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HomeMy Public PortalAbout10425 OLIVE ST_Plumbing__ -•D.B.6.1.7 23M Bels I2.44 APPLICATION FOR PERMIT DESAiENT OF BUILDING AND SAFETY �� ' COUNTY OF LOS ANGELES WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. _ _ ROUGH FIXTURES COMPLETE - HEATER CESSPOOL I SEPTIC TANK RECEIVED 13Y READY FOR DATE ISSUED FIRST INSPECTION GAB MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOBK NAME Earl 0. Stioe Coop ADDRESS 2851 Olive Stop N ADDRESS 2102 Colorado Blvdoa LOCALITY Temple City Los Anelse 41 CL 64146 NEAREST CITY � TEL.No. CROSS 8T. COUNTY CERT.No635 M EXPIRES 12NAME 51-45 Har Eo IPrf ht Cornsto Co, . - � LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL 3 NORTH ADDRESS 408 S Spring O , CITY No. 1 S AM THE LEGAL P098ESOR/�OF THE ABOV S ANGELES COUNTY CERTIFICATHrQ LIFIC -- / P MB.R I AM THE LEGAL OWNERIE P PERTY DESCRIBED ABOVE. - � I owman CORRECTIONS SOUTH DESCRIPTION OF WORK 1 0 MATH TUB FURNACE ai O . SHOWER DISHWASHER 1 LAVATORY REFRIGERATOR 1 KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP LOP SINK FLOOR DRAIN 1 WASH TRAY URINAL APPROVALS ER CLOSET DRINKING FOUNTAIN DATE IMBPKCT 8,/OR' MANX 1 WATER HEATER DENTAL LAVATORY ROUGH PLUMBING 1 METER 5 6A8 SODA FOUNTAIN oun GAS PIPING BAS.VENT CESSPOOL I I TOTAL NUMBER OF FMUREB 4 00 SEPTIC TANK I I ESSPOOT SEPTIC TANK SEWER S (�'8 UTILITY CO.NOTIFIED I TOTAL FEE Q► L� I / I 4 FINAL . -06 �� S14.9457-8129N SETS 12-44' DEPARTMENT TMENT OF BUILDING AND SAFETY,,' APPLICATION FOR PERMIT COUNTY OF LOS ANGELESPLUMBING WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. •7 GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE HEATER CESSPOOL -I SEPTIC TANK ECEIVED HY READY FOR DATE ISSUED FIRST INSPECTION GAS MISCELLANEOUS w ! APPLICANT FILL IN HEAVILY OUTLINED-PORTION ONLY UUHRAM JOB �1 L. NAME ° A. ADDRESS mCESSPOOL SERVI E 7 . ADDRESS LOCALITY2022 EMPEROR j ° NEAREST e 0. :CITY NEI a n tan r� s+9��k.We►w u n CROSS ST. COUNTY t e .�'Tms6'STsBD—o t CERT.No. EXPIRES NAME e LOCATION OF SEPTIC TANK, OR CESSPOOL3 MAILADDRESS a NORTH O CITY TEL.No. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICAMF QLIFICA ON. T�-r/�v PL M ER 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. r - OWNER CORRECTIONS - SOUTH DESCRIPTION OF WORK MATH TUH • FURNACE SHOWER DISHWASHER � _LAVATORY REFRIGERATOR _KITCHEN SINK WATER SOFTENER FLOOR BINK SAND TRAP @LOP SINK ---FLOOR DRAIN WASH TRAY URINAL - APPROVALS . WATER CLOSET DRINKING FOUNTAIN DATE 1N9P8eroR'8 NAME WATER HEATER DENTAL LAVATORY !ROUGH PLUMBIN41 NETEF GAB SODA FOUNTAIN GAB PIPING OUTL ` e GAS VENT I 76 IS ti CESSPOOL TOTAL NUMBER OF FIXTURES 'SEPTIC TANK ESSPOOa- SEPTIC TANK $SEWER. I `.UTILITY CO.NOTIFIED I. I I TOTAL FEE I /P I"FINAL WORKERS'COMPENSATION DECLARATION APPLICATION FOR pLUMB1f1 G PERMIT I hereby,affirm that I have a certificate of consent to self 7SA887A insure, or a certificate of Workers'Compensation Insurance, CE 817(REV.8/88) or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOB ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. BUILDING �y + f ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS u `� 0 • v tr Certified copy is filed with the county building inspec- NUMBER FIXTURE OR ITEM @ FEE .--+ tion department. • LOCALITY Date Appli4ant WATER CLOSET CROSS ST. t` i CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB t COMPENSATION INSURANCE OWNER SHOWER (This soction nood not bo complotod if tho work involvod by MAIL { tho permit Is for ono hundrod dollars($100)or less.) LAVATORY ADDRESS to Z Q `{ 1JC I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL.NO.E?J / so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date 6— pplicanon r i �'—"—� - CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL.NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATIONDISTRICT NO. POC ED BY GAS SYSTEM OUTLETS [" I hereby affirm that I am licensed under provisions of Chapter 9 t ` ,a (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER 1 p and Professions Code,and my license is in full force and effect, 5 PER SYSTEM FINAL /D VALIDf tION C [ DATE License Number Lic. Class 0 FIN / a Contractor Date B ;27 1 a O A C ❑ 1 am exempt under Sec. # o 0 0 0 0J 8 8 0 B.BP.C. for this reason Plan check fee Date. PLUMBING PERMIT ISSUING FEE$ 10 ' o 0 1650 Signature TOTAL FEE A 0 0 o 1 6 5 0 9 O Plan check applicant 0604-87 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 Profen ' odeowne): City Tel. No. I, as r of the property, will do the work and the 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 agency4or the performance of the work for which this permit is issSed (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. 