HomeMy Public PortalAbout9629-9633 LAS TUNAS DR_Plumbing__ 76,A 6.67—,CE 817 8/68
COUNTY OF LOS ANGELES
DEPARTNIENT•OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS s Tunas Drive
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY Temple "City,
FOR APPLICANT TO FILL IN PR NT OR TYPE) - NEAREST '
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1.50
NIAb
BATH TUB 1.50 ADDRESS
SHOWER 1..50 CITY TEL.NO.
LAVATORY 1.50 CONTRALTOS
Owen Brothers Plumbing, Inoo.'
SINK 1.50 ADDRESS 4265 N. Baldwin Ave.
DISHWASHER 1.50 CITY El Monte "TEL•NO. =00 8
CLOTHES WASHER 1.50 LIATE 11 C
CENSE NO. 231 74.1 CLASS C 36
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO GROUP~ ZONE P O BY
LAWN•SPRINKLER SYSTEM 2:00 f �NE V
WATER HEATER 1.50 INDUSTRIAL
WASTE APPROVAL CD
F-
GAS SYSTEM JrOUTLETS 1.50 .J� INSPECTION RECORD
OUTLETS OVER / 1 OW-.
.� 5 PER SYSTEM 30 d y
Z
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 UNDER SLAB WORK
Name ROUGH PLUMBING
Address 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 N PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
1 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
RESIDE IN,THE ABO ES DRE EN IAL PROPERTY. FINAL
• SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL ENG'R.
OF PERMITTEE -
1PERMRT VALIDATION( R• JM.O. CASH
ELAN CHECK VALIDATION CK. M.O. CASH 6
`J`J !*
76 A 667—CF,817 468
APPLICATION FOR PLUMBI G PERM
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS Las Tunas Drive
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY Temple City
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNERDominio r ellero
WATER CLOSET 1.50
MAIL
BATH TUB 1.50 ADDRESS
SHOWER 1.50 CITY TEL. NO.
LAVATORY 1.50 ,Q [ADDRESS
ONTRACTOR Owen Bros. Plumbin nC•
1 SINK 1.50 4265 North Baldwin Avenue
DISHWASHER 1.50 CITY El Monte TEL. NO. 443__0078
CLOTHES WASHER 1.50 STATE NO. 231 741 CLIC LASS C 36
SWIMMING POOL RECEPTOR 1.50
DISTRICT NO. GROUP ZONE [,,,PROCE�LAWN SPRINKLER SYSTEM 2.00 L-�� CL C,Z0
'2 WATER HEATER 1.50 �� 6) INDUSTRIAL / �
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD
OUTLETS OVER 10
5 PER SYSTEM '30
1
Laundry Tray
Z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE S 2 00
TOTAL FEE '
APPROVALS I)ATF, INACTOR'qSf.NATURE
Plan check applicant UNDER SLAB WORK' 65
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel. No. HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 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 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
RESIDE IN,THE ABO DESCRIBED RESIDENTIAL PROPERTY. FINAL
SIGNATURE JACK R. ALLEN, SUPERVISIN CHANICAL ENG'R.
OF PERMITTEE
PERMIT VALIDATION CK M.O. CASH
PLAN CHECK VA IDATION CK. M.O. CASH
9c43%':-6 APR 9 5 D 2 0.0 0
r
WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT
I hereby affirm that I have a certificate of consent to self 76A667A f
insure, or a 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
REPUBLIC INDE1111ITY
Policy NoPC964773. Company
❑ Certified copy is hereby furnished.
BUILDING
® FOR APPLICANT TO FILL IN(PRINT OR TYPE) T
Certified copy is filed with the county building inspec- ADDRESS 9629 3. LAS TUNAS DR.
tion department. NUMBER FIXTURE OR ITEM 0) FEE
LOCALITY TEMPLE CITY
Date JAN• 7 v t!AppIican - 2 WATER CLOSET NEAREST
BATH TUB CROSS ST. TEi4PLE CITY BLVD*
CERTIFICATE OF EXEMPTION FROM WORKERS' 1 �"
COMPENSATION INSURANCE OWNER IG,
(This section need not be completed if the work involved by 1 SHOWER E7 T
MAIL
the permit is for one hundred dollars $100 or less. 1 ADDRESS 9629 H. LAS TUNAS DR-
I
( ) ) 2 LAVATORY �.� ,�
I certify that in the performance of the work for which this
permit is issued, I shall not employ any person in any manner 1 SINK C• CITY TE14PIE CITY TEL. NO.
so as to become subject to the Workers Compensation Laws. DISHWASHER
CONTRACTOR J & D PLT7P93ING CO.
