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Home My Public Portal About9627 LONGDEN AVE_Plumbing__ 11GAGO r 17 U-50 10 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING 1 WILLIAM J. FOX. CHIEF ENGINEER I FOR APPLICANT TO FILL IN i DISTTN'O. GROUP I ZONE �e Ft1'�JVO, PLUMBER Belvedere PlumbingCo. RECEIVED BY READY FOR DATE ISSUED I f� FIRST INSPECTION. ADDRESS 136 So Palm Ave., CITY Alhambra TEL. NC.AT95025 ?AODDISG -�'.�`�Longden Ave. LICENSE NO.COUNTY 808M EXPIRES 0 1 LOC L Y Temple Cit NEAREST PERMIT FEES CROSS ST. TD_oolittle NUMBER TYPE OF FIXTURE OR ITEM V FEE OWNER J.J. O Hammond ,1 MAIL WATER CLOSET (TOILET) @ 0.5o S O +ADDRESS BATHTUB @ 0.50 50 OITY TEL. NO. SHOWER @ 0.50 5II HEREBY ACKNOWLEDGE THAT . I HAVE READ THIS , 1 LAVATORY (WASH BASIN). @ O'.5050 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND 5 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ 0.50 1 STATE LAWS REGULATING PLUMBING. II CERTIFY THAT I POSSESS THE ABOV,E. .VALID LOS LAUNDRY TUB OR TRAY @ 0.50 50 iANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESIDENT[ PROPERTY DESCRI ED ABOVE. GAS SYSTEM OUTLETS @ 0.50 O r SIGNATURE.OF- WATER HEATER @ O.50 O J PERMITTEE- /L�= SLOP SINK. @ 0.60 INSPECTION RECORD FLOOR-SINK' @ 0.50 #�::_ FLOOR DRAIN @ O.SO DISHWASHER 0.50 /J n/n i• DRINKING FOUNTAIN @ O.So. �2- /SCI- I,b / 2/ 1 ./S 6 �✓�1 URINAL 0.50 !j /�//S�•Eyi/1 t[/Y/d Q HOUSE SEWER @ 0:.50 I, AS . Z MISCELLANEOUS (� 1 0 I� Ii APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING ,GAS VENT CESSPOOL @ 1.00 [CESSPOOL SEPTIC TANK: [SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 !SEWER PERMIT , • 1.00 GAS TEST I UTILITY CO. NOTIFIED TOTAL FEE $ 5 OO FINAL n ii_ wwmf+ w wr ® APRMTION FOR PEOM D�ASTI�NT OF $oa.Dn�G AND sAFsr�r COUNTY OF LOS ANGEM PLUMBING 1 WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRJCT NO. GRO P NE PERMIT NO. S' PLUMBER R=;w1v D BY READY FOR TE ISSUED ��` ��r l �� FIRST INSPECTION n f� �;�� ADDRKSS (� Gni i BU 1 LD1 NG CITY TEL NO. ADDRKSS COUNTY EXPIRES LOCALITY ' NEAREST PERT FSS CROSS sT. NYMEEE TTM OF F Z UIR OR ITEM FEE OWNER MAIL WATER CLOSET TOILLT 0.501 ADDRESS BATH TUB O.BO CITY TEL NO. SHOWER 0.80 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY WASH BASIN 0.00 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK a 0.00 STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSKSS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY 0-00 ANGELKS COUNTY LICENSE. OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. OAS SYST� OU 0.80 SIGNATURE OF WATER HKATER 0.50 PERMITTED SLOP SINK Q 0.50 FLOOR SINK 0.50 FLOOR DRAIN 0-80 DISHWASHKR 0.50 DRINKING FOUNTAIN 0.00 URINAL 0.00 ' J HOUSK BKWKR 0.50 MISCKLLANEOUS O d' O APPSOYAm DATE INWEOTORY NAME ROUGH PLUMBING- GAS PIPING GAB VENT [CUM P6OL 1. CESSPOOL • SEPTIC TANK- SEPTIC TANK 4-- DRAIN ( ) PIT ( ) ® 1.00 00 SEWER I PERMR , 1.00 GAII TEST UTILITY CO. NOTIFIED q� I TOTAL FEE S A �O FINAL Ia't Pf ' WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I he2eby �firrin that I have a certificate of consent to self 76A667A inWre`, or o•certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) er a•certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. BUILDING EJAPPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS _ 7 Certified copy is filed with the county building inspec- tion deportment. NUMBER FIXTURE OR ITEM ® FEEWATERDate Appligont , WATER CLOSET v�/ NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CO CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed If the work Involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS / I certify that in the performance the work for which this a S 3 permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO. so as to become subject to the AWor Compensation Laws. DISHWASHER CONTRACTOR Date � —" C Applic CLOTHES WASHER NOTICE TO APPLICANT: If a ng this Certificate of ADDRESS Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR p y I CITY TEL.NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE dp LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT dt P O SSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 15 PER SYSTEM FINAL 06 VALID ION DAT 0 License Number Lic. Class FIN @' Contractor Date B to ❑ I am exempt under Sec. 'n 13. B.BP.C. for this reason g Plan check fee ► Date: PLUMBING PERMIT ISSUING FEE$ 10 Signature 041 6 Z A TOTAL FEE # 000005 Plan check applicant SINGLE FAMILY '( o o 'Z j3 5 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that Iam exempt from the Contractor's License Address o 0 0 2$ 5 Ft Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. o3. 05-;-86 ❑ 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-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE j7 Signature of Permittee Date