1 agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the yt�oye-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE: Signature of Permittee Date I I `..ORKERS'COMPENSATION DECLARATION APPLICATION F®R l!—LUMBIw®,,po PERMIT 20-0026 DPW 4/87 / Or !s PLUMBING PERMIT 1 t`lier affirm that I have a certificate of consent to self in- 76A667A dire,or a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS.No. Company F. Certified copy is hereby furnished. ©� FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ❑ Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM. ADDRESS department. @ FEE LOCALITY Date Applicant WATER CLOSET(TOILET) NEAREST L CERTIFICATE OF'EXEMPTION FROM WORKERS' BATH TUB CROSS ST. I- &711 } COMPENSATION INSURANCE SHOWER OWNER l� " (This section need not be completed if the work involved by M MAIL the permit Is for one hundred dollars($100)or less:) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK CITY' TEL. NO trait is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER �� CONTRACTOR Date Applicant C� CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If,'after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'CoMpen- CITY TEL. NO. sation provisions of the Labor.Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSEDCONTRACTORS,DECLARATION DISTRI�10� P SED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS S 9.(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER fed Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VAL ATION d DATE O License Number L'ic. Class V 4FINContractor Date O I am exempt under Sec. " W B.BP.C. for this reason W Plan check fee 91 0.1 A Date: PLUMBING PERMIT ISSUING FEE$ # a o 0 0- 5 Signature TOTAL FEE SINGLE FAMILY ° ° 4650 HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name' °.O ° 4 6-5.0'0 Law for the following reason (Section 7031.5; Business and Professions Code): Address 4-A-�t 0 a 0 3 8 g 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 ordi ces and State laws regulating Plumbing, and hereby outIMize representatives of this County to enter upon the j ab o Tritioned property f r inspe purposes. .� /3 SEE REVERSE FOR EXPLANATORY LANGUAGE Signa ure of Permittee Date ONORKERS'COMPENSATION DECLARATION APPLICATION k PPL C/k TION FOR PLUMBING A U M B I a fa P E RM I T I heLeby, affirm that I have a certificate of consent to self in- 20-0026 A PW 4/87 /`1r Ir \.s/'6 9 r�C f� 91ii 1��7 G sure,or a certificate of Workers'Compensation Insurance,or a CE 817(REV.8/86) certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company ❑ Certified copy is hereby furnished. BUILDING ` FOR APPLICANT TO FILL IN(PRINT OR TYPE) ,r� ❑ Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM ADDRESS V (4 ZS department. @ FEE LOCALITY Date Applicant WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESSJ / I certify that in the performancep of Y work for which this per- SINKE . CITw v t TEL. N mit is issued, I shall not employ an person in an manner so as to become subject to the Workers'Compensation Laws. DISHWASHER ;t CONT Date- Eb` L.r �f Applicant�����_c-f CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESS emption.,you should become subject to the Workers'Compen- SWIMMING POOL RECEPTOR CITY TEL. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS �O f 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER O and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINALVALIDATION >' fect. DATE 3 — n .3 License Number 35Z 3 t-/ Lic. Class V FINAL ��ir n� Cont Date �� �� BY I am exempt un er Sec. UJI IL V B.&P.C. for this reason U) Plan check fee � ii_)�?