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Home My Public Portal About4903 MCCLINTOCK AVE_Plumbing__ 76AF6J-CE8}'9 8-59 i APPLICATI®ISI FOR PL[JMI3II`IG PERMIT � COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION : BUILDING D 3 C JOHN A.LAMBIE, County Engineer C SATT D. GRIFFIN,Supt of Building LOCALITY FOR APPLICANT TO FILL IN NEAREST = CROSS ST. NUMBER FIXTURE OR ITEM OWNER . WATER CLOSET MAIL BATH TUB ADDRESS I SHOWER CITY TEL NO. Z LAVATORY CONTRACTOR r SINS ADDRESS 1.j 16-S- d DISHWASHER CITY Nfii4.R TEL NO. - d 7 y-7,7 2— LAUNDRY TUB REGISTRATIONNSSTATE NO. ��3 I3 3-?/,0 COUNTY CLOTHES WASHER DISTRICT NO. GROUP i ZONE P S BY WATER HEATER ' '-( ! GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD r i� o- 0 .( V G CS PER ITEM FZxTQRE $ I /D APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ I 2 00 UNDER SLAB WORK /d "LL TOTAL FEE ��, O b _- Q ROUGH PLUMBING M/,17 I � 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 PLUMBING. .. HOT WATER HEATER i HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES CENS iED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF �GAS TEST G Y/ Al ALIFORNIA OR THAT I AM THE LEGA OW ER OF THE ABOVE ESCRIBED RESIDENTIAL R PERTY. UTILITY CO.NOTIFIED 6J/o. Y �+� J�4. SIGNATURE \ OF PERMITTE w4dFINAL /y � 146, p ALMATION ROBERT A.WOOD, M.p, CASH SUPERVISING MECHANICAL.ENG'R i�^,0 9 2 7 8 fl ,IFR 4 5 A 12.0 Q %° 96A667 --011817 5/70 CITY OF TEMPLE CITY APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES B11964 DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FAADDRE DING JOHN A. LAMBIE. COUNTY ENGINEER ss 4903. Noo McClintockCOLEMAN W; JENKINS. SUPT. OF BUILDING gLITyTemple City FOR APPLICANT TO FILL IN PR NT OR TYPE) RS TT. �� NUMBER FIXTURE OR ITEM EACH FEE OWNER Jean Balber 14/ WATER CLOSET 1.50 MAIL BATH TUB 1.50 ADDRESS Same SHOWER 1.50 CITT TEL. NO: LAVATORY 1.50 CONTRACTOR dENFRAL INSTALLATION CO. slNx 1.50 ADDRESS 6558 WEST BLVD. DISHWASHER 1.50 CirY Los Angeles lEL. No. PL 3-2541 CLOTHES WASHER 1.50 STATE LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONEPROCESSED BY LAWN SPRINKLER SYSTEM 2.00 0?—/ • e ]. WATER HEATER 1.50 1 75 INDUSTRIALWASTE APPROVAL GAS SYSTEM OUTLETS 1.50INSPECTION RECORD OUTLETS OVER 5 PER SYSTEM .30' Ready, for Ina ecHon NOW z WATER SOFTENER O a� Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE.$ TOTAL FEE 4 75 APPROVALS DATE INSPEdTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING CitGAS VENT y Tel. No. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO. COMPLY PLUMBING.FIXTURES WITH ALL' COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR. UTILITY CO.NOTIFIED LICENSED AS REQUIRED' BY LOS ANGELES COUNTY AND STATE OFof- CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF.AND INTEND TO M THE LEGAL OWNER OF.AND INTEND TORESIDE IN.THE ABOVE DESCRIBED RFTI L PROPERTY. FINAL SIGNATURE • OF PERMITTEE JACK R. ALLEN SUPER VISI CH ANI CAL EN'G'R: PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.O.. CASH :Lim 93 2.2 N OCT 19 .5 D 4.7 5N %J WORKJiR'SCOMPENSATION DECLARATION 200026DPW 9I89 APPLICATION FQ4R PLUMBING PERMIT 76A667A I herebyffitm that I have a certificate of consent to self insure, ' / or a certificate of Worker's Compensation Insurance, or a certified ar' copy thereof(Sec.3800 Lab.C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No. Company ❑ Certified copy is hereby furnished. 1:1 Certified APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING �r Certified copy is filed with the county building inspection ADDRESS Q 3 , G. E department. NUMBER FIXTURE OR ITEM @ FEE1— f / LOCALITY L� (� Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST. 1D BATH TUB COMPENSATION INSURANCE ASSESSOR (This section need not be completed If the work Involved by the SHOWER MAP BOOK PAGE PARCEL permit Is for one hundred dollars($100)or less.) LAVATORY OWNER ' � I certify that in the performance of the work for which this permit AIL [[��-��CCJJ is Issued, I shall not employ any perso a an or so as to SINK ADDRES J:92V ,�&e4, �� become subject to the Workers'Comp at! C )� / DISWASHER CITE . -11yV(!