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Home My Public Portal About10144 GREEN ST_Plumbing__ 76A667 DO517 7-51 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER PLUMBING 1 FOR APPLICANT TO FILL IN Di RI I CT NO. GROUPI ZONE PERMIT NO. _PLUMBER I RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS A xtl 1 , /! --- BUILDING OI TEL No. (, ADDRESSa I A4 44 COUNTY LOCALITY 1 NSE NO. EXPIRES NR .. T O ` PERMIT FEES COs6 ST. JnyCd NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER 1j MAIL ` WATER CLOSET(TOILET) 0 0.50 $ ADDRESS BATH TUB @ 0.50 CITY & L t j TEL No. `— SHOWER a 0.50 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY G 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. GAS SYSTEM OUTLETS 0 0.50 BIONATURE OF _ I WATER HEATER a 0.50 PERMITTE SLOP SINK 0 0.50 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN 0.50 DISHWASHER 0.50 DRINKING FOUNTAIN 0.50 URINAL 0,50 J Q HOUSE SEWER 0.50 Z MISCELLANEOUS E3 (Y APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @i 1,DD CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT . . 1,OD GAS TEST I TOTAL FEE UTILITY CO.NOTIFIED � 0 C 2 FINAL 76A667 APPLICATION FOR PLUMBING PERMIT 1 CE 817 e-BUILDING AND SAFETY DIVISION Department of County Engineer County of Los Angeles BUILDING JOHN A.LAMBIE,COUNTY ENGINEER ADDRESS CASSATT D.GRIFFIN,SUPT OF BUILDING _ LOCALITY FOR APPLICANT TO FILL IN I NEAREST CROSS ST. OWNER I , DISTRICT NO. GROUP ZONE I READY FOR INSPECTION MAIL ADDRESS - - - - i INDUSTRIAL CITY _ TEL. NO. WASTE APPROVAL PLUMBER INSPECTION RECORD ADDRESS CITY - TEL. NO. LICENSE NO. 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 i CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 .� GAS SYSTEM @ $1.00 APPROVALS DATE INSPECTORS SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST !L LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE - OF PERMITTEE FINAL ,7 ROBERT A.WOOD, JOHN A. LAMBIE,COUNTY ENGINEER VALIDATION SUPERVISING MECHANICAL ENG'R K. M.0. CASH 1 2 3 5S AM16 3 3.00 78A687 CE 817 B- APPLICATION FOR PLUMBING PERMIT 1 BUILDING AND SAFETY DIVISION Department of County Engineer County of Los Angeles AESS /0 JOHN A.LAMBIE,COUNTY ENGINEER DDR CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. �. OWNER , /`) DISTRICT NO. �yGIR,ODUP(nI I ZONE READY FOR INSPECTION MAIL ADDRESS INDUSTRIAL CITY TEL. WASTE APPROVAL PLUMBER �. SPECTION RECORD ADDRESS CITY ` C TEL.NO. S! / LICENSE NO. 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 ! .� APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING GAS PIPING ?�.-• l ,;•_it,C. TOTAL FEE GAS VENT 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LO ANGELES U AND STATE OF CALIFORNIA OR THAT I A 0 OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL SIGNATURE OF PERMITTEE FINA v ROBERTA.WOOD, JOHN A. LAMBIE,COUNTY ENGINEER QVALIDATION SUPERVISING MECHANICAL ENG'R CK M.O. CASH ppW 7-7-1 ..." APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER I O. GROUP I ZONE: PERMIT N FOR APPLICANT TO FILL IN =, •y � C' 7 SS Belvedere Plumbing RECEIVED .Y ATE ISSUEDPLUMBER READY FOR ", FIRBTINBPECTION ADDRESS 136 So. Palm Ave. BUILDING 10144 Z. Green CITY Alhambra} TEL- No. ADDRESS COUNTY LICENBE NO. 80$M EXPIRES 6-3o- 53 LOCALITY Temple City NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER H.C. Grayotte WATER CLOSET(TOILET) 0 13.50 9 . MAIL 00 ADDRESS 1 BATH TUB 0.50 CITY TEL. No. SHOWER 0.50 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIB LAVATORY (WASH BASIN) Cry 0.50 1 .00 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 1 KITCHEN SINK Q 0.50AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS 1 LAUNDRY TUB OR TRAY @ 0.50 0 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER GAS SYSTEM�OUTLETS 0 0.50 .50 OF THE RESIOEN IAL PROPERTY DE D ABOVE. 