Date Applicant CLOTHES WASHER ADDRESS
NOTICE TO APPLICANT: If, after making this Certificate of 414 f S SAN GABRIEL BLVD.
SWIMMING POOL RECEPTOR
Exemption, you should become subject to the Workers' CITYTEL, NO. 287-0579
LAWN SPRINKLER SYSTEM
Compensation provisions of the Labor Code, you must forth- SAN GABRIE_,T
with comply with such provisions or this permit shall be STATE LICENSE NO. 307766 LIC. C-36deemed revoked. WATER HEATER CLASS
LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSEDJDY
I hereby affirm that lam licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS i
(commencing with Section 7000) of Division 3 of the Business OUTLETS OVER
and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL a
1 � VALIDATION
�� O
DATE
License Number 307766 Lic. Class C-3 u
1 LAUNDRY TRAY FINAL °C
Contractor Date 1 FLOOR DRAT11 BY 0
❑ I am exempt under Sec. W
1 BAR SINK °-
B.BP.C. for this reason H
Date:
Plan check fee 000. z
PLUMBING PERMIT ISSUING FEE$
Signature
TOTAL FEE
Plan check applicant
SINGLE FAMILY
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.
❑ 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 laws regulating Plumbing, and hereby
authorize representatives of this County to enter upon the
above-mentio bd p 1 for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Y � � JAN. 7, 1981
Signature of Permittee Date
ION
WORKER'S I have
a certificate
of consent to 7BAS66DPw9/89 APPLICATION FOR PLUMBING PERMIT
76A867A
I hereby affirm that I have a certificate of consent to self insure,
or a certificate of Worker's 6ompensatton Insurance,or a certified
copy thdreof(Sec.3800 Lab.C.)
COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV.
Polic Company
EJCertified copy is hereby furnished:❑ BUILDING 1 FOR APPLICANT TO FILL IN(PRINT OR TYPE)
Certified copy Is filed with the county building inspection ADDRESS V V-,
department. NUMBER FIXTURE OR ITEM
FEE LOCALITY � t c-.4-./
Date Applicant WATER CLOSET NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST.
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed if the work involved by the SHOWER MAP BOOK PAGE PARCEL
permit Is for one hundred dollars($100)or less.) LAVATORY OWNER M D
I certify that in the performance of the work for which this permit I 1
is issued, I shall not employ any person in any manner soEt to SINK MAIL
ADDRESS
become subject to the Workers'Comp satynLws. �p v qs
c DISWASHER CITY� 1 c-, TEL.NO.
Date - /� Applicant CLOTHES WASHER
NOTICE TO APPLICANT: If, after making this Certificate of CONTRACTOR }� n- 1A eml
Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS
provisions of the Labor Code,you must forthwith comply with such v f�
provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM
LICENSED CONTRACTORS DECLARATION CITY TEL.Nd?- 1 7 t a 0.
I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER
(commencing with Section 7000)of Division 3 of the Business and STATE Do. Z )) a
Professions Code,and my license is in full force and effect. GAS SYSTEM OUTLETS LICENSE NO. S C) (� CIASS e�J�O V
OUTLETS OVER DISTRICT NO. P C BY It
5 PER SYSTEM - i 1T.sLk C
License Number `D ic.Class _ ' I�
!� DATE VAL DATION O III
Contractor t Date�a_ _�� :119; s'3.01
❑ I am exempt under Sec. BY
CHECK 'f,i j
B.&P.C.for this reasonO kik o 01
Date: Plan check fee
Signature _ r PLUMBING PERMIT ISSUING FEE$ 8!:}�r
El TOTAL FEE e i ii i sly(j¢_{ 12/2"
Plan check applicant 8337
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm that I am exempt from the Contractor's License Law
for the following reason(Section 7031.5, Business and Professions Address
Code):
❑ city 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 dertify 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
p=Prtyor ins�n purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Slanature of Permittee Date