HomeMy Public PortalAbout4819 HELEO AVE_Plumbing__ 76A667-CE481 7 6-65
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY Pk
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25
MAIL p CC /�6
HATH TUB 1.25 ADDRESS 7 i� 6=A.:��J
SHOWER 1.25 CITY Jp Id Rol TEL. NO-A7
LAVATORY 1.25
CONTRACTOR �AC
SINK 1.25 ADDRESS 1cJ 9 b
DISHWASHER 1.25 CITY Q, P ����TEL. NO.
LAUNDRY TUB 1.25 -:STATE LIC
LICENSE NO. �` ' '� CLASS Q
0
CLOTHES WASHER 1.25 DISTRICT NO GRCkUJL.-1 ZONE I PROCESSED BY
WATER HEATER 1.50 5�0 - ,1 E
GAS SYSTEM_--I—OUTLETS I'M T� WASE AIPPROVAL 0
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U
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W
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APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
h ROUGH PLUMBING
TOTAL FEE d GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I 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
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
' LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTE D TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE \ A \
OF PERMITTEE , ���///���� FINAL i � ♦♦r
�ALIDATIOIV
CK. M.O. CASH
s 7" MAY 2 3 5 D .3.5 Q
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76A667-CE817 12/59
lf 'u--.LgCATRON FOR PLUMBING PERMDT
COUNTY OF LOS ANGELES s }
BUILDING N � AMeI C�N4Yv EMGIINEOERN k ADD
DEPARTMENT OF�COUNTY ENGINEER aEss
WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY
FOR`APPLICANT TO FILL IN NEAREST
CROSS ST �/-Ll—I/
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
CITY TEL. NO. ` 5
SHOWER
LAVATORY CONTRACTOR" �.�L y
SINS ADDRESS
G
DISHWASHER" CITY TEL. NO.
CONTRACTOR'S STATE
Ef-
LAUNDRY TUB REGISTRATION NO. 4� COUNTY El
d,.
CLOTHES WASHER DISTRICT NO. 1 GROUP ZONE R o SS Y
a WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD w
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A 9 �e2se�
x
U
W
in
z
6
@ $1.00 PER ITEM
OR FIXTURE APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT, $ 2100 1UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE
GAS PIPING
I HEREBY 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
PLUMBING. _
I HEREBY CERTIFY THAT M PROPERLY REGISTERED AND/OR -, PLUMBING FIXTURES
LICENSED AS REQUIRED B LOS ANGELES LINTY AND STATE OF -° GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL WNER OF THE ABOVE
DESCRIBED RESIDENTI PROPERTY./ A UTILITY CO.NOTIFIED
SIGNATURE '/
t OF PERMIT! vA�
:.3. .., . •�z;: ,.--s.r..,_ .. FINAL
BP / ¢" ALIDATION ROBERT A. WOOD,
CK. M.O. CASH SUPERVISING MECHANICAL ENG'R
r
her .;r consent to self
76A667A
insure+c ora mpensation Insurance, CE 817(REV. 10/81)
or a certified c ai30, Lab, C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company
Certified copy is hereby furnished.
QFOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
Certified copy is filed with the county building ipspec- ADDRESS
tion department: NUMBER FIXTURE OR ITEM @ FEE
LOCALITY
Date Applicant WATER CLOSET NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. 164Z,
COMPENSATION INSURANCE / OWNER
SHOWER t7
(This section need not be completed if the work involved by MAIL //11
the permit is for one hundred dollcrs ($100)or less:) LAVATORY ADDRESS
1 certify that in the performance of the work for which this
permit is issued, I shall'not employ any person in any manner SINK" CITY.� TEL. NO. _
so as to-become subject to the Workers'Compensation Laws. DISHWASHER
CONTRACTOR
Date 1 v Applicant v CLOTHES WASHER ADDRESS
NOTICE TO APPLICANT: if, after making,t is Cert' ' I ,GQ
Exemption, ..you should become subject to the o e s SWIMMING POOL RECEPTOR
Compensation provisions of the Labor Code, you must.forth- LAWN CITY TEL. NO.
SPRINKLER SYSTEM
with comply with such provisions: or this permit shall be STATE LIC.
deemed revoked. WATER HEATER LICENSE NO. CLASS
LICENSED CONTRACTORS DECLARATION DISTRICT NO. XS/
ED BY
I hereby affirm that l am licensed under provisions of Chapter GAS SYSTEM OUTLETS
v
(commencing with Section 7000) of Division 3 of the Business OUTLETS OVER, �
and Professions Code,and my.license is in full force'and effect. 5 PER SYSTEM DATEL fr�. �� VALI TION O
License Number Lic. Class
FI L O
Contractor Date f/ V
oC
I am exempt under Sec. LO
B.&P.C. for this reason
Plan check fee
Date:
PLUMBING PERMIT ISSUING FEE.$ D
Signature
TOTAL FEE �. D
Plan check applicant.
SINGLE FAMILY 2-3063A
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm that I am exempt from the Contractor's License # 0,0 0 o o 5
Law for the following reason (Section 7031.5, Business and Address
rofe ions Cit:Code) y Tel. IN o: ) o o &5 p
1w ', as owner of the.property, will do the work and the o o 0.2 a5 05
structure is not intended or offered for sale (Section
7044, Business and Professions Code). D (,Q O 38 5
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
Lender's Address
I certify that I have read this application and state that the D
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
abotione property for in ction purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
•°�v(-ecu-cam /0 �,3`�� ,.
Signature of Permittee Date
r COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0811100002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: 1 FEES PAID BUILDING ADDRESS: 1
ITR: 13329 LT: 19 1 4819 HELEO AV I
I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: ( TEMP CA 917803821 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LOWER AZUSA
18590-024-022 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J5 'LOCALITY: TEMPLE CITY, Cl
1 107 BATHTUBS/SHOWERS 1.00 FIX 16.20 1
(TENANT: 125 LAVATORIES/SINKS 1.00 FIX 16.20 11SSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1
145 WATER CLOSET/URINAL 1.00 FIX 16.20 111/10/08 SR 05/09/09
1 TOTAL FEES 76.35 1
OWNER: TEL. NO: I IFINAL DATE FIN BY: CODE:
ICHUA, CHERRY ( 1 1 ��yy
14819 HELEO AV 1 I
ITEMP 917803821 I ID SCRIPTION WORK
IPLUMBING FOR ATHROOM REMOD L
I I 1
1APPLICANT: TEL. NO: I 1
IWALKER (805) 857-0866-
12163 PALOS CT,. I 1SPECIAL CONDITIONS-: 1
INEWBURY PARK 91320
I I I I
ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
IWALKER BUILT GENERAL CONTRACTOR (805) 857-0866- I
12163 PALOS CT LIC. NO 1 1UNDER SLAB WORK - I
INEWBURY PARK, CA 91320 916231 B
I IWATER SERVICE
PLASTIC Y/N METAL Y/N
1ARCHITECT OR ENGINEER: TEL. NO: I
IROUGH PLUMBING 1
1 LIC. NO: I f
IGAS PIPING
IGAS VENT
I I I
IHOT WATER HEATER
IPLUMBING FIXTURES
I I I
LAWN SPRINKLERS
I I I
IGAS TEST
1UTILITY COMPANY NOTIFIEDI I
ICwv I
I'GRAY WATER SYSTEM
I I I
I I I I
IREPORT ID: DPR263 ROUTE TO: BS0508
I I I I I I