1.00 WTH 16.20 63 WATER PIPING BR/FIX 12.00 FIX 81.00 . TOTAL FEES 124.95 06/07/04 VG 12/04/04 OWWER: TEL. 110: F17 HOGGATT JERRY E III;LINDA E - 10062 GREEN ST TEMP 917803331 DESCRIPTION OF 6M COPPER REPIPE WITH 12 FIXTURES AND WATER HEATER CHANGE OUT APPLICANT: TEL. NO" AMERISERV PLUMBING INC. (866) 44.6-6374- SPECIAL DITIOWS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGKATUR9--- AMERISERV PLUMBING (866) 446-6374- 1053 COLORADO BLVD LIC. NO SUITE #C B/L LOMITA LOS ANGELES, CA 90041 WATER SERVI ARCHITECT OR ENGINEER: TEL. NO: PLASTIC Y/N MMLtM �— LIC. NO: ROUGH -PLUMBINGPLUMBING FIXTURESLAWN SPRINKLERS �— GAS PIPING GAS VENT TZT'ZNTER HEATER T GAS TEST UTILITY M9WW-0T= cWV t ADDITIONAL DATA ON FILE i REPORT ID: DPR263 ROUTE TO: BS0508