1 SIGNATURE OF WATER HEATER 0 0.50 0 PERMITTEE BLOP SINK 0.50 INSPECTION RECORD FLOOR SINK 0.50 FLOOR DRAIN 0.50 //) t DISHWASHER ® 0.50 vim"'''/ -'�` (/� lr�/'r icil+s• DRINKING FOUNTAIN 0.50 URINAL 0.50 J Q HOUSE SEWER 0.50 Z_ MISCELLANEOUS O fY O APPROVALS DATE INBPECTOR'■ NAME ROUGH PLUMBING " "I - GAS PIPING GAS VENT CESSPOOL 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ) PIT ) 1.00 SEWER PERMIT . . . . I 1.00 GAB TEST UTILITY CO.NOTIFIED TOTAL FEE $ 51950 FINAL 535 VORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING P E RISA I T I hereby.affirm that I hav a certtflcate of consent to self 76A667A Insure w a cdreficate of Workers' Compensation Insurance, �817(REV. 10/81) �' or a c Ifled copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES d BUILDING AND SAFETY Po I[ No. Company ❑ Certified copy Is hereby furnished. FbR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING El Artb/. tfled copy Is filed with the county building Inspec- tlon department. NUMBER FD(TURE OR ITEM O FEE LOCALITY ` Date Appllgont WAS CLOSET NEAREST cERTIFicATE bF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE OWNHt (This secs n need not be com tF the Mork Invahmd by pWM the pwmtt Is For ons hundred do Itors($100)c less.) LAVATORY MAIL ADDRESS i I certify that In the performance of the work for which this /� permit Is Issued, I shall not employ any?arson In any manner SJ NK CITY ( TH- NO. so as to become subject to the Workers Compensation taws. DISI-IWASFU CONTRACTOR Date- A.plicarnt CLOTHES WA%*R ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Woriceri SWIMMING POOL RECBTTC Compensation provisions of the Labor Code, you must forth- LAWN SPRINK Eft SYSTEM CITY � NO. with comply with such provisions or this permit shall be STATE LIC deemed revoked. WATER HEATER LIC13'E NO. CLASS LICENSED CONTRACTORS DECLARATION DtSTR BY I hereby afflmi that I am Ilcensed under provisions of Chapter 9 cutis SYSTEM OUTLETS -�!`7 Q jf(commencing with Section 7000) of Division 3 of the Buslhees OUTLETS OVHt and Professions Code,and my license Is In full force and effect. 5 PER SYSTEM FINAL VALIDATION License Number Llc. Class DATE FINAL Contractor Date BY ❑ I am exempt dndwSec_ B.BP.C. for this reason Plan check fee Date: i PLUMBING PERMIT ISSUING FSE; D Slgrxituro _, TOTAL FEE - lj L Plao check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name q Ayr 1, 1 A I hereby afflrm that I am exempt from the Contractors License Law for the following reasgn (Section 7031.5, Business and Addf°M Professions Code): CI'� Tel. No. o • o 0 0 5 p _ I, as owner of the property, WIII do the work and the . 02 ° ° 1 �5 structure Is not Intended or offered for sale (Section pool ° ° n 1 6 5 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY 1221 —82 1 hereby affirm that there Is a construction lending agency for the performance of the work for which this permit Is Issued (Sec. 3097, Clv. C.). Lendees Name l,ender's_Mdress I certify that I have read this application and state that the ► above Infccmatlon Is correct. I agree to comply with all County ordlnarices and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the a ve-mentlo ed pro rty fur Inspection purposes. SEE REVE3KE FOR EXPLANATORY LANGUAGE S ature Permittee Date!