Loading...
HomeMy Public PortalAbout6242 HART AVE_Plumbing__ 76AO67 -CE#81.7 9/63 - - PLUMBI APPLICATION FOR N PERM IT ,, COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS ° WILLIAM A. JENSEN, SUPT OF BUILDING - - LOCALITY FOR APPL ICANT TO FILL IN NEAREST CROSS ST. FNUMBER FIXTURE OR ITEM EACH FEE OWNER �G. WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS Cl SHOWER 1.25 y� TEL, NO. LAVATORY 1.25 CONT ALTO SIN B 1.25' ADDRESS DISHWASHER 1.25 CITY LAUNDRY TUB 1.25 CONTRACTOR'S STATE ❑ REGISTRATION NO. COUNTY ❑ CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PROCES D 11 WATER HEATER 1.50 0 / 1.50 INDUSTRIAL a GAS SYSTEM OUTLETS Q WASTE APPROVAL 0 OUTLETS OVER.5 PER SYSTEM .30 p INSPECTION RECORD e U a _41 .^ 111 0 p' V 4f w D_ Z a APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 ; UNDER SLAB WORK - ROUGH PLUMBING TOTAL FEE ) GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT ""o1 y r AND STATE THAT THE ABOVE IS-CORRECT AND AGREE TO COMPLY / WITH ALL COUNTY 'ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER ✓ - a PLUMBING.. -I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR. PLUMBING FIXTURES y✓ A y ,IJd LICENSED AS REQUIRED BY LOS ANGEL S COUNTY AND STATE OF t GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL WNER OF;AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDE IAL O ERTY. UTILITY CO. NOTIFIED SIGNATURE (,�,L.d djA OF PERMITTEE FINAL �(J�j'„�fAll a. VALIDATIO ROBERT A. WOOD CK. M.0.5 -CASH SUPERVISING MECHANICAL ENG'R `tLo 2 NOV 2 7 5 a 3.5(7 N ' 76 A667-CE#617 10-67 A11 II LIVATK®N ®IIIf��`®U/)--PLUMBING IreE. . WT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING �� �✓1 JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALI � FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST ,. CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 1.50 MAIL BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY TEL. NO ,:5 LAVATORY 1.50 CONTRACTOR - SINK 1.50 ADDRESS D DISHWASHER 1.50 CITY-) TEL. NO,� •���D CLOTHES WASHER 1.50 STAYE LIC - LICENSE NO. CLASS SWIMMING POOL RECEPTOR 1.50 6 .B DISTRICT NO. GR O aZONE P E D B LAWN SPRINKLER SYSTEM 2.00V O - n- O ° WATER HEATER 1.50 INDUSTRIAL VWASTE APPROVAL Q= O GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD 1-- OUTLETS OUTLETS OVER - �+•I 5 PER SYSTEM .30 G' N Z a Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE $ 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 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES -- WITHALL 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 RESIDENTIAL PROPERTY. FINAL - SIGNATURE _ JACK R. ALLEN, SUPERVISING MECHANICAL ENG'R. OF PERMITTEE PERMIT VALIDATION M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH ,.y. 76 A 6.67.—CE 8,17.8/68 APPLICATION FOR PLUM BNB PER COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPw7. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST CROSS ST. ' NUMBER - FIXTURE OR ITEM EACH FEE Ink OWNER WATER CLOSET 1.50 • MAIL s7 BATHTUB 1.50 -ADDRESS SHOWER 1.50 CITY TEL. NO. LAVATORY 1.50 CONTRACTOR SINK1.50 A .ADDRESS DISHWASHER 1.50 CITY TEL: NO. / CLOTHES WASHER 1.50 - STATE LIC LICENSE NO. .alq 7i- CLASS "C (O SWIMMING POOL RECEPTOR 1.50 . DISTRICTNC. GROUP ZONE ESSED BY LAWN SPRINKLER SYSTEM 2.0007 © O WATER HEATER 1.50 ` INDUSTRIAL c.;o WASTE APPROVAL Z 0 >`''''•- G 4S`SY.ST EM OUTLETS 1.50 INSPECTION RECORD F= U OUTLETSOVER 5 PER SYSTEM .30 - d N Z Plan clieck fee 25% of 'above. See reverse. PLUMBING PERN1IT ISSUING FEE 8 2 00 TOTAL FFE —s:-o 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 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION - AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES n. .-. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. 