The URL can be used to link to this page

Home My Public Portal About10112 LYNROSE ST_Plumbing__ 78w887A (CE 817B) -4/77 BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILLIN(PRINT OR TYPE) BUILDING C NUMBER FIXTURE OR ITEM ® FEE ADDRESS f WATER CLOSET LOCALITY Temp16 City BATH TUB NEAREST CROSS ST G l i C kma n SHOWER OWNER Mr. and Mrs. D. Bachelder LAVATORY MAIL ADDRESS 10112 Lynrose St. r� SINK CITY Temple City TEL N�47—1 79c`7 i DISHWASHER CONTRACTOR E. L. PAYNE COMPANY CLOTHES WASHER SWIMMING POOL RECEPTOR ADDRESS 166W Live Oak h CITY Arcadia TEL NO 446-6118 r LAWN SPRINKLER SYSTEM STATE LIC f WATER HEATER LICENSE NO 120228 CLASS C-20 GAS SYSTEM OUTLETS DISTRICT NO GROUP I ZONE PR ESSED BY 1 OUTLETS5 PER OVER 3 OO INDUSTRIAL / V WASTE APPROVAL y INSPECTION RECORD U W N , Z Plan check fee PLUMBING PERMIT ISSUING FEE$ 00 F TOTAL FEE 10 00 Plan check applicant Name APPROVALS DATE INSPECTOR S SIGNATURE UNDER SLAB WORK 'L 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 S 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 IDENTIAL aw a.i PROPERTY /J/' — UTILITYCO NOTIFIED SIGNATURE ` C'Vd�, OF PER EE FINAL q d PLAN CHECCKQVALI�ATION c M 0 CASH PERMIT VALIDATION cK M 0 CASH 0-, i Qu OQ V-,A ►� e� -.� ES�cS i , 76A667 OBB 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY momm /0 COUNTY OF LOS ANGELES1 WILLIAM J. FOX, CHIEF ENGINEER PLUMBINIG - DISTRICT NO. GROUP I ZONE PERMIT Nu. FOR APPLICANT TO FILL IN S PLUMBER RECEIVED BY READY FOR DATE ISSUED VAUEY BOULtVANUNG A: FIRST INSPECTION /�....5 ADDRESS 8300 EAST VALLLY bLVD. BUILDING CITY TEL NO. ADDRESS Q COUNTY 2-2/19 LOCALITY LICENSE NO. EXPIRES NEAREBT PERMIT FEES CROSS BT. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLO0 SET(TOILET) 0.5 $ g17ADDRESS BATH TUB @ 0.50 CI SHOWER @ 0.50 1 HEREBY A NOWLEDGE THAT 1 HAVE READ THIS 120001 LAVATORY (WASH BASIN) @ 0.50 d (' APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50 Q AND STATE LAWS REGULATING PLUMBING. 1 P CERTIFY THAT 1 OBBESS THE ABOVE VALID LOS LAUNDRY TUB O TRAY @ 0.50 SQ ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWN OF THE RESIDENTIAL R PERTY 2RIBE0 ABOVE. GAB SYSTEM OUTLETS Q 0.50 ,5 /,b ATURE OF WATER HEATER (� 0.50 BIGNPERMITTE� SLOP SINK 13.50 INSPECTION RECORD FLOOR SINK 0.50 FLOOR DRAIN 0.50 DISHWASHER 0.50 DRINKING FOUNTAIN Q 0.50 URINAL 0.50 .J Q HOUSE SEWER 0.50 Z_ MISCELLANEOUS E9 It O APPROVALS \ DATE INSPECTOR'S NAME ROUGH PLUMBING d GAB PIPING � GAS VENT Al- CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMITI 1.00 GAS TEST • UTILITY CO. NOTIFIED/ TOTAL FEE $ �� FINAL 76A667•CE0617 9/63 n n 1� �1 V , A .. tl L� , V CATIOFOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER = BUILDING AND SAFETY DIVISION BUILDING foil ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A. JENSEN, SUPT OF BUILDING �w�, ^`� A ' LOCALITY f �/ e FOR APPLICANT TO FILL IN NEAREST p CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE WATER CLOSET $1.25 OMAIL WNER ADDRESS BATH TUB 1.25 ! SHOWER 1.25 CITY ` TEL. NO-4+7471T LAVATORY 1.25 CONTRACTOR SINS . 1.25 ADDRESS ORO&o DISHWASHER 1.25 CITY_54W 1 6"k/eLTEL. NO.AT(p0-&" LAUNDRY TUB 1.25 REGISTRATION NO. /CJS to f COUA CLOTHES WASHER 1.25 ° DISTRICT NO GROUP ZONE PROCESSED BY WATER HEATER 1.50 5-. ;; Gar r GAS SYSTEM OUTLETS 1.50 INDUSTRIAL a WASTE APPROVAL O OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U �' TR R-P i A�GIA�ib o t l� $PQM us zs u W CL to Z 1 APPROVALS DATE INSPECTORS hIGNATURE PERMIT $ 2 00 UNDER SLAB WORK _ ^� ROUGH PLUMBING TOTAL FEE J GAS PIPING I HEREBY ACKNOWLEDGE THAT I 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 I 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 O INTEND TO RESIDE IN,THE ABOV DE SCRIBED SIDEN IAL P PER UTILITY CO NOTIFIED SIGNATURE OF PERMITTEE FINAL V(„r VALIDATION ROBERT A WOOD Ir cK M O CASH SUPERVISING MECHANICAL ENG R LA—L'03 2 3 31-0 AUG 2 8 5 D 3.2 5 Q j WORKER'S COMPENSATION DECLARATION 200026 DPW 9/89 ®ppLICATION FOR PLUMBING PERMIT } • 76A667A ^ I herebtyaffirm that I have a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or a certified _ cop ther of(Sec 3800 Lab C) - j� 0� COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV. P�o iicy No Compa Certified copy is hereby furnished 110/ BUILDING M (� p y� FOR APPLICANT TO FILL IN(PRINT OR TYPE I v Certified copy is fled with the county building mspect«on ADDRESS departmentC �,' t NUMBER FIXTURE OR ITEM - p FEE LOCALITY Da O�q Applicant Wv�� "� WATER CLOSET I NEAREST z_011 � \ Q 1C.