The URL can be used to link to this page

Home My Public Portal About10061 LA ROSA DR_Plumbing__ 79 A„6 AT—OE BIT 8/68 APPLICATION FOR PLUMB NG ER T COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DPdISIONBUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS Q 'O JA COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY 1]A, FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST CROSS ST. A A NUMBER FIXTURE OR ITEM EACH FEE _ WATER CLOSET 1.50 OWNER �S G sNLE MAIL BATHTUB 1.50 ADDRESS iF LA �U SHOWER 1.50 C3TY SIT p CjU TEL. NO. .J92 LAVATORY 1.50 CONTRACTOR I SINK 1.50 ADDRESS AY� DISHWASHER' 1.50 CITY C TEL. NO. 3 ' CLOTHES WASHER 1,50 STA TELIC LICENSE NO.L/ 6 1P CLASS ^/ SWIMMING POOL RECEPTOR 1.50 DI6TRICT Npy� GROUP ZONE P O 6 BY a LAWN SPRINKLER SYSTEM 2.00All l O CD WATER HEATER 1.50INDUSTRIAL Z WASTE APPROVAL 2 GAS SYST EA1 OUTLETS 1.50 INSPECTION RECORD c� w TS OVER d 5 PER 5 PER SYSTEM '30 Z Plan check lee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE S 2 00 1`J 1�fI FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan cheek applicant UNDER SLAB WORK Name ,I ROUGH PLUMBING Address /oo F // GASPIPING / CILC �-f A� S TeI. No.��p �� (p HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLVMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AHO/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BV LOS ANGELES COUNTY ANO STATE OF / CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO n RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PR FINAL L - SIGNATURE - JACK R. ALLEN, SU PER VISIN HANICAL EN G'R. OF PERMITT PERMIT VALIDATIO cK. M.O. CASH PLAN,CNECK VALIDATION CK. M.O. CASH � , � 2452�i; OGT28 5 D 3 .50 WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT ( hereby'affirm that I have a certificate of consent to self 76A667A 'insure, ora certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof (Sec. 3800, Lab. C. COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS tion department. NUMBER fl%TURE OR ITEM C FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. Wx W COMPENSATION INSURANCE SHOWER OWNER QUE .IL. (This section need not be completed if the work Involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS US I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL, NO.k1i 03 so as to beaom subject to the Workers'Co pensalion Laws. DISHWASHER CONTRACTOR Date Applitatff CLOTHES WASHER NOTICE TO APPLICANT: If, a making this Certificate of ADDRESS Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY TEL. NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. SSED e I hereby affirm that I am licensed under provisions of Chapter 9 r GAS SYSTEM OUTLETS l C (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 15 PER SYSTEM I FINAL VALID ION DATE O License Number Lic. Class FINAL O, Contractor Date BY f1' ❑ I am exempt under Sec. 0 B.BP.C. for this reason 26 5 6 1 A W Plan check fee i Date: # e e e • e 5 rn PLUMBING PERMIT ISSUING FEE$ a S Signature ;( - - 2250 TOTAL FEE Plan check applicant is is is 2 2 5 0 5 SINGLE FAMILY _ HOME OWNER-BUILDER DECLARATION Name �`J4}'m J, r 0224-87 1 hereby affirm that I am exempt from the Contractor's License Address S Law for the following reason (Section 7031.5, Business and / ✓ 'PPro(ffessions Code): City (L� I Tel. No. I�U lL7�es_owner of the property, will do the work and the structure is not intended or offered for sale (Section lop, Business and Professions Code). 