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Home My Public Portal About9142 LA ROSA DR_Plumbing__ 76A667-CE4817 6-65 CITY OF TEHPI CITY �7,"/ ?-V C l APPLICATION' FOR PLUMBING PERMIT 7 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FNEAREST JOHN A. LAMBIE. COUNTY ENGINEER 9142 Ila Ross Dr., COLEMAN W. JENKINS SUPT. OF BUILDING Temple City,, FOR APPLICANT TO FILL IN CROCROEncinitas NUMBER FIXTURE OR ITEM EACH FEE OWNER Comunity Disp Rockenbach- Contr) WATER CLOSET 2 ftture 61.25 6�2�` g ADDRESS MAIL - SHOWER 1.25 9 10128 E.Rush St., 4 BATH TUB .. 1.25 CITY So.El Monte. TEL, NO,GI 455 _ 5 LAVATORY (2-Future) 1.2s 6.25 CONTRACTOR Aero Plumbing Co. 1 SINK 1.25 25 ADDRESS 2845 N.Durfee Ave. DISHWASHER 1.25 CITY El on a TEL. NO. GI 246 STATELIC LAUNDRY TUB 1.25 LICENSE NO 238485 CLASS C-36 CLOTHES WASHER 1.25 DISTRICT y,Q. GROUP ZONE PROCESSED BY 1 WATER HEATER 1.50 .50 �7 �'Z-� '2 GAS SYSTEM OUTLETS 1.50 .00 INDUSTRIAL d WASTE APPROVAL 0 OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD V 0 H V w -- c d _ N ��• Z APPROVALS DATE INS PEC R'S SIGNATURE PERMIT S 2 00 UNDER SLAB WORK 0r TOTAL FEEROUGH PLUMBING �,fg/`"�t� •.� `Z .`Z GAS PIPING IH ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER c PLUMBING. ,^ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES Y' LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNE .,OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDENTI ROPERTY. UTILITY CO. NOTIFIEDeo SIGNATURE OF PERMITTEE FINAL VALIDATION CK. M O CASH L 1�o 4 7 9 ^� SEP 1 6 5 2 0.2 5 76A667-C Etl817 4-64 P UMBIN PEERMIT APPLICATION FOR L COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ER FADDDRESS BUILDING AANNB E SAFETY DCOUNTY NIVISEON WILLIAM A. JENSEN, SUPT OF BUILDING FOR APPLICANT TO FILL IN , NUMBER FIXTURE OR ITEM EACH FEE OWNER�� WATER CLOSET 31.25, MAIL BATH TUB 1.25 ADDRESS SHOWER 1.25 CITY �� TEL. NO. CONTRACTO LAVATORY 1.25 E SINK 1,25 ADDRESS DISHWASHER 1.25 CITY TEL. NO. ""z' - -LZ STATE LAUNDRY TUB 1.25 REGISTRATION NO. COUTNY ❑ CLOTHES WASHER 1.25DIS,'PRICT NO. GROUP ZONE P OCES D BY WATER HEATER 1.50 GAS SYSTEM OUTLETS 1'50 INDUSTRIAL WASTE APPROVAL 0 Q OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U oC 02 V W a t� . Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 pp UNDER SLAB WORK _ ROUGH PLUMBING - TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY ORDINANCES, AND STATE LAWS REGULATING HOT WATER HEATER , PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO. NOTIFIED SIGNATURE Af OF PERMITTEE FINAL LIDATION ROBERT A. WOOD cK M 0 CASH SUPERVISING MECHANICAL ENG'R WORKER'S COMPENSATION DECLARATION DPW9/89 76A667A - APPLICATION FOR PLUMBING PERMIT 76A667 I hgreby affirm that 1•have a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or a certified ! copy thereof(Sec 3800 Lab. C.) , COUNTY OF LOS ANGELES, DEPT. OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV. Policy No. Company ElCertified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING - Certified copy is filed with the county build ing'inspection ADDRESS AR department NUMBER ,FIXTURE OR ITEM po FEE LOCALITY Date Applicant WATER CLOSET NEAREST JC ' /► CROSS-ST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE MAP BOOK PAGESSOR PARCEL , (This section need not be completed If the work Involved by the SHOWER , permit,is for one hundred dollars($100)or less.) LAVATORY OWNER r I certify that in the performance of the work,for which this permit is issued, I shall not employ an person in an manner•so as to MAIL P Y Y P Y SINK 7 ADDRESS A-- become subject to the Workers' Compensa on Laws � DISWASHER CITY TEL NO. Date Applicant CLOTHES WASHER '� CONTRACTOR l - NOTI•E TO APPLI ANT- If, after making this Certificate of - (� Exemption, you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith'comply with such ADDRESS T provisions or this permit shall be deemed revoked LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL:NO �- I hereby affirm that I am licensed,under provisions of Chapter 9 WATER HEATER d STATE 1-16. (commencing with Section 7000) of Division 3 of the Business and LICENSE NO CLASS Professions Code, and my.license is in full force and effect. GAS SYSTEM OUTLETS (� OUTLETS OVER DISTRICT N6. PROCESSED BY 5 PER SYSTEM — q License Number L/ Lic.ClassZA FINAL DATE VALIDATION LU D _,, a ,Contractor Date _ - CO) ❑ _ FINAL•' ' am exempt'under Sec. BY Z B.&P.0 for this reason Date Plan check fee 1 T EM v Signature PLUMBING PERMIT ISSUING FEE$ 4B 5 D ,:I - - u ❑ - TOTAL FEE / ' CHECK. SINGLE FAMILY Plan check applicant -CHAP Ni ;!JI.: 3� HOME OWNER-BUILDER DECLARATION Name I hereby affirm that.l am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Address - - - �I E�-�!�I_I i :�.�.'�i•�': Code): `-� ❑ City t 4 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 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 ]-certify that I have read this application and state that the above 1 information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of this Coun to enter,upon the above-mentioned property for.ir p ion purpa e SEE REVERSE FOR EXPLANATORY LANGUAGE - (, Signat re'of Permittee Date ,