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HomeMy Public PortalAbout4904 KAUFFMAN AVE_Plumbing__ 76AS67 OBS 17 11-50 APPLICATION FOR PERMIT DEP�&IIJMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES w WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICTGROUP ZONE PERMIT NO. PLUMBER R.E.. la denREC IVED BY READY FOR DATE ISSUED n ✓C�'� ADDRESS 5Q42 Rosemead Blvd. FIRST INSPECTION BUILDL C n ADD EISS 4904 Kauffman NG CITY Pico TENo. X 97915 COUNTY 8143 LICENSE N0. EXPIREHJ uj�e LOCALITY Temple City NEAREST PERMIT FEES CROSSST. Sparklett NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER Perry Layton MAIL 2 WATER CLOSET(TOILET) @ 0.50 $I,; Q0 ADDRESS 5031. Temple City Blvd. 1. BATH TU.B @ 0.50 0 .50 CITY Temple City TEL No. AT 72321 SHOWER @ 0.50 - 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS 2 LAVATORY (WASH BASIN) @ 0.50 T • 00 E A13OVE IS CORRECT ANDLAGREE TO COMPLY WITH ICATION AND STATE AALLHCOUNTY ORDINANCES 1 KITCHEN SINK @ 0,513 50 AND STATE LAWB REGULATING PLUMBING. 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER 1 SYSTEM 0 50 OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. GAS OUTLETB @ 0.50 1 SIGNATURE OF WATER HEATER @ 0.50 . 50 PERMITTE � SLOP SINK @ 0.50 INSPECTION RD FLOOR SINK @ O.SO FLOOR DRAIN @ 13.50 in aw DISHWASHER @. 0.50 DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 ti oS '1 Q HOUSE SEWER @ a.so MISCELLANEOUS �� L7 T Automatic washer .50 0 APPROVALS DATE INSPECTO�•m ROUGH PLUMBING GAS PIPING ' GAS VENT CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT I 1.00 GAS TEST Y� UTILITY CO.NOTIFIED TOTAL FEE $ 5 50 FINAL 76A667T C E#817 lb-67 APPLICATION FOR. PLUMMNC PEE 1 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 LOCALIT ' FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEARES - CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 1.50 MAIL BATH TUB 1.50 ADDRESS SHOWER 1.50 CI TEL. NO LAVATORY 1.50 CONTRA SINK 1.50 ADDRESS c DISHWASHER 1.50 CI L. NO CLOTHES WASHER 1.50 S ATE LIC ... LICENSE N - CLASS SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE P 05E ED BY LAWN SPRINKLER SYSTEM 2.00Gr. O WATER HEATER 1.50 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.50 INSPECTION A C,ORD 17V OUTLETS OVER /� W - 5 PER SYSTEM •30 N 0. Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant t UNDER SLAB WORK Name -ROUGH PLUMBING " Addre 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 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING �1 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 1 AM THE LEGAL OWNER OF,AND INTEND TO ey RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL SIGNATURE JACK R. ALLEN, SUPERVISIN HANICAL EN'G'R: OF PERMITTE • PERMIT VALIDATIION K. m.o. CASH PLAN CHECK VALIDATION K. .O. CASH WORKERS'COMPENSATION DECLARATION l��1p° l�l!°� t�%d��(�� ®�° �° ��J�f .o Q�� PER07 I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 �j • insure, oro certificate of WorkersCompensation Insurance, 76A667A Il f or a certified copy thereof (Sec. 3800, Lab. C. COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Polity No. 1•(147C1ti� �nY nCertified copy is hereby furnished. � FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 17X Certified copy is filed with the county building inspec- ADDRESS 4904 Kau fTna n tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITYTem 1e Cit WATER CLOSET Date /12.4 R 9 Applicant PYRAMTT) RTTIT,T)E NEAREST CERTIFICATE OF-EXEMPTION FROM WORKERS' BATH TUB CROSS ST. Lower Azusa COMPENSATION INSURANCE SHOWER OWNER F,'ETNER . (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars.($100)or less.) 3 LAVATORY l ADDRESS 4904 Kaufman I certify that in the performance of the work for which this. permit is issued, I shall not employ any person in any manner SINK CITY Temple City TEL. NO. 285 72 2 so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR PYRAMID. BUILDERS Date Applicant t CLOTHES WASHER SS NOTICE TO APPLICANT: If, after making this Certificate of ADDRE16332 .E. San. Bernardino Rd. Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN•SPRINKLER SYSTEM CITY Covina TEL. N09 6 7. 1342 with comply with such provisions or this permit shall be STATE LIC. deemed revoked. f WATER HEATER LICENSE NO. '400289 CLASS . B LICENSED CONTRACTORS DECLARATION ` DISTRICT NO: CESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 / GAS SYSTEM :2 OUTLETS 61 (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VALIDATION Z License Number 4n 1719 8 DATE Lic. Class B , U, Contractor PYRAMID BUILDIir'MRS 8/ _�f�9 BY fr ❑ - O I am exempt under Sec. W B.&P.C. for this reason T Plan check fee � _ ai' Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check applicant = c SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name PYRAMID. BUILDERS PYRAMID- ACCT. -I hereby affirm that I am exempt from the Contractor's License �"' Law for the Address following reason (Section 7031.5, Business and 1 3307 Professions Code): City COv , Tel. No ITEMS ❑ I, as owner of the property, will do the work and the TOTAL o t ,T0 structure is not intended or offered for sale (Section 7044, Business and Professions Code). f1( Cl: 70.50 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for CMGE °C the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name 000CI-01001 v� tw9 Lender's Address %32 1 AM8°54 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'property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 8/18/89 Signature of Permittee Date WORKERS' COMPENSATION DECLARATION - A p0 UCS TPON FOR PL UJI1Vll ° NG Il'15RI1VU0 U I hereby affirm that I have a certificate of consent to self 20;0026 DPW 6/87 insure,.or.a certificate of Workers' Compensation Insurance, 76A667A or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No, 104.796:ac-49;yState Fund Certified copy is hereby furnished. ® FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS 4904 Kauffman tion department. NUMBER FIXTURE OR ITEM Q FEE LOCALITY Temple City Date 414. 0 9Applicant PVRAMTTI 'RTTTT.T)ER WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' 1 BATH TUB �_ CROSS ST. Lower Azusa COMPENSATION INSURANCE OWNER (This section need not be completed If the work Involved by MAIL SHOWER BILL. FETNER the permit Is for one hundred dollars ($100)or loss.) 2 LAVATORY ADDRESS 4904 Kauffman I certify that in the performance of the work for which this p, permit is issued, I shall not employ any person In any manner SINK CITY temple Cit TEL'N L 85, 7228 so as to become subject to the.Workers'Compensation Laws. DISHWASHER CONTRACTOR pyRAMID BUILDERS Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of 16332 E. San. Bernardino SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY Covina TEL. NO. 96'7 1342 with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. 4 0 0 2 8 9 CLASS B LICENSED CONTRACTORS DECLARATION 71RICT NO. PRO SED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER nK and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL ALll TION a� DATE Q• License Number 4 0 0 9 A 9—Lic. ClassB-- U. FINAL Contractor PYRAMID RTTTT-11)(B 2S 4/4.490 BY = ❑ O I am exempt under Sec. VULIW B.BP.C. for this reason D ILI Plan check fee z Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name pyRAMID. BUILDERS { a I hereby affirm that I am exempt from the Contractor's License Address 1 2' a Law for the following reason (Section 7031.5, Business and 3307 43.00 Professions Code): City Covina Tel. No.'967. 