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 slate that the ► above information is correct. I agree to comply with all County , ordinances and State laws regulating Plumbing, and hereby authorize representative f Th is County to enter upon the obove�--ppp111entioned pro rt or inspec on purposes. �J /' ,�--`'e� SEE REVERSE FOR EXPLANATORY LANGUAGE / dJ ajde of Permittee Dole- WORKERS;COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT {� I hereby„offirm'that I have a certificate of consent to self 76A667A u i,sere;-orb certificate of Workers' Compensation Insurance, CE 817(REV. 10/8I) or a certified copy thereof (Sec. 3800, Lab. C) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING �t / Certified copy is filed with the county building inspec- ADDRESS s/ � �k- /llJ S�G_ tion department. NUMBER FIXTURE OR ITEM C FEE LOCALITY Date Applicant J/ WATER CLOSET NEAREST // CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. c{f ! V� COMPENSATION INSURANCE '1 OWNER SHOWER v (This section need not be completed If the work involved by !!// MAIL pp the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS ct. L O S C— I certify that in the performance of the work for which this permit is issued, I shall not employ any person in ckpy rcariner SINK CITY e C j I fTEL, NO. 3 so as to become subject to th&rs' n ws. DISHWASHER fCONTRACTORDate Applica CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, acate ofSWIMMING POOL RECEPTOR Exemption, you should becomesuborkers' CITY TEL NO. Compensation provisions of the Labor st forth- LAWN SPRINKLER SYSTEM with comply with such provisions orhall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION GAS SYSTEM OUTLETS DIST gL[T N(y�. �O ESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 L (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER 4 Z and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VALI TION DATE d License Number Lic. Class15X0 FINAL U. Contractor Date BY ❑ I am exempt under Sec. U B.BP.C. for this reason W Plan check fee ► d Date: N PLUMBING PERMIT ISSUING FEE$ Z Signature TOTAL FEE Plan check applicant ;25 121 A SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name # e is e e e 5 1 hereby affirm that I am exempt from the Contractor's License Low for the following reason (Section 7031.5, Business and Address Vis - 31L50 Prof ssions Code): City Tel. No. e is * 34.505 1, as owner of the property, will do the work and the , structure is not intended or offered for sale (Section 07.24t86 7044, Business and Professions Code). 1 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 thotil'h ve read this application and state that the ► above informal' n is correct. I agree to comply with all County o Ees.a`n State,�Ippws regu toting Plumbing, and hereby - o e e nese tiles of this County to enter upon e ed r�pert spection II burp es SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee / Date COUNT)' OF' tOS ANGELES TEMPLE CITY # 0508 PLUMBIC NG PERMITI, DEPARTMENT OF PUBLIC WORKS : 9071 LAS TUNAS PL 0508 9706170002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: - ES PAID BUILDING-ADDRESS: - TR: 10821 LT: 8 BL: A010061 LA ROSA?DR FEE DESCRIPTION: QUANTITY: LION: AMOUNT: `—\TEMP CA 91780330 ASSESSOR INFORMATION B : NEAREST CROSS STREET:-ARDEN 8585-007-012 01 PERMIT ISSUANCE FEE 27.75 THOMAS-PAGE:_597—GRID:_B4 LOCALITY: TEMPLE CITY - 60 DWV REPAIR OR ALTER 1.00 SYS 16.35 TENANT: TOTAL FEES 44.10 ISSUED 0 PROCESSED N IRE ON: 06/17/97 TC 06/17/98 OWNER: TEL. N0: FINAL DOTE FI IALC DE: GRUETER ROBERT T;BETTY N TRUSTEES (818) 918-3912- _ 1249 MICHELLE ST WCOV 917905334 ESC DON—OF-WORK— PLUMBING _ PLUMBING FOR NEW ADDITION APPLICANT: 0: J & D PLUMBING (818) 287-7832- SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSP CTOR SIG ATUR J & D PLUMBING (818) 287-7832-414 S. SAN LIC. NO - O RLSAN GABRIEL, CA1EL 91776VD 307766 C36 - /�! `� UNDER SL W --'-F— .�.� ATER SE VIC .� ,_ •�� PLASTIC Y/N MET L Y/N A E - ROUGHPL B_I G LIC. NOc ' -- GAS PIPING GAS N • - HOT WATER HEATER PLUMBINGI% LAWN SPRINKLERS _ GAS_TEST_ . UTILITY COMPANY CW GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508