` �� m . �� Signature � Date: PLUMBING PERMIT ISSUING FEE$ � D 1-3'L'��'. '�as.l�• TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and Professions Code): Address F] i k n =i 4#•.f::1 � !'Ili 7 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 authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. Q SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I have a certificate of consent to self in- 20-0026 DPW 4/90 76A667A sure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company F1 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR'TYPE) BUILDING F1 Certified copy is filed with the county building inspection ADDRESS C/ department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Ddte Applicant WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL ,o the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS � �J ®���/�f I certify that in the performance of the work f�w�rinseper- SINK CITY 7TEL.NO�mit is issued, I shall not employany per rso �,as to bec a subject to the Workers' o tion L. I DISHWASHER (��CONTRACiOR `j/ �y— Dat ` Appiican CLOTHES WASHER4 ADDRESS x � NOTICE TO APPLI ANT: If, after making t s ertific a of Ex- SWIMMING POOL RECEPTOR / emption,you should become subject to a orkers'Compen- CIT�/� � / 9j �i���EI�iIVO. sation provisions of the Labor Code,yo st forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. �7 All C ,'1 LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSEb BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS O/ 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER 5 PER SYSTEM and Professions Code, and my license is in full f rc nd ef- FINAL VALIDATION Li cf. �7 c�/ HSE BIB DATE C l _ a License N r c. Class Sp - _ p FINAL Contrac Dote By ❑ lam xe tunder Sec. r �sL� i �• LU B.BP. . for this reason i y � _ a Plan check fee ti� � Date: PLUMBING PERMIT ISSUING FEE$ ® Ill r c I r z Signature TOTAL FEE = Ec -r.La L= SINGLE FAMILY `5 05 HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name �,__ , •i- Low for the following reason (Section 7031.5, Business and :l_!_I(1-00-01 5 �i�/#4 Professions Code): Address 51 I 4AN Cr,s1._,,4 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 I (Sec. 3097, Civ. C.). Lender's Name I I Lender's Address I certify that I have read this application and state that the i above information is corre ree to comply with all County ordinances and e s rp6lating Plumbing, and hereby authorize re a t• of this County to enter upon the above-m i e perty for inspection os e*+ t �. -�� SEE REVERSE FOR EXPLANATORY LANGUAGE Sign6ture ofr ermitte Date xye., y +WORKERS'COMPENSATION DECLARATION �������T�®1�9 ® PLUMBING PERMIT here&y affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof(Sec. 3800, Lob. C..) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. F-1ADDRESSAPPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ADDRESS y�v :� (C L Certified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Appliqant WATER CLOSET NEAREST r CERTIFICATE.OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. A COMPENSATION.INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I.-shall not employ any person in any manner SINK " CITY TEL.NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER • CONTRACTOR Date Applicant CLOTHES WASHER f ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers CITY TEL.NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DIST NQ,./ ESSED BY I hereby affirm'that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS U�,(+ (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full'force and effect.. 5 PER SYSTEM FINA VALIDA N DATE License Number Lic. Class FIN 09 Contractor Date BY ❑ 1 am exempt under Sec. B.BP.C. for this reason us Date: Plan check fee > �Signature PLUMBING PERMIT ISSUING FEE$ / a . TOTAL FEE �j 2,1 6 Q6 A Plan check applicant , #. 0 0 0 0 0 5 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION. Name II o o 2:6 5 0 1 hereby affirm that I am exempt from the Contractor's License Address.gddre Law for the following reason (Section 7031.5, Business and -'- o2&500 Prof�.e ins Code): City Tel. No. 0.2 2 8 i 8 5 LJ I, as owner of the property,.will do the work and the. 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 Ilcer4y 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 o -mentioned property for inspection purposes. � -2-:9- r SEE REVERSE FOR EXPLANATORY LANGUAGE ( Ablutl _Z. z�. 9-� Signature of Permittee Date