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Home My Public Portal About9421 OLEMA ST_Plumbing__ V 1V 76F�{567 ( E-817)-8-71 a APPLICATION FOR PLUMBIN PERMIT 'T, COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS 1 Olema Street LOCALITY Temple City FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 1,75 OWNER BATH TUB 1.75 ADDDRESS 1010 East Las Tunas SHOWER 1.75 CITYSBn Gabriel 9177 TEL. NO.At 6-9822 LAVATORY 1.75 CONTRACTOR Owen Br08• Plumbing, InCe SINK 1.75 ADDRESS 4265 N. Baldwin -Ave* DISHWASHER 1.75 CITY El Monte 91731 TEL. NO.4}3-0078 CLOTHES WASHER 1.75 STATE2 1 LIC 6 ZL LICENSE NO. 3 741 CLASS C 3 SWIMMING POOL RECEPTOR 1.75 DISTRICT NO. I GROUP 4. ONE ROCE E BY' LAWN SPRINKLER SYSTEM 1.75 WATER HEATER 1.75 INDUSTRIAL o O / WASTE APPROVAL GAS SYSTEM OUTLETS 1.75 If YNSPEC, ION RE RD OUTLETS OVER 5 PER SYSTEM 30 %i O H U W O. • W Z 0 Plan check fee See reverse. PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS .DATE IN PECTOR' 31 NATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Z Address GAS PIPING City Tel. No. GAS VENT HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST A' PLUMBING. i I HEREBY CERTIFY THAT 1 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 RIBE0 RESIDENTIAL PROPERTY. FINAL ' SIGNATURE O'F PERMITTEE PERMIT VALIDATION CK M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH 077'Cp_—" .AUG 24 5 T. 22'.25- V 7BA667 (CE-817)-4/72 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING ADDRESS Q7 , HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 1,75 OWNER �aG� MAIL G^ BATH TUB 1.75. ADDRESS CJ SHOWER 1.75 CITY TEL.'NO. LAVATORY 1.75 CONTRACTOR SINK 1.75 ADDRESS DISHWASHER 1.75 CITY "'•� TEL. N0. CLOTHES WASHER 1.75 STATE / �� CLIC LASS LICENSE NO. SWIMMING POOL RECEPTOR 1.75 DISTRICT NO. UP NE OCESS BY LAWN SPRINKLER SYSTEM 1.75 i WATER HEATER 1.75 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD OUT ETS OVER �y 5 KISYSTEM .30 mfg zn/ Lu z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE ;J 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 TH AM PRO RLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REdUIRE Y L S ANOE E COUNTY AND STATE OF CALIFORNIA OR THA AM E LEG NER OF, AND INTEND TO _ RESIDE.IN TH E.A70. BED RE E TIAL PROPERTY. FINAL SIGNATURE ~� OF PER'MI PERMIT VALIDATION (:J 0. CASH PLAN CHECK VALIDATION CK. M.O. CASH 17 5 D 4.75A9d 76 A 867 a CE 817 8/68 � • APPLICATION R PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADDRESS C JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY y FOR APPLICANT.TO FILL IN(PR NT OR TYPE) NEAAEST CROSS ST. /y a! NUMBER FIXTURE OR ITEM EACH FEE OWNER Fs WATER CLOSET 1.50 MAIL BATH TUB 1.50 ADDRESS &AJej SHOWER 1,50 CITY TEL. NO LAVATORY 1.50 CONTRACTOR SINK 1.50 ADDRESS' DISHWASHER 1.50 CITY 00'O TEL. NO, CLOTHES WASHER 1.50 STATE LIC LICENSE NO. 0 CLASS SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. pmwp IE PSEDA13Y a LAWN SPRINKLER SYSTEM2.00 C3 s v WATER HEATER 1.50 INDUSTRIAL Z WASTE APPROVAL o GAS SYSTEM OUTLETS INSPECTION RECORD C-') OUTLETS OVER Ch-PER SYSTEM .�. Z Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEET . TOTAL FEE "— APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT city Tel. No. HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT 1 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 GAS TEST °�yJ uJ� f�I.43'`j�ixkiTyV PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF �]�8� �t�� -a 7-:7 o- (;�,- Q.k� �r CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO {� [� /' + RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL Mg SIGNATURE JACK R. ALLEN, ?6PERV1SII G M CH N.ICAL ENG-R. OF PERMITTEE PERMIT VALIDATIO CK. ;O. CASH PLAN CHECK VLIDA41ON CK. M.O. CASH 0 7 7r-_jUL 17 5 D 6.5 J ,&-,, WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self I76A667A insure, or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof(Sec. 38 ,.Lab. COUNTY OF LOS ANGELES B IN AND SAFETj Policy No. Compan _/ Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified copy is filed with the county building inspec- 000 tion dle�parens. NUMBER FIXTURE OR ITEM (e4 FEE LOCALITY Date o— AL Appli4an n WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE OWNER (This section need not be completed If the work Involved by I MAIL SHOWER the permit is for one hundred dollars($100)or less.) i LAVATORY ADDRESS L I certify that in the performance of the work for which this OF permit is issued, 1 shall not employ any person in any manner SINK CITY i TEL. NO.,---f so as to become subject to the Workers'Compensation Laws. DISHWASHER ` 6 ^ �^ ^ _ CONTRACTOR Date pplicant L�IL Jl� �Y1C./1�/b`l CLOTHES WASHER ADDRESS/ NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY TEL. NO. Compensation provisions of the Labor Code, you must forth- Vy LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. f deemed revoked. WATER HEATER LICENSE N CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS + d (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 15 PER SYSTEM FINALr(,�q ��d VALIDATION 0 e DATE F G e Licensembe Lir. Class v ; 129n £ FINAL ' r O Contracto Date BY ; g ¢ V Ell am exempt under Sec. 916 BAP.C. for this reason Plan check fee S at PLUMBING PERMIT ISSUING FEE$ D " " ~ `= Q e- Signature TOTAL FEE Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name / I hereby affirm that I am exempt from the Contractor's License Address Law, for the following reason (Section 7031.5, Business and Professions Code): City Tel: No. ❑ d 3 I, as owner of the property, will do the work And the //7 structure is not intended or offered for sale (Section /'V 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY 1 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.). aj" � Lender's Name yV` 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 representatives of this County to enter upon the above-mentione ropers for inspection purposes. m ` p 70� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee �/ Date