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Home My Public Portal About9035 HERMOSA DR_Plumbing__ 76 A,17 (CE-81)1-4/72 APPLICATIO OR PLI�BING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION AIA ICE CHECKS Pit YA U LE TO: BUILDING ✓ ADDRESS HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY r FCANTTOPLICANT TO FILL IN (PRINT OR TYPEI NEAREST CROSS ST. NUMBERFIXTURE OR ITEM @ FEE OWNER CLOSET 1.75 MAIL UB 1.75 ADDRESS R 1.75 CITY TEL. NO. ORY 1,75 CONTRACTOR 1.75 ADDRESS ✓ASHER 1.75 CITY (fr11 TEL.ESWASHER 1.75 STATE LIC LICENSE NO. CLASS ING POOL RECEPTOR 1.75DIS ICT NO. GROUP ZONE FR ESSED BY SPRINKLER SYSTEM 1.75O9 HEATER 1.75 INDUSTRIALWASTE APPROVALSTEM OUTLETS 1.75 / INSPECTION RECORD V OUTLETS OVE .30 p 5 PER SYSTEM W d N Z r _ 5 Plan check fefSee Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE OO APPROVALS DATE (els PeeTOR•s sIr,NAru RE Plan Check applicant UNDER SLAB WORK Name ROUGH PLUMBING t� Address GAS PIPING City Tel. NO. GAS VENT HOT WATER HEATER IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES .y �l WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. HEREBY CERTIFY TNAT M PROPERLY REGISTERED PND/OR UTILITY CO. NOTIFIED LICENSED AS RE REO BY OS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I A TH LEGAL OWNER OF, AND INTEND TO �f RESIDE IN THE ABOVE I9= O RESIDENTIAL PROP TY.. - FINAL SI GNA TU RE OF PERMITT l/ PERMIT VALIDA 10 + CK. /Kf.D. CASH PLAN CHE VALIDATION CK. .D. CASH 8 9"3':AUG 7 5 D , 1 0,0 0 ♦y3 WORKE NSATIONDECLARATION se817 ) APPLICATION. FOR PLUMBING PERMIT I hereby affirm ave a certificate of consent to self CE en lz-as insure, or a certit.. orkers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) - COUNTY OF LOS ANGELE � BUILDING,AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING O Certified co O ADDRESS copy is filed with the county building inspection NUMBER FIXTURE OR ITEM FEE department LOCALITY `[/P �I Q,. Date WATER CLOSET Applicant ' BATH TUB CEAREST SL. CERTIFICATE OF EXEMPTION FROM WORKERS' - COMPENSATION INSURANCE SHOWER -- OWN a 6Y.4 ?A( ' le - LAVATORY MAIL (This section need not be completed if the work involved ADDRESS � C by the permit is for one hundred dollars ($IUo) or less.) SINK CITY TEL.NQ !1 I certify that in the perform f the work for which this DISHWASHER G'D O permit is issued, I shall not pl any person ina y.manner CONTRACTOR so as to�b comb subject tot e W r er ' Co ansa ton Laws. CLOTHES WASHER / /� t)) ADDRESS Date CL--App or SWIMMING POOL RECEPTOR _ r—. I / (~j CITY Exemption,nCE O you LWANT If, aft making sho Id become subject to the Cert,W rkesf LAWN SPRINKLER SYSTEM STATE�� O(-� LIC. NO ft� ��0(7 p� N Compensation provisions of the Labor Code, you must Orth- WATER HEATER LICENSE NO. SIJ CLASS - z_ with comply with such provisions or this permit shall be DISTRICT NO. O ED BY deemed revoked. GAS SYSTEM OUTLETS LICENSED CONTRACTORS DECLARATION" OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL 7 mess and Professions Code, and my license is in full force and DATE r• r�J VALIDATION effect. _q /(/p C-� V FINAL 00, License Nu S l Lic.Class \p BY Contractor Y/l%�ti Data �fT I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ «rill III . acting in my professional capacity (Section 7051, Bus- ,n mess and Professions Code). TOTAL FEE v Lic.or Reg.No. Date Plan check applicant I HOME OWNER-BUILDER DECLARATION Name �3 9 0.7 A " 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): 12l • 2 Q 5 1, as owner of the property, am exclusively contracting - with licensed contractors to construct the project - e -'* 20.506 (Section 7044, Business and Professions Code). - CONSTRUCTION LENDING AGENCY 0 5.0 6'-8 2 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 above information is correct. I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordina s an State laws regulating Plumbing, and hereby - .mho Ixv epr sentatives of this' Co my to enter upon the above ment one pro arty for insUeCJon purposea Signature kf Permittee Date WORKERS'COMPENSATION DECLARATION -r8A667A I hereby affirm that I have a certificate of consent to self OE „r (:-aa) APPLICATION FOR PLUMBING PERMIT. insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.) Policy No. 442586 Company State Fund COUNTY OF LOS ANGELES �� BUILDING AND SAFETY _ I Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ADDRESS 9035 Hermosa Drive ' .Certified copy is filed with the county building inspection . NUMBER FIXTURE OR.ITEM FEE depyr rp0 82 WATER CLOSET LOCALITY Temple City Date b 1 Applicant AAA Cond. Air, Inc. NEAREST BATH TUB CROSS ST. Rosemead CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER (This section need not becomple[ed if the work involved. LAVATORY MAILADDRESS .} by the permit is for one hundred dollars ($100) or less.) SINK CITY Temple City TEL. NO.28 — 347 O I certify that in the performance of the work for which this DISHWASHER U permit is issued, I shall not employ' any person in any manner CONTRACTOR ccso as to become subject to the Workers' Compensation Laws. CLOTHES WASHER Date Applicant ADDRESS 10160 Vallee Blvd. O SWIMMING POOL RECEPTOR U NOTICE TO APPLICANT: If, after making this Certificate of CITYEl Monte TEL. NO-579_1800 W Exemption, you should become subject to the Workers' LAWN SPRINKLER•SYSTEM STATE LIC. N Compensation provisions of the Labor Code, you must forth- LICENSE NO. 293529 CLASS C20 Z with comply with such provisions or this permit shall be WATER HEATER ' deemed revoked. 1 GAS SYSTEM OUTLETS DISTRICT NO. PROCESSED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER Q I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL �I� J�� VALIDATION ness and Professions Code, and my license is in full force and DATE effect. License Number 293529 Lic.Class C20 _ BV AL Contractor AAA.Cond. AilDate 6/15/82 I am exempt from the licensing requirements as I am.a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ - acting in my professional capacity (Section 7051, Bus- . iness and Professions Code). - TOTAL FEE Lic.or Reg. No. Date Plan check applicant ' HOME OWNER-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. - 2.4,4.58 A' ness and Professions Code): 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project - �� 25O (Section 7044, Business and Professions,Code). - , CONSTRUCTION LENDING AGENCY .� ° • ) 2•5 0-F—' I hereby affirm that there is a construction lending agency 00.00-08 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 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 of_14s t s County to enter upon the, above-mentioned.property r' sp n purposes. David CrOSS6/15/82 Signature of Permittee Date