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Home My Public Portal About5113 MCCLINTOCK AVE_Plumbing__ 76A667 VE-817)- 8/79 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER Al, BUILDING AND SAFETY DIVISION `` MAKE CHECKS PAYABLE TO: BUILDING \\ �C ADDRESS ` L HARVEY T. BRANDT, COUNTY ENGINEER . LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) CROSS NEARESTT . f` NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 1,75 OWNER \ MAI L `. BATH TUB 1.75 ADDRESS 11,113 MC SHOWER 1.75 C ITY CAk4 TEL. NO.L q4 ' LAVATORY 1.75 l CONTRACTOR SINK 1.75 ADDRESS DISHWASHER 1.75 CITY TEL. NO. CLOTHES WASHER 1.75 STATE -LIC LICENSE NO. . CLASS SWIMMING POOL RECEPTOR 1.75 DISTRICT NO. GROUP I ZQNEI,;"— PfftnESSEQ BY LAWN SPRINKLER SYSTEM 1.75 WATER HEATER 1.75 INDUST IAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.75r J.NSPE'CTION REWORD CD OUTLETS OVER ,.s Ado Q'.) 5 PER SYSTEM .30 �: �'Y /�y O U LLI h Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 Do TOTAL FEE Ar APPROVALS AT )� ECTO �G N,AR' TU RE , Plan check applicant UNDER SLAB WORK /' � \ �j0 ROUGH PLUMBING - Kyle- Name .. Address \ i` C C GAS PIPING'+~ GAS VENT City Tel. No. � HOT WATER HEATER ""' / s• I HEREBY AC OWLEOGE THAT I HAVE READ THIS APPLICATION I _ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING L PLUMBING. GAS TEST f I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED O LICENSED AS REGUIRED BY LOS ANGELES COUNTY AND STATE OF _ CAL.FORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE AB DESCRIBED RESIDENTIAL PROPERTY. FINAL ` SIGNATU RE OF PERMITTEE Y PERMIT VA ATION cK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH 3 2 NOV 1 d 5�0 1 1.7 5 b�'-- 76A667-CE#617 4-64 , APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT .OF COUNTY ENGINEER7NrEAREST BUILDING AND SAFETY DMSION JOHN A. LAMBIE. COUNTY ENGINEERWILLIAM A.JENSEN, SUP'T OF BUILDINGFOR APPLICANT TO FILL IN NUMBER FIXTURE OR ITEM EACH FEE OWNER o WATER CLOSET $1.25 RATH TUR 1.25 ADDRESS 5 SHOWER 1.211 CITYMa TEL. NO. LAVATORY 1.25 CONTRACTOR SINS 1.25 ADDRESS O DISHWASHER 1.25 CITY TEL. NO. LAIINDAY iU8 1.25 CONTRACTOR'S STATE REGISTRATION NO. 9 COUNTY p CLOTHES WASHER 1.ES DIST GROUP ZONE P SSED BY WATER HEATER 1.50. n. GAS SYSTEM OUTLETS 1.50 _ WASSTSEAPAPPROVAL O OUTLETS OVER 5 PER SYSTEM. .30 INSPECTION RECORD U W a .. N Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK - RQU.GH PLUMBING- TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE 16 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. 1 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 RE:%IAL PR UTILITY CO.NOTIFIED SIGNATURE '��l OF PERMITTEE FINAL /VALIDATION ROBERT A.WOOD CK. M.0. CASH SUPERVISING MECHANICAL ENG'R s �� nlIs 16 5 D 3.50- RKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT ''!ir• that I have a certificate of consent to self in- 20-0026 DPW 4/87 ' ticate of Workers'Compensation Insurance,or a CE 817(REV.8/86) e c py thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. BUILDING copy y P FOR APPLICANT TO FILL IN(PRINT OR TYPE) `�1 Q Y Cs r�y�1�1��t� Certified co is filed with the count buildinginspection ADDRESS V6 1f6 t✓ department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY g r+, Date Applicant WATER CLOSET(TOILET) NEAREST 1 `s % CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. 001f ZAI A • . COMPENSATION INSURANCE SHOWER OWNER ` (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS 0 1 certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so CITY TEL. NO-Q6 as to become subject to the Workers'Compensation Laws. DISHWASHER V CONTRACTORD I �(f Date Applicant CLOTHES WASHER ADDRESS ,v �t NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC.. ed. WATER HEATER LICENSE NO, CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. P CESSED BY I hereby affirm that I am licensed under provisions of Chapter I GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER fe a,Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION a DAT O License Number Lic. Class C1 FIN Contractor Date B O F- ❑ I am exempt under Sec. W a B.