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Home My Public Portal About9441 LONGDEN AVE_Plumbing__ WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 insure, or a certificate of Workers'Compensation Insurance, 76A667A (,'1ty of Temple City or a certified copy thereof(Sec. 3800, Lab. C.) COUNTYOF LOS ANGELES I DEPT.OF PUBLIC WORKS Policy No. 201916Company SCTF 3 1 Certified copy is hereby furnished. BUILDING ® FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS 9441 Longden Ave Certified copy is filed with the county building inspec- NUMBER FIXTURE OR ITEM ® FEE tion department. LOCALITY Date 14/1/Q9 _Appli4aftneraY Tristar l . WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER Gary Steffins (This section need not be completed if the work involved by MAIL the permit Is for one hundred dollars($100)or less.) LAVATORY ADDRESS 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 MW-285_$652 so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Genedal Installation Co Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of 6558 West $1Vd. Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CIN LOS An cies TEL.NO. 753-254 LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WAT TERLICENSE NO. CLASS1719 LICENSED CONTRACTORS DECLARATION 6 �� DISTRICT NO. OCESSED BY GAS SYST OUTLETS . 09 O Q I hereby affirm that I am licensed under provisions of Chapter 9 j !J (commencing with Section 7000)of Division 3 of the Business I OUTLETS O and Professions Code,and my license is I;full force and effect. 5 PER SYSTEM FINAL VALIDATION License Number 151839 —tic. class C36 i `Q DAT � C FI Contractor W.O. Proyin/Date 4/89 lZ ❑ I am exempt under Sec. In LL B.&P.C. for this reason I a Plan check fee ® rf Date: PLUMBING PERMIT ISSUING FEE$ 10150 Signature TOTAL FEE 16150 SINGLE FAMILY Plan check applicant - � HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Low for the following reason (Section 7031.5, Business and Address Professions Code): ; City Tel. No. y`-- 5.5C ❑ 1 L i�`4 I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section ® 0—icy -16 - 50 7044, Business and Professions Code). :�+4_{.�.: ey;- 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.). M h Lender's Name ! _ 7 Ail Lenders Address I.1 tl 1.`. 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 Stat ws gulating Plumbing, and hereby authorize repress olives this County to enter upon the above-menti proper for inspection purposes. SEE REVERE FOR EXPLANATORY LANGUAGE t � ignature of P e Date I -IIIB-17 8.59 APPLICATION .FOR PLUMBING. PERMIT D83.17 DMSION OF BUILDING AND SAFETY Department of County Engineer County of Los Angeles NG WM.J. FOX.COUNTY ENGINEER ADDRESS CASSATT D.GRIFFIN,SUPT OF BUILDING BUILDb" LOCALITY a -+ 7LAg— j FOR APPLICANT TO .FILL IN NEAREST CROS_S ST. d 4r.-, kyr/) OWNER � / ` , CNG me A/ Sri-�/! DISTRICT NO. GROUP ZONE READY FOR INSPECTION MAIL. / ADDRESS ��H; .g ' INDUSTRIAL . CITY .� TEL.NO. WASTE APPROVAL PLUMBER ��K Ad Al' 'INSPECTION RECORD ADDRESS' GiiCQ7 s� � -M6Jy►�/% CITY 1 TEL-NO 40 G(0 LICENSE NO. O 2-ed 2- NUMBER' NUMBER' TYPE OF FIXTURE OR ITEM' FEE WATER CLOSET (TOILET) S BATHTUB SHOWER .LAVATORY (WASH BASIN) KITCHEN SINK DISHWASHER LAUNDRY TUB OR TRAY CLOTHES WASHER TOTAL NO. @ o.eo APPROVALS DATE INSPECTOR'S SIGNATURE. GAS SYSTEM OUTLETS @ 1.00 WATER HEATER @ 1.00 UNDER SLAB WORK PERMIT S 1 00 ROUGH PLUMBING GAS PIPING' TOTAL FEE / d GAS VENT I HEREBY ACKNOWLEDGE THAT- 1-HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS.CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES PLUMBING, I HEREBY CERTI Y T I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS RE IRED . LOS ANG NTY-AND ST E OF CALIFORNIA OR HAT' A TH IG ER OF T ABOVE UTILITY CO.NOTIFIED DESCRIBED RE DENT OPERTY. SIGNATU .