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HomeMy Public PortalAbout9555 LA ROSA DR_Plumbing__ 76 A 667 - CE 817 7-69 n APPLICATION -FOR. -PLUMBING FERMI COUNTY OF LOS ANGELES u DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING r JOHN A LAMBIE. COUNTY ENGINEER ADDRESS v COLEMAN W JENKINS SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 1 SOMAIL �J+ BATH TUB _ 1.50 ADDRESST- ' • SHOWER 1.50 CITY NO.� I LAVATORY 1 50 CONTRACTORS j SINK 1 50 ADDRESS f •E _ DISHWASHER _ 41 50.- CITY-_ -�C• - �C� "NO. Jl�- - �~ CLOTHES WASHER 1 50 STATELIC -T 6 �i / CLASS �^ Z LICENSE NO �CCo / SWIMMING POOL RECEPTOR 1 50 DISTRICT NO GR ZONE PR DB LAWN SPRINKLER SYSTEM 2 00 Q WATER HEATER 150 - - _ ^• WAST� EAPPROVAL O GAS SYSTEM / OUTLETS, 1 50 D' INSPECTION RECORD , U OUTLETS OVER 9 7® �f"�JP�� n. 5 PER SYSTEM 30 r/ V I / f ,O � •�/ _T�✓ ' Vf Z Plan check fee 25% of above See reverse PLUMBING PERMIT ISSUING FEE 8 2 00,, TOTAL FEE sQ APPROVALS DATE INSPECTOR 5 SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT CitLPRESIDE Tel No HOT WATER HEATER EBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES LL COUNTY ORDINANCES AND STATE LAWS' REGULATING GAS TEST /I 1 G d - EBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED D AS,REQUIRED BY LOS ANGELES COUNTY AND STATE OF NIA OR THAT I AM THE LEGAL OWNER OF,AND IN TO N,THE ABOVE DECC ED RESIDE IAL OPERTY FINAL _ I-'7 O /URE JACK R. ALLEN, SUPERVISING MECHANICARMITTEE PERMIT VALIDATION CK M O c.ASH PLAN CHECK VALIDATION CK M O CASH ' i.'7- x:`22 'JUL1_6 j5-D 3;5�p� ��,, ��� t- .8 17 aM BETS 4-43 APPLICATION FOR PERMIT DEPAR�'MENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES �`������ WM. J FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUPZONE PERMIT NO. ROUGH FIXTURES COMPLETE 6` / I t / // 66 7 HEATER CESSPOOL SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION GAS MISCELLANEOUS �j t� APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB �/7 NAME ,/"..�'� ADDRESS 0G LOCALITY ! m ADDR SS f . NEAREST R CITY / *' - r ��,� TEL No � �, /�j CROSS ST. COUNTY ('� !CERT No EXPIRES �� W NAME t! LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL ADDREBB -NORTH______NORTH — — CITY p(6� TEL.No,OC ,f I AM THE LEGAL POSSESS R OF THE ABOVE L09 ANGELES COUNTY CERTIFIC OF QUALIFIC TIO Ar I kOWERTR I AM THE LEGAL OWNER OF THE P OPERTY DESCRIBE ABOVE yI D 3 OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK a z BATH TUB FURNACE 6 I HOWER DISHWASHER 0 LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP LOP BINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING F6UNTAIN` DATE INSPECTOR'S NAME ' WATER D7HEATER DENTAL LAVATORY ROUGH PLUMBING I !� I 'V.,- META R GA8 SODA FOUNTAIN GAS PIPING OUTL GAS VENT 174 , / CESSPOOL I I TOTAL NUMBER OF FIXTURES 17 J SEPTICVTANK CESSPOOI SEPTIC TANK SEWER $ UTILITY CO NOTIFIED I TOTAL FEE JFINAL 2 D B S-17 25n1 SETS 6-46APPLICATION IFOR PERWr D�PAR7aVIENT OF BUILDING AND SAFETY PLUMBING ������� COUNTY OF LOS ANGELES WM.J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE J_ A B / HEATER CESSPOOL ��SE=Lmam"4<�- CE YEDBY" READY FORDA EIB U D FIRST INSPECTION m L A8 MISCELLANEOUS �/ /'12�f,471v APPLICANT FILL IN HEAVILY OUTLINED PORTION +�Q'ONLY 7, ///� E NAME M• C• NOTTINGHAM CO. ADDRE89 a�.ems Fr�Y"A, �[r9��.4 /a w 07 M ADDRESS 123 lr o, Cloyerly Ave.