1342 +^, ❑ I, as owner of the property, will do the work and the 1 ITEMS structure is not intended or offered for sale (Section D TOT AL 43-100 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY CHECK `°0 l I hereby affirm that there is a construction lending agency for CHANGE ,071 the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name113000-00'01 4/ 5190 i 9919 1 AM 7e43 Lender's Address I certify that I have read this application and state that the I D above information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby i authorize representatives of this County to enter upon the above-mentioned'property for inspection purposes. I SEE REVERSE FOR EXPLANATORY LANGUAGE ' <°...���►�— 41419 0 Signature of Permittee Date I. WORKERS' COMPENSATION DECLARATION . APP"UCATION FOR PLUM I herebBING PERMIT " r 6A667A DPW 4/87 f� y,"affirm that I.have a certificate of 'concent to'self in- :j6A567 • � '�jull sure or a certificate of Workers Compensation Insurance,or'a CE 817(REV. 8/86) certified copy thereof (Sec. 3800,Lab. C.) ` Policy No: 01179Fi3=E$$lpar`y. State Fl1rL_ COUNTY OF.LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy is hereby furnished. BUILDING �T FOR APPLICANT TO FILL IN (PRINT OR TYPE) © Certified copy is filed with the county building inspection ADDRESS 4904 Kaufman NUMBER FIXTURE OR ITEM FEE LOCALITY department. @ Temple -Git Date .'1.1210/90`Applicant_PVRAMth AiTTT.TI WATER CLOSET(TOILET) PP ER NEAREST. CERTIFICATE OF EXEMPTION,FROM WORKERS' BATH TUB CROSS ST. Lower Azusa COMPENSATION INSURANCESHOWER OWNER Fetner (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars•($100)or less.) LAVATORY ADDRESS 4904 Kaufman 1 certify that,in the performance of the work for which this per- mit is issued, I-shall not employ any person in any manner so SINK CITY.Temple City TEL. NO 285, 7228 as to become subject to the Workers'Compensation,Laws. / DISHWASHER 7 00 CONTRACTOR " PYRAMID. BUILDERS Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making ADDRESS this Certificate of Ex- 16332 E.* San Bernardino emption, you should become'subject to the Workers'Compen- SWIMMING POOL RECEPTOR CITY Covina TEL. NO.967. 1342 sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER"SYSTEM ly with such provisions or this permit shall be deemed"revok'- STATE LIC.' ..ed. WATER HEATER. LICENSE No4 0 0 2 8 9 CLASS. B LICENSED CONTRACTORS DECLARATIONDISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM f OUTLETS ^ ,p 9,(commencing with'Section 7000)of Division 3 of the Business OUTLETS OVER fed,Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION DATE O License Number'—A. 2 9 Lic. Class $ ConttactorPYRAM'ID BUILDRPS3120j9_0 Fl O O ':I am exempt under Sec. UjVVV B.&P.C. for this reason ► - Plan check fee . Date: PLUMBING PERMIT ISSUING FEE$ 1 00 Signature TOTAL FEE 35 15- 0 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan-check applicant C I hereby affirm that I am exempt from the Contractor's License Name" Law for the following reason (Section 7031.5, Business and PYRAMID: BUILDERS ;`; o$ Professions Code):' Address Z 3307 3 .50 El I; as owner,of the property, will do, the work and the City COvina` Tel. No., 967. 1342 structure is not intended or offered for sale(Section 7044, 1 ITENS Business and Professions Code). Poo. TI_ITAL 35. 5 CONSTRUCTION LENDING AGENCY ' 35.MI I'herebyaffirm that there.is a construction lending agency for the performance of the work for which this permit is issued CHANGE .00 (Sec. 3097, Civ. C.). , Lender's Name 0000-0001 3/30/90' Lender's Address 9819 1 AM10:55 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 I bove-mentioned property for ins ection purposes. 3/20/90 SEE REVERSE FOR EXPLANATORY LANGUAGE -9-ignature of Permittee Date