Loading...
HomeMy Public PortalAbout10137 LYNROSE ST_Plumbing__ 76A667 (CE-817) - 1/78 APPLICATION F R PLUMING PERMIT • COUNTY OF LOS ANGELES , DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO.' BUILDING ADDRESS j�(j/�© G !/i( fes HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TY PEI NEAREST CROSS ST NUMBER FIXTURE OR ITEM p FEE OWNER WATER CLOSET 200 MAIL / Q - /c/ BATH TUB 200 ADDRESS cam- i/1fd S SHOWER 200 CITY _ aj EL. NO. LAVATORY 2 00 CONTRACTOR _ �G SINK 2 00 ADDRESS CJ f DISHWAS 2 00 ,A - CITY e P TEL. NO CLOTHES WASHER 200 STATE LIC LICENSE NO CLASS SWIMMING POOL RECEPTOR 2 00 DISTRICT NO GROL)Pr�) ZONE PR ESS D BY LAWN SPRINKLER SYSTEM 2 pp '^ Gv j !_7Z�• o WATER HEATER 2 000 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 2 00 (j INSPECTION RECORD 0 OUTLETS OVER 5 PER SYSTEM .30 V O F- U t W a N Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ o TOTAL FEE I APPROVALS DATE INSPECTOR S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel NO. GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED 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 DESCRIB RESIDENTIAL PR ERTY, FINAL SIGNATURE OF PERMITTEE ' PERMIT VALIDATIONCCM,O. CASH PLAN CHECK VA DATION CK. M. CASH5 O�nEG 5 2 0 0 , 76AS67 D8917 11-SO APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY �p 9 COUNTY OF LOS ANGELES 1 WILLIAM J. FOX, CHIEF ENGINEER PLUMBING DISTRIL'T NO. GROUP I ZONE Nu. FOR APPLICANT TO FILL IN 1tUMBING Co- 5-11 PLUMBEq • READY FOR REC��EJI,,VED BY FIRST INSPECTION DATE ISSUED t f9 y 0 ADDRE99ROSEMP-AW WE 2-27t9 t` BUILDING CITY - TEL, No. ADDRESS �� COUNTY �/lw LOCALITY LICENSE NO. EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER > / MAIL WATER CLOSET(TOILET) Q 0.50 >a D ADDRESS y BATH TUB @ 0.50 d CITY .EL Nn. SHOWER 0.50 I HEREBY AC NOWLEDGE THAT I HAVE READ THIS / LAVATORY (WASH BASIN) @ 0.50 Q APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES / KITCHEN SINK @ 0.50 .j AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT I POSSESS THE ABOVE VALID L09 LAUNDRY TUB OR TRAY Q 0.513 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER J OF THE RESIDENTI PROPERTY DESCRIBED ABOVE. GAS SYSTEM OUTLETS 0.50 SIGNATURE Of- WATER FWATER HEATER 0.50 ,�� PERM[TTE SLOP SINK Q 0.50 INSPECTION RECORD FLOOR SINK 0.SO FLOOR DRAIN 0.50 DISHWASHER 0.50 DRINKING FOUNTAIN 0.50 URINAL 0.50 _I a HOUSE SEWER 0.50 _Z MISCELLANEOUS t7 APPROVALS DATE )INSPECTOR'S NAME ROUGH PLUMBING /�q GAS PIPING d GAS VENT CESSPOOL 1.13D CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) f@ 1.00 SEWER / PERMIT I 1.00 1GAS TEST �, ,� •__ - •-9� TOTAL FEE UTILITY CO.NOTIFIED f I � d - FINAL *`,WORKERS' COMPENSATION DECLARATION APPLICATION FOR .PLUMBING PERMIT 51 hereby, affd'm that I have a certificate of consent to self m_ 20-0026 DPW 4/90 sure,or certificate of Workers'Compensation Insurance,ora 76A667A certified copy thereof (Sec 3800, Lab. C ) COUNTY OF LOS ANGELES - DEPT. OF PUBLIC WORKS, Policy No Company ❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ❑ Certified copy is filed with the county building inspection ADDRESS /V department NUMBER FIXTURE OR ITEM @ FEE LOCALITY, Date Applicant WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' _ BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by the permit is for one hundred dollars($100)or less.) LAVATORY MAIL ADDRESS (� a I certify that in the performance of the work for which this per- r mit is issued, I shall not employ any pars a ner so SINK CITY F e TEL N0 7 �� as To become subject To the Workers' n Laws DISHWASHER �'U O CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE'TO APPLICANT If, after making This CUkers'Compen- to of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the WCITY TEL Nsation provisions of the Labor Code, you mustth comp- LAWN SPRINKLER SYSTEMS ly with such'provisions or this permit shall bed revok- STATE �� Sa ed WATER HEATER LICENSE N LICENSED,CONTRACTORS DECLARATION DISTRICT NO ESSED BY 4Jo4O 1 hereby affirm that"1 am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL r WATIOI3 e4 '�tv } fect HOSE BIB DATE / 'F v License Numb 7 Z51Lic Class -:- C d FINAL O Contracto Date �z BY CHANE .00 U Q da� ❑ I am exem un er Se O B &P C for reasons 9/12/95 WPlan check fee a Date PLUMBING PERMIT ISSUING FEE$ Q 2247 1 AM 8°57U) ,Signature 7D TAIL FEE TO SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION PP I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031 5, Business and Professions Code) Address 1, as owner of the property, will do the work and the City Tel No 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 .ee to comply with all County ordinances and caEqe la regu ing Plumbing, and hereby authorize re ese ati a is County to enter upon the above-meq, ion pr y for inspection pylposes `- �/. 2j---—7 SEE SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 7 PLUMBING-PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9610090012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL FEES PAID BUINIPff ADD SS:1' TR: 16957 LT: 139 10140 LYNROSE-ST- FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA_9178027-16--/ ASSESSOR NFORMAT 0 NUMBER: NEAREST CROSS STREET: 8586-019-022 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 1.00 FIX 16.35 TENANT: 25 LAVATORIES/SINKS 1.00 FIX 16.35 ISSUED ON: PROCESSED BY: PLAN EXP ES ON: 45 WATER CLOSET/URINAL 1.00 FIX 16.35 10/09/96 TC1 09/97 TOTAL FEES 76.80 OWNER: TEL. NO: FINAL DAT 1_4FINAL CODE: _ SUN TONG;ZHENG MEI (818) 574-5808- 10140 LYNROSE ST TEMP 917802716 DESCRIPTION OF WOR - NEN BATHROOM ADDITION 40 SQ. F APPLICANT: . NO: SAME AS OWNER �C� \\ SPECIAL CONDITIONS: �v D o � CONTRACTOR: TEL. NO: �O �'. APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - ? '� ' ' LIC. NO �6�A f 00 ER SLAB WORK p� p��� /� WATER SERVICE ARC )a ff 1/J\\//\1 0�� Q n�� PLAST I C Y/N METAL Y/N U U�l�J Uuuyl uu ��JJ t� a ((11 LIC. N0: ROUGH PLUMBING �' Mutt GAS PIPING HOT G WATER PLUMBING FIXTURES ��Q L ERS 03 GAS TEST UJIIUTILITY COMPANYOTI IED CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508