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Home My Public Portal About5913 IVAR AVE_Plumbing__ 76A667 (CE-817) -;•1/75 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES AR_ TMENT OF,COUNTY ENGINEER �� U + H S AB " IONS UILDING ((�] / � 091E DDRESS HARVEY T. BRANDT, CO N E` 1 OCALITY L e i FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. . " NUMBER 'FIXTURE OR ITEM @ FEE - ' OWNER !' WATER CLOSET 2.00 MAIL BATH TUB 2.00 ADDRESS SHOWER 2.00 C ITYPtz,�TEL: NO-;?J115 _3D� LAVATORY 2.00 CONTRACTOR Ii }� SINK 2.00 ADDRESS••`Q y�D DISHWASHER 2.00 CITY .Q- TEL. NO. L/qc;�__ 0 ) 10 CLOTHES WASHER 2.00 STATELIC, i LICENSE NO. a�IQ�GJ� CLASS SWIMMING POOL RECEPTOR 2.00 DISTRICT NO.GAQVZONE 2.00 PROCESS BY LAWN SPRINKLER SYSTEM S Z,_� S �I WATER HEATER 2.00 INDUSTRIAL r WASTE APPROVAL p '( GAS SYSTEM OUTLETS 2.00 INSPECSION.REC'ORD ' C:) OUTLETS OVER 5 PER SYSTEM .30 CD - W CL Plan Check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE ®0 APPROVALS DATE INSPECTOR'S SIGNATURE Plan Check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS.VENT ' 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 WITH ALL, COUNTY ORDINANCES AND .'STATE LAWS REGULATING - PLUMBING. - GAS TEST - I. HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REOUI RED BYL OS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL-OWNER OF, AND .INTEND TO " RESIDE IN THE ABOVE DESCRIBED RESIDE NTI PROPERTY FINAL SIGNATURE OF PERMITTEE - PERMIT VALIDATION �f CK�. M,O, CASH PLAN CHECK VALIDATION CK. M.O., CASH 4 0 9rSP 2 . 5 =p 5.0 0' '76A667 (CE-817) 1/75 _V72 LC c l-pi , APPLICATION FOR PLUMBING PERMIT COUNTY.OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION q MAKE CHECKS PAYABLE TO: ADING DDRESS/ �S /. I f �� 1 0 HARVEY T. BRANDT, COUNTY ENGINEER _' LOCALITYNEAREST �� ZW�, C FOR APPLICANT TO.FILL IN (PRINT OR TYRE) CROSS ST. �`„'L.1 1 7 1 Lfd L.J koD, NUMBER _ FIXTURE OR ITEM @ FEE 1A WATER CLOSET 2:00 OWNER Q1 {)e1k MAIL ' c BATH TUB 2.00 ADDRESS n UGI SHOWER 2.00 CITY - -' EL. NO. LAVATORY 2.00 CONTRACTOR \� nn y\"PCk111lIS SINK 2.00 ADDRESS1c'1q'z � GIp-Pr r) �V DISHWASHER 2.00 ` � i lE 'QQ?S -31 C09 I, CITY l TEL. NO. i CLOTHES WASHER 2.00 STATE \ p LIC LICENSE NO. 1 p CLASS SWIMMING POOL RECEPTOR 2.00 DISTRICT N(�O.GROUP ONE PR CES EDEjfY LAWN SPRINKLER SYSTEM 2,00 1 1()p T I` WATER HEATER `J' 2:00 INDUSTRIAL WASTE APPROVAL GAS'SYSTEM OUTLETS 2.00 INSPECTION RECORD a} t OUTLETS OVER30 C) 5 PER SYSTEM ag LJ Plan Check fee See Reverse- PLUMBING eversePLUMBING PERMIT ISSUING FEE-S A TOTAL FEE - APPROVALS DATE' INSPECTOR'S SIGNATURE , Plan check'applicant 7�� UNDER SLAB'WORK Name ROUGH PLUMBING ' AddressGAS PIPING City Tel. NO. GAS VENT 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 WITH AL'L COUNTY ORDINANCES AND STATE' LAWS REGULATING PLUM B,I NG. GAS TEST - I HEREBY CERTIFY, THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED -LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF _ CALI FORNIA -0R THAT I AM THE LEGAL OWNER OF, AHD INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL SI G N A TU RE - OF PERMITTEE a— - PERMIT VALIDATION cK. o: CASH PLAN CHECK VALIDATION CK. M.O. CASH 76A667 (CE-817)-4/72 L 11�C! h� APPLICATION FOR PL SING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING ADDRESS 913 North Ivar v— HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY Temple City FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST NUMBER FIXTURE OR ITEM @ FEE CROSS ST. OWNER Cardella WATER CLOSET 1.75 MAIL BATH TUB 1.75 ADDRESS 5913 N. Ivar SHOWER 1.75 CITY Temple City TEL. NO. 285-3202 LAVATORY 1,75 CONTRACTOR Bryant Heating & Air Cond. SINK 1.75 ADDRESS 1350 E. Las Tunas Drive DISHWASHER 1.75 CITY San Gabriel TEL. NO. 286-1141 CLOTHES WASHER 1.75 STATE LIC LICENSE NO. 221751 CLASS C20 SWIMMING POOL RECEPTOR 1,75 D1�4„TRICT NO. GROUP ZONE OCESSED BY LAWN SPRINKLER SYSTEM 1,75 E _ c 1 WATER HEATER 1.75 INDUSTRIAL WASTE APPROVAL G GAS SYSTEM OUTLETS 1.75 1 75 INSPECTION RECORD V" OUTLETS OVER v' 5 PER SYSTEM '30 C) V W a N Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE 1 4175 APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. NO. GAS VENT 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 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED - LICENSED AS REOU IRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM LEGAL OWNER OF, AND IN NO TO RESIDE IN THE ABOVE DESC BE RESIDENTIAL PROPERTY. SIGNATURE , OF PERMITTEE CC.V// - \1 PERMIT VALIDATION cK. IA,O. CASH PLAN CHECK VALIDATION CK. M.O. CASH -179 .:jJ 22'. 