- LOCALITY J NEAREST IL CITY C40SS BT. COUNTY / CERT NO. EXPIRES K NAME /.0'744-, LOCATION OF SEPTIC TANK, OR CESSPOOL W Z MAIL i 3 ADDRESS NORTH O CITY 1 TEL.NO. I AM THE LEGAL POSSG880R OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QU�ALI_EICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. � 4 3 a f/I OWNER -0 i CORRECTIONS SOUTH J DESCRIPTION OF WORK z BATH TUB FURNACE Q' SHOWER DISHWASHER E3 LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER—GAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT ` /� CESSPOOL I I All Alc TOTAL NUMBER OF FIXTURES (EI —/T��/ SEPTIC TANK CESSPOOL SEPTIC TANK 4e SEWER II " S UTILITY CO.NOTIFIED + TOTAL FEE Y� or FINAL 76A667-CE847 12/59 TEMPLE C�TY APPLICATION FOR PLMBING PERMIT � } COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDINGiNDE$�FETY RIVISION BUILDING JOHN A L MBI ouNTY NGINEER ADDRESS WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST EARECROSS ST . � NUMBER FIXTURE OR ITEM OWNER WATER CLOSET MAIL BATH TUB ADDRESS CITY TEL NO. SHOWER LAVATORY CONTRACTOR SINS ADDRESS /)/ -] DISHWASHER CITY Is TEL. NO. (p C 3 C1 1' CONTRACTORS _ _ _ �^ STATE ❑ - -- _ -LAUNDRY-TUB - REGISTRATION NO. COUNTY ❑ CLOTHES WASHER DISTRICT NO I G ZONE P SED BY WATER HEATER t GAS SYSTEM INDUSTRIAL WASTE APPR VAL / INSPECTION RECORD y o a Q $1.00 PER ITEM I / OR FIXTURE $ APPROVALS D^ATE ,INSFECCTOR S"SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK I I p f ��!� L I , ROUGH PLUMBING 4 /J7-,- a �k'.iaz TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER /eZ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AHD/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE _ DESCRIBED RESIDE L PROPERTY. UTILITY CO NOTIFIED + /\ SIGNATUR OF PERMITTEE' �y�- �� �/'�w u p � FINAL 1//GV-�p•r � 1�fu'af(1✓, ®P VALIDATION ROBERT A WOOD. cK. M.O. CASH SUPERVISING MECHANICAL ENG'R 5 3 5 7 ;D 21 5 D 1 0.0 0 M vWORKERS'COMPENSATION DECLARATION '06APA16ATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV 10/81) u or o certified copy thereof (Sec 3800, Lob C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No 00020,10eOnpany CNA ❑ Certified copy is hereby furnished BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS 9555 LaRosa Dr .. © Certified copy is filed with the count ns c NUMBER FIXTURE OR ITEM @ FEE tion department LOCALITY Temple City Date 12/19/86 Applican WATER CLOSET NEAREST CERTIFICATE OF EXEMP ION FR W ERS' BATH TUB CROSS ST MAIL COMPENSATI N INSU AN OWNER (This section need not be completed if th ork involved by SHOWER Sal:aida the permit is for one hundred dollars (S 0 or less ) LAVATORY ADDRESS 9555 L3R0Sa Dr . 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 Tera le Cit TEL NO2S6-50441 so as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR Nat Taylor s El Date Applicant CLOTHES WASHER ADDRESS T NOTICE TO APPLICANT If, after making this Certificate of 8402 �Zatella Ave ._ Exemption, you_jshould become subject to- the-Workers' _ SWIMMING POOL RECEPTOR— – - - --Compensation provisions of the Labor Code, you must forth- _ CITY Stanton TEL N628-0550 LAWN SPRINKLER SYSTEM ' with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER 00 6 . 00 LICENSE NO 136616 CLASS C 3 6 . 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 n fu I force and effect 5 PER SYSTEM FINAL' VALIDATION a. License Number �113 6616 i Class C36 DATE 0 FIN Contract D tel 2/19/8 6 BY A ❑ am exerrl t u der S O� U 8 8P C for this re n W Plan check fee ® CL, Date PLUMBING PERMIT ISSUING FEE$ 10 . 50 2 6 4 7.0 A Z Signature — TOTAL FEE 1 16 .150 Plan check applicant SINGLE FAMILY L HOME OWNER-BUILDER DECLARATION Name 't� e el 6,5 0 I hereby affirm that I am exempt from the Contractor's License = Law for the following reason (Section 7031 5, Business and 11 Address 0 200 1 () Professions Code) Cit Tel No ❑ 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 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 jaws re ati g Plumbing, and hereby authorize re r sentati thi ounty to enter upon the I r r for spection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 12/19/86 gnatur of ermi Date i