�1 �� \ 0� CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST- COMPENSATION INSURANCE ASSESSOR- n L�Z�j (This section need not be completed if the work Involved by the SHOWER MAP BOOK �� PAGE PARCEL l permit is for one hundred dollars($100)or less) OWNER I certify that in the performance of the work for which this permit LAVATORY is issued, I shall not employ any person in any manner so as toMAIL SINK become subject to the Workers' Compensation Laws ADDRESS DISWASHER « CITY .-•v . G TEL NO Date Applicant i CLOTHES WASHER CONTRACTOR S `M��• NOTICE TO APPLICANT If, after making this Certificate of Exemption,you should become subject to the Workers' Compensation SWIMMING POOL RECEPTOR ADDRESS' �^C) provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked LAWN SPRINKLER SYSTEM r LICENSED CONTRACTORS DECLARATION CITY TEL N*kJ_J 27 } I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER a 111��' 1� (commencing with Section 7000) of Division 3 of the Business and STATE GAS SYSTEM OUTLETS LyQjl CLASS `�� O ICENSE NO Professions Code,and my license is in full force and effect V -� OUTLETS OVER DISTRICT NO P 5 PER SYSTEM ` O Q License Number �C Lic Class p. FINAL VAf ID TION W fl—' , DATE Contractor Date �6- b fi':l h. co El • FINAL _ - -�,- CZ I am exempt under Sec BY __I!� - B&P C for this reason 1 s T EhiS_ Plan check fee Date 1 S { 27-1 e_ PLUMBING PERMIT ISSUING FEE$ 2 Signature- t.. 7 V r TOTAL FEES' ' ❑ 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) ❑ i City rC Tel No 4 J- 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) I CONSTRUCTION LENDING AGENCY 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 pro rty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Ll nature of Permittee Date ION DECLARAT WORKER'S h ve a certificate of consent to 76A667 DPW 9/89 APPLICATION FOR PLUMBING PERMIT 76A667A APPLICATION I hereby affirm that I have a certificate of consent to self insure, or a certificatoraf.Worker's Compensation Insurance, or a certified copy thereof(Sec 3800 Lab C) •• Tv// COUNTY OF LOS ANGELES D PT OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No Company ❑ Certified copy is hereby furnished f ` FOR APPLICANT TO FILL IN(PRINT OR TYPE) I BUILDING 41 Certified copy is filed•with the county building inspection ADDRESS Z F-13S i department NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Applicant WATER CLOSET NEAREST BATH TUB CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST /�s✓ �/,��l�ii� COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the work involved by the SHOWER MAP BOOK I PAGE PARCEL permit is for one hundred dollars($100)or less) LAVATORY OWNER :,certify that in the performance of*the work for which this permit is issued, I shall not employ any person in any mariner so as toMAIL become subl t to the Workers'Compensation Laws SINK ADDRESS p� � - DISWASHER CITY - TEL NOL/(J%�� Date/ Applicant CLOTHES WASHER CONTRACTOR NOTI E TO APPLICANT If, afte making this Certificate of �� ✓c!' Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked LAWN SPRINKLER SYSTEM " LICENSED CONTRACTORS DECLARATION CITY ,,,/��—' TEL ✓ `� d I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER 0 / ��l �J / (commencing with Section 7000)of Division 3 of the Business and STATEGAS SYSTEM OUTLETS LICENSE NO �Q�/�! �/ CLASS ` Fj• O Professions Code,and my license is in full force and effect OUTLETS OVER DISTRICT NO f CESSED BY 5 PER SYSTEM Q License Number ✓" y� Lic Class FINAL VALIDATION W Contractor Date` DATE IsITEMS 43.40 cn ❑ I am exempt under Sec , FINAL ?BY.. . ,,. _., w1 J B&P C for this reason J TOTAL •"�[ 4 3 m 0 Date Plan check fee 43' M3 _ �" Signature PLUMBING PERMIT ISSUING FEE$ '�� - ( ( ((( ❑ TOTAL FEE f Plan check applicant C -OOOii I g`oc 1 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, J performance of the work for which this permit is issued (Sec 3097, Civ C) Lender's Name Lender's Address y 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 p oses �� /� SEE REVERSE FOR EXPLANATORY LANGUAGE