The URL can be used to link to this page

Home My Public Portal About5949 OAK AVE_Plumbing__ I 78AG87(CE 817) 8/73 APPLICATI FOR P MBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO BUILDING 59 Oak Ave ADDRESS HARVEY T BRANDT COUNTY ENGINEER LOCALITY Temple City FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 1 751,�'a OWNER Barr BATH TUB 1 75 ADDRESS AI L 10258 B• L8 8088 Dr, SHOWER 1 75 CITY Temple City TEL NO 44"533 LAVATORY 1 75 '3 1 CONTRACTOR ften BroSe PJUMbMngt IIICe SINK 1 75 ADDRESS 65 No Baidw= Ave DISHWASHER' 1 75 CITY 91 Morrie TEL NO 40-M78 CLOTHES WASHER 1 75 STATE LIC SWIMMING POOL RECEPTOR 1 75 LICENSE 431 741 CLASSC36-20 DISTRI NO GROUP NE PR ESSE BY LAWN SPRINKLER SYSTEM 1 75 V(/ / WATER HEATER 1 751 INDUSTRIAL WASTE APPROVAL GAS SYSTEMOUTLETS 1 75 7 INSPECTION RECORD OUTLETS OVER 30 5 PER SYSTEM p 3 Q,41RJ 17Y S'' W CD N a I Plan check fee See Reverse PLUMBIA,PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPEXAL&AS DATE INSPECTOR 4 SIGNATURE Plan check applicant UNDER&MVIJITIM - -2 r Name ROUGH PLUMBING 4q-j►j,; Address GAS PIPING City Tel NO GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ TN19 APPLICATION HOT WATER HEATER —7 AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES ^ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING r PLUMBING GAS TEST i 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 1 M THE LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE RI ESIDENTIAL OPERTY FINAL i SIGNATU RE OF PERMITTEE PERMIT VALIDATION cK Mo CASH PLAN CHECK VALIDATION CK MID CASH 0-7?o-Mt 14 5 2 7.8 0 A-% 7GA667 (CE 817) 5/73 t \ Z 6 APPLICAT ION OR PL BING PERMIT S COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY,ENGINEER BUILDING AND SAFETY DIVISION fADDREss UILDING MAKE CHECKS PAYABLE TO 5948 Oak Ave* HARVEY T BRANDT, COUNTY ENGINEEROCALITYFOR APPLICANT TO FILL IN (PRINT OR TYPE) EARESTROSS ST NUMBER FIXTURE OR ITEM G) FEE WATER CLOSET 1 75 OWNERJoh Barr AIL BATH TUB 7 75 ADDRESS 10258 La Rosa Dr, SHOWER 1 75 CITYRemole City TEL NO LAVATORY 1 75 CONTRACTOR Owen Bros, Plumb:Lnng, Inc* SINK 1 75 ADDRESS 4265 N Baldwin �Av"e �r� DISHWASHER 1 75 CITY El Monte TEL Nch43--00/8 LICENSE NO CLOTHES WASHER 1 75 STATE 231 741 CLIC LASS C3�0 SWIMMING POOL RECEPTOR 1 75 LAWN SPRINKLER SYSTEM 1 75 DISTRICT NO GROUP ZONE CESSE BY S WATER HEATER 1 75 INDUS TR AL WASTE At�PROVAL GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD OUTLETS OVER 30 CC 5 PER SYSTEM O Lu1-- W CL N Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR 4 SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel No GAS VENT f HOT WATER HEATER IllHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AD STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES 7nU— 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 D RI RESIDENTI OPERTY L FINAL + , � SIGNATURE OF PERMITTEE PERMIT VALIDATION cK M o cnsH PLAN CHECK VALIDATION CK M o CASH 7 6 7&4-JUN 28 5 D 4.7 5 °y6 �ffy I \1 WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm thgt I have a certificate of consent to self 20 0026 DPW 6/87 Is insure or a Sertificate of Workers Compensation Insurance 76A667A or a certified copy ther of(Sec 3800 Lab10 C ) COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS Policy No ompany Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 1L�I Certified copy is filed with the county budding inspec ADDRESS T1r ug" OA tion de rim t NUMBER FIXTURE OR ITEM � FEE 'J ,� f1 J �f LOCALITY bo,'`V�,�. Q Date Applicant Cw 6—M WATER CLOSET CROSS ST T �wl, `T C RTIFI TE OF EXEMPTION FROM WORKERS BATH TUB COMPENSATION INSURANCE SHOWER OWNER r— LAM DDS (This section need not be completed If the work involved by MAIL ° the permit Is for one hundred dollars($100)or less) LAVATORY ADDRESS SA 215 1 certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner SINK CITYTEL NO so as to become subject to the Workers Compensation Laws DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESSQ ' NOTICE TO APPLICANT If after making this Certificate of SWIMMING POOL RECEPTOR Exemption you should become subject to the Workers CITY `� Compensation provisions of the Labor Code you must forth LAWN SPRINKLER SYSTEM �/ with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS �Q/ (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code and my license is in full force and effect 5 PER SYSTEM FINAL VALIDATION C 3&pC"3 DATE License Number Lic Class V FINAL Contractor Date BY no ❑ I am exempt under Sec B 8P C for this reason Plan check fee Z Date PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check applicant SINGLE FAMILY AT°* HOME OWNER BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor s License =7 7 20°50 Law for the following reason (Section 7031 5 Business and 1 IT Professions Code) City Tel No EM ❑ 1 as owner of the property will do the work and the _ TOTAL 20.50 structure is not intended or offered for sale (SectionS CACK 20.% 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY CHS °� I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued 1 17J1�89 (Sec 3097 Civ C Lender s Name 76M 1 AM11s 17 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 ordinances and State laws regulating Plumbing and hereby authorize reprelentafrves of this County to enter upon the above endo d property for inspection purposes 9 SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of-Permittee Dbte