1 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 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL SIGNATURE .TACK R. ALLEN",'SUPERVISING HANICAL ENG'R. OF PERMITTEE PERMIT VALIDATION cK. M.O. CASH PIAN CHECK AILIIDA TRON- cK. M.O. CASH _ tAr �;:s ;oma X2'3 5 D 6.50N _ ak TEAFLE CITEtP6E FDEPACROTU7�TYT OF LOS ANGELES OF COUNTY ENGINEER �yNG AND SAFETY DIVISION BUILDING y JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS WILLIAM A. JENSEN, SUP'T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST ; CROSS ST. NUMBER FIXTURE OR ITEM OWNER WATER CLOSET ADDRESS BATH TUB �-- CITY TEL. N0. — Q J.� SHOWER CONTRACTOR LAVATORY SINK ADDRESS DISHWASHER CITY TEL. NO. CONTRACTOR'S STATE ❑ LAUNDRY TUB REGISTRATION NO. COUNTY ❑ ,a 'a CLOTHES WASHER DISTRICT NO. Ir GROU M ZONE SS D BY WATER HEATER, GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD y It l, OU 0 U W [AND @ $1.00 PER ITEMOR FIXTURE $ /. • APPROVALS DATE INSPECTOR'SSIGNATURE ERMIT $ 200 UNDER SLAB WORKTOTALFEE ROUGH PLUMBING„' . GAS PIPINGREBY ACKNOWLEDGE THAT 1 HAVEREAD THIS APPLICATIONGAS VENT TATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ,ALL COUNTY ORDINANCES AND STATE LAWS REGULATING . HOT WATER HEATER ING.REBY CERTIFY THAT I AM PROPERLY REGIST AND/OR . PLUMBING FIXTURES ED AS REQUIRED BY LOS ANGELES COUNT• D'STATE OGAS TEST RNIA OR THA''''''������//////111111IIIIII AM THE LEGAL�O�NE OF HE ABOVEBED RESIDEN A PROPERTY. % UTILITY CO.NOTIFIED TURE ,: �s ',!lw^,AERMITTE FINAL 'S. 77,777 OF VALIDATION ROBERT A. WOOD, CK. M.O. CASH SUPERVISING MECHANICAL ENG'R 76A667 (,�E-817)-4/72 _ JAPPLIC,�T FOR P�UMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF, COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BU DI ADDRELDISS NG HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY — FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM @ FEE �. /V-5— OWNER { WATER CLOSET 1.75 MAIL BATH TUB 1.75 ADDRESS - SHOWER 1,75 CITY4ZZC EL. NO. LAVATORY 1.75 CONTRACTOR / } SINK 1.75 ADDRESS DISHWASHER 1.75 CITY TEL. NO. ti3 672 . CLOTHES WASHER 1.75 STATE LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR 1.75 DISTRICT NO. GROUP NE PR ESSE BY ' LAWN SPRINKLER SYSTEM 1.75 �i WATER HEATER 1.75 INDUSTRIAL WASTE APPROVAL a GAS SYSTEM OUTLETS 1.75 „ IN8_PECTI N RECORD V OUTLETS OVER- S PER SYSTEM 30 1 ♦��� �� ,{p. O LLA a. C/! • Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE I PFCTORd 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 L- — �� WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST ' f I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY TATE OF I CALIFORNIA OR THAT I. M THE EGAL OWNER OF, ND I TEND TO RESIDE IN THE ABOVE E CRIBE ESIDE IAL PROV; - FINAL - L 2v^ SIGNATURE A OF PERMITTEE PERMIT VALID TI IN CK. M.O. CASH PLAN CHECK V DATION CK. M.O. CASH I .J 3v U?.�. SCD 2 5D ' 1 1 .75c 42 WORKERS'COMPENSATION DECLARATION 76A66:A I hereby affirm'that I have a certificate of consent to self cE an (z-eo) fi__\%P Ir LL_1 C A T ON FOR P L 1 11 M M II CIG PERMIT insure, or a ceii'ificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C) -COUNTY OF LOS ANGELES e C� BUILDING AND SAFETY . Policy ��Comparyy�� �j'^"-�� ertified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE)' BUILDING ADDRESS Certified copy'is filed with the county building inspection NUMBER FIXTURE OR ITEM O FEE LOCALITY Datq�partm t� WATER CLOSET �0v Applican NEAREST BATH TUB CROSS ST. Cie CERTIFICATE OF EXEMPTION FR M WORKERS' COMPENSATION INSURANCE SHOWER OWNER LAVATORY MAIL >_(This sectio n• need not be completed if the work involved ADDRESS iL by the permit-is for one hundred dollars ($100) or less.) aO O SINK CITY TEL.NO.Ife U I certify that in the performance of the work for which this DISHWASHER permit is issued, I shall not employ any person in any manner 3 CONTRACTOR - 0 so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER ADDRESSre— � W Date Applicant SWIMMING POOL RECEPTOR d NOTICE TO APPLICANT:If, after making this Certificate of CITY TEL.NO. to Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. Icy Z Compensation