&P.C. for this reason ► Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ a 14 3.4 a Signature TOTAL FEE O SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION pp I o - 31L50 I hereby affirm that I am exempt from the Contractor's License Name o 0 0 3 4,5 0 ' Law for the following reason (Section 7031.5, Business and Professions Code): Address 12.30-88 I, 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 agree to comply with all County ordinances and State laws regulating Plumbing, and hereby outho ize representatives of this County to enter upon the ab ov mentioned,property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKERS'COMPENSATION DECLARATION rowesr() APPLICATION F O R �P L U M B I N G PERMIT I herebyaffirm that I have a certificate of consent to self ct: etz z-eo insurb, or a cettificate of Workers'Compensation Insurance,or a certified copy reof(Sec.3800,Lab.len' Policy N Company �AAo* csr� 1 ,5•60 COUNTY OF LOS ANGELES BUILDING AND SAFETY )(ww 1 %90 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDINGo C..L_ j�// ❑ Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE ADDRESS 0 rn department. WATER CLOSET LOCALITY Date Applicant NEAREST CERTIFICATE OF EXEMPTION'FROM WORKERS' BATH TUB CROSS ST. l COMPENSATION INSURANCE SHOWER OWNER o ON LAVATORY MAI L {{ } (This section need not be completed if the work involved ADDRESS CC, 1•A 1T' a. by the permit is for one hundred dollars ($100) or less.) SINK CITY s I e C TEL.NO qg_V/ V I certify that in the performance of the work for which this DISHWASHER ffW permit is issued, I shall not employ any person in any manner CONTRACTO 0 so as to become subject to the Workers'Compensation Laws. CLOTHES WASHER ADDRESS W Date Applicant SWIMMING POOL RECEPTOR CITY_StTEL.N N NOTICE TO APPLICANT: If, after making this Certificate of diQir Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. _ lO/ Compensation provisions of the Labor Code, you must forth- WATER HEATER /� C LICENSE NO. Q CLASS with comply with such provisions or this permit shall be deemed revoked. GAS SYSTEM OUTLETS DISTPICT�NNOO. PROCESSED BY / LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL q VALIDATION ness and Professions Code, and my license is in full force and DATE 2/ 0 z effect. FINAL License Numb eryb3 g/ 3 Lic.Class 144 BY Contractors qU bQ vs CoVADate p �� F1 I am exempt from the licensing requirements as I am a Plan Check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ dJ'� 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 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. —`9 2 4 9 9A ness and Professions Code): # 0 0 0 0 0r+ I, as owner of the property, am exclusively contracting v with licensed contractors to construct the project 2 o'0 1 2 5 0 (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency 1 231 —81 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 ordinance and State laws regulating Plumbing, and hereby suthoriz representatives of this County to enter upon the a ve- enti ed rAet f�inspecflonses.ermittee COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0109280002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: S G TR: 13384 LT: 26 5113 MCCLINTOCK AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803557 ASSESSOR NEAREST CROSS STREET: 8574-004-012 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY, C 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TOTAL FEES 43.95 ISSUED ON: PR005SS5DEXPIRES 0 : 09/28/01 VG 03/27/02 OWNER: T5L. 0: FINAL TI Y: CODE: THOMPSON DONALD K;GLORIA J (626) 448-2740- / 5113 MCCLINTOCK AV !0 1 6o v TEMP 917803557 DESCRIPTION 0 GAS FOR FAU APPLICANT: L. O: FAST TRAK PERMIT SERVICE (909) 279-0604- SPECIAL CONDITIONS: G L e� CONTRACTOR: TEL. N0: Cj �� APPROVALS DATE INSPECTOR SIGNATURE AIR-TRO, INC. (626) 357-5311- 1630 S. MYRTLE LIC. NO % " R SLAB WORK MONROVIA, CA 91016 258228C20 / WATER SERVICE ARCHITECT OR G : - s PLASTIC Y/N METAL Y/N / ROUGH B G LIC. N0: GAS PIPING GAS VENT G JQ L GC ��` r 3�'17 0 ER HEATER J LI ll FIXTURESPLUMBING Zf ol LAWN SPRINKLERS fj S TEST UTILITY COMPA97-16TrFM U ofCw C `dei'vice lfthi GRAY WATER SYSTEM * ADDITIONAL DATA ON FILE REPORT ID: DPR263 ROUTE TO: BS0508