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HomeMy Public PortalAbout9534 LIVE OAK AVE_Plumbing__ 76A667A (CE 8178) -4/77 APPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETYID VISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM ® F— /y'EE ADDRESS -46 Vy0-e - WATER CLOSET LOCALITY NEAREST BATH TUB CROSS ST. SHOWER OWNER MAIL r LAVATORY ADDRESS SINK . CITY TEL.NO.�� DISHWASHER CONTRACTO AAIA CLOTHES WASHER ADDRESS J SWIMMING POOL RECEPTOR CITY a�IA24 TEL.NO. — 3 LAWN SPRINKLER SYSTEM STATE LIC. _ WATER HEATER LICENSE NO. CLASS GASSYSTEM OUTLETS DISTRICT NO, (3 ODUP N ��pROCES$E� OUTLETS OVER ` (' (3 CD 5 PER SYSTEM INDUSTRIAL V WASTE APPROVAL ` INSPECTION RECORD U W sz-,4/h i �� '"I-s fish. fn Plan check fee PLUMBING PERMIT ISSUING FEE$ 0� TOTAL FEE 4 Plan check applicant APPROVALS DATE INSPECTOR'S SIGNATURE Name UNDER SLAB WORK Address ROUGH PLUMBING City Tel.No. GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OFPERMITTEE FINAL PLAN CHECK.VALIDATION-----�iz � a—�zxsH PERMIT VALIDATION CK. M.O. CASH 5.7 2 r"MAY ~2 5 D 0..0 U f5 FO CY NUMBER: 76A667-CE#817 2-66 APPLICATION FOR P�LLIJMdING PER IT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS 953 . E. Live Oak Avenue COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY Temple City FOR APPLICANT TO FILL IN CROSS ST. Cloverly & Temple City Blvd NUMBER FIXTURE OR ITEM EACH FEE OWNER Charlotte Brandin WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS same me a s above SHOWER 1.25 CITY Te=le Cl TEL. NO. LAVATORY 1.25 CONTRACTORAnthonM poolS, I C SINK 1.25 ADDRESS 5871 E Firestone Blvd DISHWASHER 1.25 CITY South Gate TEL. NO. SlD 3®2219 STATE LIC LAUNDRY TUB 1.25 LICENSE N0.190179--053 CLASS CLOTHES WASHER 1.25 DISTRICT UP Z N R B WATER HEATER 1.50 '-�) GAS SYSTEM OUTLETS 1.50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD v Water piping O I-- C-3 W N APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT s 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE 3 ,50 GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 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 HOT WATER HEATER PLUMBING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGPOWNE NTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAOF, INTEND TO GAS TEST RESIDE IN,THE ABOVE ES IBED RESIRO RT UTILITY CO. NOTIFIED SIGNATURE s OF PERMITT FINAL DATION JACK R. ALLEN M.o. CASH SUPERVISING MECHANICAL ENG'R. LIG1 .541 OCT 13 5 0 3.5 0~ 4' 78A887 -CE#817 12-84' APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS C /7`!C+ OSS COLEMAN W. JENKINS, SUPT OF BUILDING , LOCALITY FOR APPLICANT TO FILL IN NEARE ST. 3 NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS CITY TEL. NO.te;�r� a SHOWER 1.25 LAVATORY 1.25 CONTRACTOR YI//101P®/V IC.,7 SINK 1,25 ADDRESS 113 5 MAA,)2_AA1/T� DISHWASHER 1.25 CITY NO. 3 3 Q�2?0 LAUNDRY TUB 1.25 REGISTRATION NO. Dp'Z COUNTY CLOTHES WASHER 1.25 DISTRICT NO. GROUP Z NE R E BY L. WATER HEATER 1.50 j GAS SYSTEM OUTLETS 1.50 INDUSTRIAL WASTE APPROVAL @6 OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD C= g l APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE O GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 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 HOT WATER HEATER PLUMBING. I HEREBY CERTIFY THAT 1 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,TH ESA VE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED SIGNAT U�2 E/ 9G1. OF PERT LIDATION ROBERT A. WOOD CK. M.O. CASH SUPERVISING MECHANICAL ENG'R LAo '; 2 5178 00720 5 D 3.50N WORKERS' COMPENSATION DECLARATION20-0026 PW 4/87 APPLICATION FOR PLUMBING PERMIT t I eby, o�`vm that f have a certificate of consent to self in- 76A667A suIf or a ce^tificate of Workers'Compensation Insurance,ora CE 817(REV. 8/86) certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company Sj t'<��G j'Vr.