provisions of the Labor Code, you must forth- LICENSE NO: � 9 ° CLASS C7 with comply with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT�NO. PRO ESSED B LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9commencin with Section 7000 of Division 3 of the Busi- FINAL'''E ' ness and Professions Code, and my license is in full force and DATE VALIDATION effect. �J7 ,� FINAL , ear License Numb90�` Lic.Classy BY (T Contrac ate ' 779 p o I am exempt from the licensing requirements as I am a Plan check fee o �`� licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE a Lic.or Reg.No. Date Plan check applicant HOMEOWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section.7031.5, Busi- City Tel.No- ness and Professions Code): I, as owner of the property, am exclusively contracting 0 6'7,5 A with licensed contractors to lonstruct the project (Section 7044, Business and Professions Code). # o`o 0 0 0 5 CONSTRUCTION LENDING AGENCY 2;0,0 2 Q O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is oo'0 2 Q Q issued(Sec. 3097,i�v C.).• Lender's Name 0807-81 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives ofthis C y to enter upon the rty f above-mentio d prop; in n purposes. g� Signature f Permitte Date • 1 WORKER'S I have a certiIONficate of consent'to 76A667ADPW 9/69 APPUCAMN FOR PL�M(�1BN3 pC�G�NT I hereby affirm that I have a certificate of consent'to self insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof(Sec.3800 Lab. C.) Policy No. 1360029-93Company State Fund COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV.' ❑- Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection - ADDRESS 6242 N. Hart" Ave. department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date 12113194 Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM-WOR BATH TUB ERS' CROSS OR COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the work involved by the SHOWER MAP BOOK PAGE PARCEL permit is for one hundred dollars($100)or less.) OWNER Mary Jane Thompson I certify that in the performance of the work for which this permit LAVATORY is issued, I shall not employ any person in any manner so as toSINK MAIL become subject to the Workers'Compensation Laws. ADDRESS 6242 N. Hart Ave. DISWASHER CITY Temple City TEL.NO. 285-6546 1 - - Date Applicant CLOTHES WASHER CONTRACTOR NOTICE TO APPLICANT: If, after making this Certificate of A & M Air, Htq, & PZumb Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR " provisions of the Labor Code, you must forthwith comply with such ADDRESS 123 E. Olive Avenue provisions or this permit shall be deemed revoked. AWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.NO. �- 66 7 1 hereby affirm that I am licensed under provisions of Chapter 9 1 WATER HEATER 15 45 Monrovia - STATE LIC. (commencing with Section 7000)of Division 3 of the Business and LICENSE NO. 23490'3 C ASS V Professions Code,and my license is in full force and effect. GAS SYSTEM OUTLETS C20 C36 OUTLETS OVER DISTRICT NO. PROCESSED BY 1Z 234903 C20 C36 5 PER SYSTEMC� O License Number Lic.Class FINAL r VALIDATION W Contractor r�j�Te 12/13/94 DATE ❑ ` 1 um FINAL 0.Z I am exempt under Sec. BY B.&P.C.for this reason Date: Plan check fee i[... / Signature PLUMBING"PERMIT ISSUING FEE$ 26.40 3' O ❑ TOTAL FEE 4 1.85 Plan check applicant =3 SINGLE FAMILY r HOME OWNER-BUILDER DECLARATION Name r' I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Address Code): City Tel. No. T '_; El1,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business _"AL 4 L 3.5 and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the STORE #602 'IfiE== 'I"1ia performance of the work for which this permit is issued (Sec. 3097, Civ.C.) i !f f1'_E,_i'a Lender's Name _ i -Mii i _�. . a . I' ,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 above-mentioned pro or inspection urpose SEE REVERSE FOR EXPLANATORY LANGUAGE 12/13/94 Signature of Permittee Date