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Home My Public Portal About10146 LYNROSE ST_Plumbing__ 76A667.CE9817 5/63 FP R ® P COUNTY OF LOS ANGELES FOR PLUMB E DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ADDRESS Cli JOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST ' CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE O OWNER WATER CLOSET $1.25 MAIL T BATH TUB 1.25 ADDRESS SHOWER 1.25 Ci TEL. NO. LAVATORY 1.25 CONTRACT SINK 1.25 ADDRESS DISHWASHER 1.25 CITY NO. LAUNDRY TUB 1.25 CONT CTOR'S STATE , REGISTRATION NO.�Q ��(� COUNTY ❑ CLOTHES WASHER 1.25 DIJRICT GROU ZO E P OC 6 BY WATER HEATER 1.50 �Q d"L� } 1.50 INDUSTRIAL a GAS SYSTEM OUTLETS O WASTE APPROVAL U OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD O u W CL to Cie z ` U APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE 6,12 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 OF,AND INTEND TO RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL P PERTV. UTILITY CO. NOTIFIED " SIGNATURE -[74OF PERM ITT FINAL `7m$ ;♦ ) „r LIDATION ROBERT A. WOOD CK. M.O. CASH SUPERVISING MECHANICAL ENG'R 5 LAW iQ '5 8 5 m jUN 9 .5 0 6.2 76AS67 OBS 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OF ANG AND SAFETY COUNTY OPF LOS LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER DIST-RDIST-RTCT NO. GROUP . FOR APPLICANT TO FILL IN PLUMBER VALLEY BOULEVARD PLUMBING CO. RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS X300 EAST VALLEY BLVD. i5 '/-/7 -.S / BUILDING h CITY ROSEMEAD TEL. No AT. 2-2713 ADDRESS dl COUNTY 93M6-30-5/ LOCALITY / LICENSE NO. EXPIRES NEAREST PERMIT PEES CROSS ST. �l NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) @ 0.50 $ "O ADORE BATH TUB @ 0.50 twl CI i , //�EL. No SHOWER @ 0.50 1 HEREBY ACKADWIEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 ,2 — APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50 „5'® AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB O TRAY @ 0.50 49 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER GAS SYSTEM OUTLETS @ 0.50 OF THE REBIDENTIA�PPERTY DESCRIBED ABOVE81GNATURE �'�� J�9 � WATER HEATER @ 0.50 PERMITTED BL13P SINK @ 0.50 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 J Q HOUSE SEWER @ 0.SO Z_ MISCELLANEOUS - I7 O APPROVALS �n7DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING it GAS VENT CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT I 1.00 GAS TEST TOTAL FEE �� UTILITY CO.NOTIFIED ' Jv FINAL � � /�4-1 76A667-0817-8-58 c � APPLICATIO F PLUMBING PERMI COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. County Engineer ADDRESS `�l�� .t CASSATT D. GRIFFIN,Supt of Building LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. q NUMBER FIXTURE OR ITEM OWNER WATER CLOSETMAIL / BATH UB ADDRESS JI / SHOWER CITY TEL. NO. /STA 60 G CONTRACTOR LAVATORY p �J SINK ADDRESS L' / 4 o' S SCfiLv %v(l?A'd 46 > DISHWASHER CITY -CWVI �G��/ TEL. NO. CONTRACTOR'S /q (� STATE LAUNDRY TUB REGISTRATION NO. Ot !3✓� COUNTY ❑ CLOTHES WASHER DISTRICT NO. GROUP ZONE PRgC�ESSED BY WATER HEATER ♦� �J f i GAS SYSTEM G o INDUSTRIAL WASTE APPROVAL INSPECTION RECORD APPROVALS .00 PER ITE OR FIXTURE M $ / -00 DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 2 00 ROUGH PLUMBING TOTAL FEE 3 ',90 GAS PIPING g I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR r GAS TEST iL[�fi7.6•w� 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 RESIDENT AL PROPERTY. r , SIGNATURE / 6L/ OF PERMITTEEvO/AFINAL x.e ROBERT A.WOOD. ®F m• VALIDATIO SUPERVISING MECHANICAL ENG'R CK. Id.O. CASH -i WORKERS'COMPENSATION DECLARATION 76a6e7A �� p p �� I hereby affirm that I have a certificate of consent to self ce e17 (z-ao) ��P LL=I C A T�O N FOR P p�L�U M B N G PERMIT insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec,3800,Lab.C.) 02 COUNTY OF LOS ANGELES �� - BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING101/`�j �ya�o�E S ADDRESS �T ElCertified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM O' FEE department. LOCALITY WATER CLOSET Date Applicant NEAREST BATHTUB CROSS ST. '`YN�DS ��iLIeI�C /♦/ CERTIFICCOMPEATE NSAT ON INSURAO CE WORKERS' SHOWER Q OWNER {�19I-(AMM Ali) &YO-C I-OL¢ LAVATORY MAIL (This section need not be completed if the work involved 3 ADDRESS } by the'permit is for one, hundred dollars ($100) or less.) SINK CITY /v) l��/ T E L. N O.� t¢ I certify that in the performance of the work for which this DISHWASHERL) permit is issued, I shall not employ any person in any manner CONTRACTOR (I WAI p so as to beco a subject to the Workers' Compensation Laws. CLOTHES WASHER ADDRESSA � � � O VDate Applicant 0 SWIMMING POOL RECEPTOR U NOTICE TU APPLICANT:If, afterpilring this Certificate of CITY' TEL. NO. W Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATECIL LIC. CA Compensation provisions of the Labor Code,,you must forth- LICENSE NO. CLASS Z with comply with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. P OCESSED B LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL ,r VALIDATION ness and Professions Code, and my-license is in full force and DATE effect. _ FINAL License Number Lic.Class. BY Contractor Date I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING-FEE.$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE 40. Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from.,the Contractor's Address License Law for the following reason (Section.7031.5, Busi- City Tel.No. ness and Professions Code): 1 3 4,ei A I, as owner of the property, am exclusively contracting o'o o.o o 5 with licensed contractors to construct the project (Section 7044, Business and Professions Code). 2;0,0 1600 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency o o,0 1 60.0 5 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes: pvI ' Signat yetof Permittee �/} Dated--