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Home My Public Portal About10129 LA ROSA DR_Plumbing__ 76AG67 -CEREI7 tO-E2 APPLICATION 9OR PLUMB NG PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER r DING BUILDING AND SAFETY DIVISION RESS �j JOHN A. LAMBIE. COUNTY ENGINEER O Z / r WILLIAM A. JENSEN, SUPT OF BUILDING ALITY FOR APPLICANT TO FILL IN SSSST. r-�/ NUMBER FIXTURE OR ITEM EACH FEE ER WATER CLOSET $1.25 ,rQHATH TUB 1,25 1 2 r RESS - CITY �G'— TEL. NO. SHOWER 1.25 � Z/i `Z. LAVATORY 1.25 fQ CONTRACTOR _ SINK 1.25 �^ ADDRESS 3 ISS i DISHWASHER 1.25 C[TY G-�t�cu"+�+ TEL'NOO. �(� 7374 STATE LAUNDRY TUB 1.25 BEGIN STAAT OCTON NO. G-.3 Ca 3✓ /lD COUNTY CLOTHES WASHER 1.25 2 S^ DISTRICT NO. GROUP Z E PR SED BY I WATER HEATER 1.50 Z GAS SYSTEM OUTLETS 1.50S D INDUSTRIAL G d WASTE APPROVAL 0 OUTLETS OVER 5 PER SYSTEM .90 �. INSPECTION RECORD �' U / ' I / K u 3�2a-/c��y ,rte.- ��•��' ��J+�iY — Z 3 QV APPROVALS ATE INSPECT 'S.SION IRF PERMIT $ 2 00 UNDER SLAB WORK W-4 In ROUGH PLUMBING �� r•T�/" TOTAL FEE / S-100 GAS PIPING 1 HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION �/� 9( AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT 1 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER -, Ae/'If✓'�Cr PLUMBING, I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR PLUMBING FIXTURES I� p) ��"�A��/ yH LICENSED AS REQUIRED BY LOS ANGELES COUNTY Arv0 STATE OF GAS TEST f/!� � iyl A CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF.AND INTEND TO 11 RESIDE IN.THE ABOVE DES RIBEO flE51DEN IAL PROPE UTILITY CO. NOTIFIED IJAI'!_112 .G�' SIGNATURE ) OF PERMITTEE FINAL ://N+/,i•f7jj�y-�� VALIDATION ROBERT A:WOOD V M.o. CASH SUPERVISING MECHANICAL ENG'R ✓ LAL'o1 2 7 8G FEB 25 5 :D 1 5.00~ 76A667-CER8I7 2-66 CITYOF TEMPLE CITY APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES B 252 DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING 10129 East La Rosa JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY Temple City FOR APPLICANT TO FILL IN NEAREST Ba ldwin CROSS ST. FDISHWASHER FIXTURE OR ITEM EV E OWNER L. Copeland TER CLOSET $ MAIL TH TUB ADDRESS same CITY TEL. NO. OWER 1.23 VATORY 1.25 CONTRACTOR General Installation Co. K 1.25 ADDRESS 6558 west Blvd. 1.25 CITY Las Angeles TEL. NO. FL 3-2541 LAUNDRY SUB 1.25 ATE LICENSE NO. C-36 151839_ LIC CLASS CLOTHES WASHER 1.25 DISTRICT Np.� GROUP ZONE PROCESSED BY WATER HEATER 1.50 GAS SYSTEM OUTLETS 1.50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U 1 WATE13SOFTENER 1 Ready for Inspection Now CD U W O_ N Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 OO UNDER SLAB WORK TOTAL FEE 3 50 ROUGH PLUMBING GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE 1CORRECT AND AGREE COMPLY WITH ALL COUNTY ORDINANCES S AHO STATE LAWS REGULATING HOT WATER HEATER PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANDIDR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY ANDSTATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF.AND INTEND TO RESIDE IN.THE ABOVE DESCRIBED RESID- IALyRO UTILITY CO. NOTIFIED SIGNATURE (lam/N// OF PERMITTEE n FINAL /6 / VALIDATION JACK R. ALLEN M.O. CASH SUPERVISING MECHANICAL ENG-R. � er„ s 5 1 4� F�a�O r, 3i50� a WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT hereby affirm that I have a certificate of consent to self 7,)A667A ,sure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) a certified copy thereof (Sec. 380`0, Lab. C.) COUNTY OF ANGELES BUILDING AND SAFETY j licy No 6-13 -A JTh1E F'171J�] Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING / "� Certified copy is filed with the county.bmlding'.inspec- ADDRESS /Q/e�9 �(,//- � Q tion department NUMBER FIXTURE OR ITEM C' FEE '/ LocquTv.�m L6�T )ate 3'O7b^ Applicant //23kE:YE Loisc NATER CLOSET NEAREST I \ 'CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. t' E FJ COMPENSATION INSURANCE OWNER EV (Thissectionneed not be completed if the work'involved:by SHOWER A'IJ.S the permit is for one hundred dollars $100 or less. MAIL' t P ( ) ) fAVATORY ADDRESS 10I.QctLR gA I certify that in the performance of the work for which this '�- +�p Ipermll is issued, I shall not employ any person in any manner SINK CITY 1 'tTV� l TEL. NO. v f l^31c so as to become subject to the Workers'Compensation Laws. DISHWASHER l/ CONTRACTORQ(7 S Date 3-a Applicant /s' l nC.t CLOTHES WASHER ADDRESS g CV NOTICE TO you should If, after subject this Certificate of V T POI:S�' Exemption, you shoudbecome subject To the. Workers: SWIMMING POOL RECEPTOR Compensationprovisions of the Labor,Code; you must forth- LAWN SPRINKLER SYSTEM CITY v1U TEL. NO. �.-��.S�If with comply with such provisions or this. permit shall be - STATEhh LIC. deemed revoked WATER HEATER LICENSE NO. .y CLASS C- 3 LICENSED CONTRACTORS.DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 1 5 PER SYSTEM FINAq ! 3 DATEL-Y"z/a_ VALIDATION V 0. License Number 7 381 Li<. Class177- ,/ FINAL - Iz O Contractor //• 23• LU$K Date -fib^ BY F ❑ I am exempt under Sec �5 CL !/h 8 BP.C. for this reason W Date: Pian check fee Z 'PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5,Business and Professions Code): City Tel. No. ❑ 1, as owner of the.property, will do Ihe,work and the - L G 9 6 8 A structure is not intended or offered for.sale (Section 7044; Business and Professions Code). # • o's • • 5 i CONSTRUCTION LENDING AGENCY ' 1 hereby affirm that there is construction lending agency for 1 ,650 � iheperformonce of the work for which this permit is issued _ (Sec. 3097, Civ. G). 11 '6 5 Q 5 Lender's Name 103z'6-84 Lender's Address - I certify that I have read this application and state that the ► above information 4s correct I agree to comply with all County. - - - ordinances and.State laws regulating Plumbing, andhereby - authorize representatives.ofibis County to enter upon the. above me' ned property f 'i pecnon purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permi a Date