� ✓/ _ ' OF PER FINAL `S 79/ �• _ WILLIAM J.FOX. LINTY ENGINEER VALIDATION R.A.WOOD.CHIEF PLBG.INSPECTOR :. C05 4 1512 JUL 7 3 1..8 0 '� 71BAG67A• �. CES 17 IRIkV.6/78) APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING1 NUMBER FIXTURE OR ITEM ® FEE ADDRESS C1 q� iV60FIV LOCALITY WATER CLOSET NEAREST BATH TUB CROSS ST. SHOWER OWNER 4 0-1 LAVATORY MAIL e ADDRESS SINK CITY TEL.NO. DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS L4g v SWIMMING POOL RECEPTOR CITYTEL.NO.Z`L/s- `s LAWN SPRINKLER SYSTEM STATE LIC. WATER HEATER LICENSE NO. CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES GAS TEST Z® (y ��/�' wowo Plan check fee UTILITY CO.NOTIFIED g PLUMBING PERMIT ISSUING FEE$ TOTAL FEE FINAL �2 Plan check applicant PLAN CHECK VALIDATION Name �� Address City Tel.No. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE4 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ar ' AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION { Ff 0 0 0 0 0 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED'AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL O V u l PROPERTY. C O C SIGNATURE OF PERMITTEE r r DISTRICT NO. PR SED BY ,5- O INDUSTRIAL WASTE APPROVAL r 76AC�67=CE#• 817 5-&I- APPLICATION 61•APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT.OF COUNTY ENGIIdSEER BUIMING AND SAFETY DIVISION Fro7 JOHN A.LAMBIE. COUNTY ENGINEER WILLIAM A. JENSEN, SUPT OF BUILDING „pFOR APPLICANT TO FiI.L II� CROSS ST. NUMBER FIXTURE OR ITEM ovmm WATER CLOSET Kam •BATH TUX -ADDRESS 91f/w EW sxowER012 • cm N . LAVATORY. CONTRACTOR .- SII18 ADDRESS DISHWASHER CITYNO ' -- S LAIINDRY TnB MGMMTION NO. CODNTY CLOTHES WASHER DISTRICT'NO. GROUP ZONE P BED BY WATER HEATER GAS SYSTEM INDV WASTE APPROVAL RIISPR=0N RECORD LU to OR rE ��•+/'./� _ _ L-� �•-'1� • TTIRB $ —(�= APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2100 UNDER SLAB WORK TOTAL FEE ROUGH PLUMBING GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY-. GAS VENT WITH ALL COUNTY ORDINANCES AND STATE -LAWS -REGULATING PLUMBING. HOT WATER HEATER 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 THA I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENT L PROPERTY UTILITY CO.NOTIFIED SIGNATURE I OF PERMITTE FINAL gAllATION ROBERT A. ,Ott ` M.G. CASH SUPERVISING MRCH%N L ENIR ,s utl:o s 2 9 DEC12 5 A 3.50,v 76A867-CE'y7 2-62 `� /11 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING rI / JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS ( / WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY 1 FOR APPLICANT TO FML IN NEAREST caoss sr. NUMBER FIXTURE OR ITEM EACH FEE i OWNER WATER CLOSET 51.25 MAIL BATH TUB 1,25 ADDRESS SHOWER 1.25 CITY TE NO. LAVATORY 1,25 CONTRACTOR ` •. . SINK 1,25 ADDRESS DISHWASHER 1.25 CITY ► TEL. NO. ' ® LAUNDRY TUB 1,25 CONTRACTOR'S STATE REGISTRATION NO. COUNTY ❑ CLOTHES WASHER 1.25 DISTRICT NO. GRO P ZONE PROCESSED BY WATER HEATER 1.50 D GAS SYSTEM OUTLETS 1.50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD° ISI1,//4o O 3 APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT S 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE 31. GAS PIPING - 1 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 PLUMBING. HOT WATER HEATER I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGE ES COUNTY AND STATE OF GAS TEST J CALIFORNIA OR THAT 7 AM THE LEG OWNER OF AND INTEND TO RESIDE IN,THE ABOVE DE CRIBED.1 I ENTIAL PROPERTY UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEE d + �15 FINAL �1 n /Xilll 19//' LIDATION ROBERT AAWOOD� (// I CK. M.0. CASH SUPERVISING MECHANICAL ENG'R 6869 ' NOV 13 5 A 5.75-