/ / Date / y/ Applican CLOTHES WASHER NOTICE TO APPLICANT: If, a ter a Ing i ertificate of CONTRACTOR Exemption,you should become subject to the rker 'Compensation SWIMMING POOL RECEPTOR ADDRES �� provisions of the Labor Code,you must forth 'h c mply with such provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY �� `� ® a WATER HEATER I hereby affirm that I am licensed under provisions of Chapter 9 / c r (commencing with.Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS LICENSE NO. 47 / F1 CLASS �(ro 0 Professions Code,and my license is in full force and effect. / OUTLETS OVER DISTRICT NO. PROCESSED BY Q ,.�/' 5 PER SYSTEM �Q� Q License Num3 811 Lic.Class� V FINAL VALIDATION III rL DATE 21- a Contract o Date y�� /- 93 fA ❑ 1 am exempt un C. r c. BY AL ! Z B.&P. for this re n D ACCT.� Date: Plan check fee , 3307 53.85 _ Signature PLUMBING PERMIT ISSUING FEE$ a A/ 1 I I EMS El [TOTAL FEE �, TEAL 53„ 1,35 SINGLE FAMILY Plan check applicant CHECK 53.85 HOME OWNER-BUILDER DECLARATION Name CHANGE .110 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. 001]-110131 1/15/93 I,as owner of the property,will do the work and the structure is not Intended or offered for sale(Section 7044, Business 7657 1 A[ IOn-24 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 a ree to comply with all County ordinances and State r ati g Plumbing, and hereby authorize repress olives his my to enter upon the above-mentioned props y far purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE S faftatUfe f Per tt a Date ORKERS'COMPENSATIONDECLARATION 817; ) APPLICATION FOR PLUMBING PERMIT 1 herebya'affirm that I have certificate of consent to self CIE ce e» z-eo insure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,6ab�C. COUNTY OF LOS ANGELES BUILDING AND SAFETY 47 Policy No. Company f �L / , /6_ rl L ee Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ! 'ArT� C ADDRESS Certified copy is filed with th unty b i'din inspection NUMBER FIXTURE OR ITEM FEE dep '% ant. WATER CLOSET LOCALITY L Date_ Applicant NEARESTOR BATH TUB CROSS ST. ,� j CERTIFICATE OF EXEMPTION ROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER •77 RY MAIL aT LAVATORY n M (This section need not be completed if the work involved LADDRESS // ,[ by the permit is for one hundred dollars ($100) or less.) SINK CITY TEL.NO I certify that in the performance of the work for which this DISHWASHER cc a CONTRALTO C permit is issued, I shall not employ person in any manner �• !e�/� �� O so as to b o subject to the or s'C ns ion Laws. CLOTHES WASHER ��,,,///��t rr I— Date y� A licant ADDRESS/ 1- c� �- ��?�x��, W pp SWIMMING POOL RECEPTOR <<v , / c_ a NOTICE TO APPLICANT: If, after m ng this Certificate of CITY [ j^ EL.N Q Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM Compensation provisions of the Labor Code,you must forth- STATE i LIC. p p LICENSE NO. �1I� CLASS with comply with such provisions or this permit shall be WATER HEATER deemed revoked. DISTRICT NO. P CESSED B GAS SYSTEM OUTLETS i LICENSED CONTRACTORS DECLARATION OUTLETS OVER r �� I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL VALIDATION ness and Professions Code, and my license is in full force and DATE Z - .3—�' effect. License Numbe /0? ic.Clas BY FINAL 'r f ' I^ Contractor t J1114744Z I am ro the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ � acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE / Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name Address ) 9, oil I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Busi- ICIty Tel.No. 0 0 0 0 0 r ness and Professions Code): IDI, as owner of the property, am exclusively contracting c 0 1 0.C r, with licensed contractors to construct the project (Section 7044,Business and Professions Code). 0 ' ) 'r CONSTRUCTION LENDING AGENCY I. �. 1A 1 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 I 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 I SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above- en 'oned jjr9perty for inspection pur oses. ignature ermittee Date