The URL can be used to link to this page

Home My Public Portal About9929 LOWER AZUSA RD_Plumbing__ DAPPLICATION FOR PLUMBING PERMIT V1 DBS-17 B_I� VISION OF BUUMING AND SAFETY Deportment of County Engineer County of Los Angeles BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS 9929 Lower Azusa CASSATT D.GRIFFIN,SUP'T OF BUILDING , LOCALITY Temple Cit FOR APPLICANT TO FML IN NEAREST CROSS ST. OWNER DISTRICT NO. GROUP I ZONE. READY FOR INSPECTION MAIL ADDRESS or INDUSTRIAL CITY TEL. NO. WASTE APPROVAL PLUMBER Belvedere Plumbing Co. INSPECTION RECORD ADDRESS - 11900 E. Garvey Ave. ' Ave. CITY E1 Monte TEL. NO. GI 89836 • ^``""" LICENSE NO. 54932 NUMBER TYPE OF FIXTURE OR ITEM FEE d Z WATER CLOSET (TOILET) ' @ $1.00 5110 l BATH TUB @ $1.00 1100 SHOWER @ $1.00 i LAVATORY (WASH BASIN) @ $1.00 1,000 KITCHEN SINK @ $1.00 1100 DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 k 0 WATER HEATER @ $1.00 Tr0 GAS SYSTEM @ $1.00 APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING gZ SCOO 4 TOTAL FEE 9 00 GAS PIPING GAS VENT - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER I K AND STATE THAT THE ABOVE IS CORRECT.AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR. THAT I AM THE LEGAL 9WNER OF TH ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTI L PROPERTY. SIGNATURE OF PERMITTEE FINAL. JOHN A.L,AMBIE.COUNTY ENGINEER ALTION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR • V I Y.0. � CASH 7 7 0 5 APR 30 3 .213 76AS87 APPLICATION FOR PLUMBING PERMIT C:E BIS e-BUILDING AND SAFETY DMSION .� Department of County Engineer County of Los Angeles BUILDING JOHN A. AMBIE,COUNTY ENGINEER ADDRE L. SS CASSATTD,GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO Fii.I. IN NEAREST CROSS ST. OWNER t t DISTRICT NO. GR66E ZONE p READY FOR INSPECTION MAIL TION ' ADDRESS OlA!'�'✓ �'� INDUSTRIAL CITY �x TEL. NO. b WASTE APPROVAL PLUMBER // INSPECTION RECORD ADDRESSqqaf g h 1011d, CITYet TEL.NO. LICENSE NO. NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 $ BATH TUB @ $1.00 SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $1.00 KITCHEN SINK @ $1.00 DISHWASHER @ 81.00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 GAS SYSTEM @ $1.00 / APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT 8 I 1 00 ROUGH PLUMBING �G GAS PIPING TOTAL FEE GAS VENT I D HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER ANSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESID TIAL PROPERTY. SIGNATURE OF PERMITTE FINAL rl6 ROBERT A.WOOD, JOHN A. L.AMBIE,COUNTY ENGINEER ATION SUPERVISING MECHANICAL:ENG'R 06. E.0. CASH 3 9 JUL19 3 2.0 0 WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that t have a certificate of consent to.self 20-0026 DPW 6/87 insure, or a certificate of Workers'Compensation Insurance, 76A667A or a certified copy there f(Sec. 3800, L b.c.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS ` Policy Nc tf g_� ompony 4 , ❑ Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS a7'/ tion d port ent. ' NUMBER FIXTURE OR ITEM ® FEE LOCALITY r Date Appl igant WATER CLOSET NEAREST ERTI ICATE OF EXEMPTION FROM WORKERS' ?/ BATHTUB CROSS SL COMPENSATION INSURANCE OWNER (This section need not be completed If the work Involved by SHOWER 7 ,50 MAIL the permit is for one hundred dollars(=100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which thla permit Is Issued, I shall not employ any person in any manner SINK CITY TEL. NO. ' to as to become subject to the Workers'Compensation Laws. / DISHWASHER CONTRACTOR Dote Applicont CLOTHES WASHER ADDRESS lip NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' 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 LIC. deemed revoked. WATER HEATER LICENSE NO. .%O / . CLASS LICENSED CONTRACTORS.DECLARATIONI NRqaT BY I hereby afflrm•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. s PER SYSTEM FINAL f/�/ ALIDATION /� /_6/4 //4 DATE pCj. FINLicense Number Lic. Class �1' BY AL -Q/ 0 Contractor Date G F- ❑ 1 am exempt under Sec. U W B.BP.C. for this reason nI Plan check fee Date: h Z PLUMBING PERMIT ISSUING FEES V Signature TOTAL FEE SINGLE FAMILY Plan check applicant 5 '-� HOME OWNER-BUILDER DECLARATION Name C�.g I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and 3307 118.00 Professions Code): City Tel. No. I, as owner of the property, will do the work and the 1 ITE Cl structure is not Intended or offered for sale (Section TOTAL 118.00 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY MM 1118.0111 I hereby affirm that there is a construction lending agency for CKWZ M the performance of the work for which this permit is Issued (Sec. 3097, Civ. C.). Lender's Name WM"M1 7/ 2/90 Lender's Address 16M 1 AM 9:41 1 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 reprelentatives of this County to enter upon the above-mentioned'property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE • 7/x/9 D Signature of Permitt Dole