�7 COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy is hereby furnished. BUILDING r- FOR APPLICANT TO FILL IN (PRINT OR TYPE) ❑ Certified copy is filed with the county building inspection ADDRESS (/ � - '•. department. , r J NUMBER FIXTURE OR ITEM @ FEE LOCALITY Dote I LO�ppIicant `�1 �1-�1 WATER CLOSET(TOILET) NEAREST f- n CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. '"1 PL Gl 1 SL.4 COMPENSATION INSURANCE SHOWER1 it OWNER f-1 12S, - CH (This section need not be completed if the work,involved by (/ MAIL g the permit is for one hundred.dollors (;100)or less.) LAVATORY ADDRESS (� F I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so SINK CITY, S�1t�a Gh TEL. NO. as'to become subject to the Workers' Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS •� ''L xSO� NOTICE TO APPLICANT: If, after making this Certificate of Ex- t SWIMMING POOL RECEPTOR em tion,YCompen- sation should become subject to the Workers' P �� � l provisions of the Labor CodCITY TEL. NO.J©j-'� Code, you must forthwith comp- LAWN SPRINKLER SYSTEM l `l ly with such provisions or this permit shall be deemed revok- STATE / LIC. ed. WATER HEATER LICENSE NO. 1c�-7 Y CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROC ED BY 4--v- 1-hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER `J U and Professions.Code, and my license is in full force and ef- 5.PER SYSTEM FINAL VALID ION >_ fect. DATE License Number � Lic. Class U _ FINAL Contractor Vh ll�-S�PP-421 Date BY O ❑ I am exempt under Sec. LU L I I i I i B.&P.C. for this reason Plan check fee Date r PLUMBING PERMIT ISSUING FEE $ (� c Signature 1­1TOTAL FEE SINGLE FAM Yt!OCT HOME OWNER-BUILDER DECLARATION Plan check applicant `- L) �� Ort 3I 1 i 34=50 I hereby affirm that I am exempt from the Contractor's License Name _ Law for the following reason (Section 7031.5, Business and jl=j�S Professions Code): Address t . 50 I, as owrer of the property, will do the work and the City �� Tel. No. a�- � 1"I:i?L structure is not intended or offered for sale(Section 7044, -� �' Business and Professions Code) ► ,!l ! CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which thispermit is issued _'� (Sec. 3097, Civ. C.). 07 i s .(� Lender's Name Lender's Address I certify that I have read this application-and state that the above information is correct.•1 agree to comply with all County 101111.ordinances and State laws regulating Plumbing,.and hereby authorize representatives of this County to enter upon the above-mentioned roper y for inspection purposes. SEE REVERSE FOR,EXPLANATORY LANGUAGE Sig re of Perm ee Date WORKER'S COMPENSATION DECLARATION 6DPW 9/69 APPLICATION FOR PLUMBING PERMIT I hereby a• 76A66ffirm that I have a certificate of consent to self insure, 76A667A 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 ❑ Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING �� LI ✓/ � 1�/ ,(,If Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY ✓. Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. // y COMPENSATION INSURANCE ASSESSOR SHOWER MAP BOOK �� PAGED Cts PARCEL/ (This section need not be completed if the work involved by the permit is for one hundred dollars($100)or less.) OWNERg44;LAVATORY -/) , -/�� 67 I certify that in the performance of the work for which this permit MAIL /J � is issued, I shall not employ any person in any manner so as to SINK ADDRESS (� pL�(/ became subject to the Workers'Comp salion Laws. _ e DISWASHER CIT TEL.NO. _ � n Date Applicant• CLOTHES WASHERl NOTICE TO APPLICANT: If, after making this Certificate of CONTRACTO Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS ` provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY G T . O I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER STATE _ (commencing with Section 7000) of Division 3 of the Business and �/ LICENSE NO. -bo �� CLASS 0 AS SYSTEM OUTLETS Professions Code,and my license is in full force and effect. / �' OUTLETS OVER DISTRICT NO. PROCESSED BY cc �y^� l\ 5 PER SYSTEM O l% License Number 6 � Lia Class `� • Q GG�GTi1 V/, �f�D-�' FINAL DATE 1-- � VALIDATION Contractor Date ❑ I am exempt under Sec. BY AL B.&P.C.for this reason �© )^� 'Plan check fee --- � Date: _ Signature PLUMBING PERMIT ISSUING FEE$ Lf _ •= TOTAL FEE HL r ❑ - Plan check applicant 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, Business7. : 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-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date