5-.D 4.75 A96 WQRKERS'COMPENSATION DECLARATION �('p np �CA��®fin. ® j �pjp p pn/�(��M� PER(»�7 20-0026 DPW a/vo 4TT to L� Il N R IT LSIuJUVlllp� IIVl1 I hereby,'affirm that I have a certificate of consent to self in- 76A667A sure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof (Sec. 3800, Lab. C. - COUNTY.OF LOSnANGELES , DEPT. OF.,PUBLIC WORKS.- Policy No.- Company nCertified copy is hereby furnished. FOR APPLICANT.TO FILL IN(PRINT OR_TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS NUMBER FIXTURE OR ITEM FEE LOCALITY,io -fi�AA department.. @ l Gl"t WATER CLOSET(TOILET) Dote Applicant � .NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL ' the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK CITY TEL. NO. mit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER CON TRACTOR J Date- Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this,Certificate of Ex- ADDRESS em tion,yob should become sub'ect to the Workers'Com en- SWIMMING POOL RECEPTOR P Y I P CITY TEL. NO. sation provisions of the Lab.-)r Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be,deemed revok- STATE LIC. ed.- WATER H€ATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION / DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the.Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect. HOSE BIB DATE "�(/•C�L� y, License Number Lic. Class FINAL 0 Contractor Date Y ❑ I am exempt under Sec. B.&P.C. for this reason, U " Plan check fee � N Date: PLUMBING PERMIT ISSUING FEE$ �� zj 2E Signature TOTAL FEE - — SINGLE FAMILY " HOME OWNER-BUILDER DECLARATION Plan check applicant tPly, / d- '-'L-) I hereby affirm that I am exempt from the Contractor's License Name -.3,03 Law for the following reason (Section 7031.5, Business and Professions Code): Address . I, as owner of`the property, will'do the work and,the City . Tel. No. structure is not intended or offered for sale(Section 7044, r" i y'% " j Business and Professions Code). ® )j Pif;t3 =gti's 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 ti (Sec. 3097, Civ. C.). _ l j j+i 14' 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 ordinances and State laws regulating'Plumbing, and hereby authorize representatives of this County to enter upon, the abo mentioned pr rty f r nspection purposes. l SEE REVERSE FOR EXPLANATORY LANGUAGE ure of Pe tee Date WORKERS'COMPENSATION DECLARATION APPUCAMH FOR pdMG�ii [ MIG PERMT I hereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation.-Insurance, CE 817,�REV. 10781+ `T or certified copy thereof (Sec. 3800, L COUNTY OF LOS ANGELES / BUILDING AND SAFETY Po lo!40 97 Company ❑ Certified copy is hereby furnished. Ae l ®" FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING — %I� -A ry J Certified copy is flied with the county building inspec- ADDRESS (r'//�,. tion department. NUMBER FIXTURE OR ITEM @ FEE LOCAL ITY° LC Date `V-14 13 Applicant WATER CLOSET NEAREST �� ! CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS SL >l COMPENSATION INSURANCE OWNER .��.t..�� (This section need not be completed if the work involved by SHOWER the permit is for one hundred dollars $100 or less. MAIL P ( LAVATORY ADDRESS-5i I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. NCZQ5 , u so as to become subject to the Workers'Compensation Laws. DISHWASHER ca�� ✓ CONTRACTOR DateApplicant CLOTHES WASHER NOTICE TO APPLICANTADDRESS: If, after making this Certificate of E' Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR f Compensation provisions of the Labor Code, you must forth- CITY ® � TEL. LAWN SPRINKLER SYSTEM with comply with such provisions or .this permit shall be STATE ��? � LIC. deemed revoked. WATER HEATER LICENSE NO, CL S • LICENSED CONTRACTORS DECLARATION DISTRICT NO. OCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS.OVER and Professions Code, and my license is in full force and effect. 5 PER SYSTEM FINA�' ,� / DATEL VALIDATION License Number :23 . Lic. Class _ } 1__� / /r�i0 ' as FINAL 0- Contractor'� �� Date BY� � ❑ I am exempt under Sec. 7l}6 7(/ CL B.&P.C. for this reason ` / V) Plan check fee D Z Date: 1 PLUMBING PERMIT ISSUING FEE$ O J Signature [L Q p A TOTAL FEE fl 010 ° ° ° 5 Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name u ° 1 6,50 I hereby affirm that I am exempt from the Contractor's License Address c 1 6 5 Q� Law for the following reason (Section 7031.5, Business and Professions Code): City 7-7—A Tel. No. /,2 9—Ci 3 ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section. 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is o 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 ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-me coned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 7• 24 Signature of Permittee Date