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Home My Public Portal About10526 OLIVE ST_Plumbing__ (3) .78A55(i7-CE#81,7 10-67 AcPPLICATION FOR` PLUM ING PER IT COUNTY`OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ® ` �+ / 1 JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS f0 S V COLEMAN W. JENKINS. SUP'T. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN(PRINT O TYPE) NEAREST. CROSS ST., NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 1.50 O!b MAIL �I BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY L' TEL.NO. LAVATORY 1.50 CONTRACTOR 44-nD bAaZ ..y . SINK .. 1.50 a ADDRESS j_3 _7 -k 1_ DISHWASHER d 1.50 fjND ) `STATE `6 TEL. NO. —6 f•/•' - LIC CLOTHES WASHER /— .1.50 AT NO. p2,�,q V 6 7 CLASS C 3C SWIMMING POOL RECEPTOR 1.50 CT N G.R Z PR S B LAWN SPRINKLER SYSTEM 2.00 ® 7 O WATER HEATER 1.50 L C.) PROVAL GAS SYSTEM OUTLETS 1.50 CTION CORVOUTLETS OVER305 PER SYSTEM Nfir ic /u quo .46A iA<s.,&=,fr1 g7 410 0AIE Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING:FEE $ 1 2 00 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 I 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 PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AD/OR UTILITY CO.NOTIFIED LIN CENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I LEGAL O •OF,AND 1NTEND,TO RESIDE IN,THE ABOVE ED RES TI RO RTY. FINAL e SIGNATURE JACK R. ALLEN, $U'PERVISI G - EH ANICAL EN'G'R. OF PERMITTE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIEKtION CK. M.O. CASH LACD6 9 7 .2% OCT22 5 0 950— q- + WORKERS'COMPENSATION DECLARATION �' O�'—f-JjAPPLICATION FOR PLUMBING PERMIT I hilreby offirr% that I have a certificate of consent to self 76A667A ins.ire�'ul•a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) City Of Temple City er a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY � cy No. 201916 Company SCZF 8537 Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS 10526 Olive Street IR Certified copy is filed with the county building inspec- tion department. i NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date 4-1-87 Appliqant General Xnstall. WATER CLOSET NEAREST Temple Cit CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. El 4o. e-Ave, COMPENSATION INSURANCE SHOWER OWNER Ralph Parch (This section need not be completed if the work Involved by the permit is for one hundred dollars($100)or less.) LAVATORY AMD DRESS 10526 Olive Street I certify that in the performance of the work for which this. permit is issued, I shall not employ any person in any manner SINK CITY TEL.'443-81.09 so as to become subject to the Workers'Compensation Laws.: DISHWASHER CONTRACTORGeneral T-nstallation Co- Date— Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of 6558 West Blvd Exemption, you should become subject to the Workers' SWIMMING POO RECEPTOR CITY TEL. NO. Compensation provisions of the Labor Code, you must forth- LAWNSPRINKL STEM Los Angeles with comply with such provisions or this permit shall be STATE LIC. deemed revoked. 1 WATER HEATER LICENSE NO. 151839 CLASS C3 LICENSED CONTRACTORS DECLARATIONDISTRICT NO. P ESSED BY dw I hereby affirm that 1 am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETSOC.l p='` e (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER ` and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL License Number '1-5181 Lic.Class r'AA DATE / 7 `s - 0 Aw FINAL L Contractor W.Q. PY'ny Y_n Date4—S S BY /� / /A I am exempt under Sec. F B.BP.C. for this reasonLL Plan check fee F7, p Date: PLUMBING PERMIT ISSUING FEE$ 10 50 ® 2 Signature TOTAL FEE 16 50 SINGLE FAMILY Plan check applicant 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. ❑ 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 ;9 6 0 k 8 A I hereby affirm that there is a construction lending agency for # 0 0 0 0 0 5 the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). I o a 1 650 Lender's Name o 0 0 1650-7- Lender's 6.5 0---- Lender's Address 1 202-.!86 1 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-mentionedpr erty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of P&tbittee Date WORKERS'COMPENSATION DECLARATIONnt s a••�:;L� APPLICATION FOR PLUMBING PERMIT I hereby 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, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. J FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ADDRESS [JCertifiedcopy is filed with the county building inspec- � tion department. NUMBER FIXTURE.OR ITEM FEE LOCALITY r'e"JC4 AGE Date Appli4ant WATER CLOSET Gr f NEAREST '40e. CERTIFICATE CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. E�7 i+ COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for,one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this SINK. =CITY permit is issued, I shall not employ ari. person in any manne so as to become subject to the Work. Comp satin La DISHWASHER CONTRACTOR Date 'LZ 4 flApplicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after maki this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- ' CITY TEL.NO. STATE LIC.LAWN SPRINKLER.SYSTEM 'with comply with such provisions or this .permit,shall be , deemed revoked.. WATER HEATER LICENSE NO.. ' ' CLASS 'LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS y 0%7 (commencing with Section 7000)of Division 3 of the Business OUTLETS:OVER K and Professions Code,and my license is in full force and effect. .5 PER SYSTEM FINAL. DATE -� VALIDATION 0 License Number Lic. Class @S FINAL. O Contractor Date BY I am exempt under Sec. H B..BP.C. for this reason z Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ I p Signature TOTAL FEE Plan check applicaht SINGLE FAMILY i HOME OWNER-BUILDER DECLARATION Name 5 4 0.7 ,. r I hereby affirm that I ani exempt from the Contractor's License Address o �'r 0 0 0 0 Law fo he following reason (Section 7031.51 Business and r ro Bions Code): City Tel. No. 2 � - 1 6 5b i, as owner of the property, will do the workand the Astructure is not intended or offered for sale (Sectionpop 'o'o 0 1 6 0 r 7044, Business and Professions Code). ,O ?Q—FS;J 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.). I f Lender's Name I Lenders Address I certify that I have read this application and state that the i ► above information is correct; I agree.to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of Ihis County to enter upon the ab mentio d property ns .ction purposes. ' � �� SEE REVERSE FOR EXPLANATORY LANGUAGE , z -� ;S'ignat of Permittee Date ; L � 1 WORKERS'COMPENSATION DECLARATION '� } APPLICATION FOR PL MBING PE"RMIT'("O' I hereby affirm that I have a certificate of cartsent to Self 76,46yjq • # ;& :2., insure, or a certificate of Workers'Compensation I�nsurance,6 j:CE,§17(REV. 19/81:) 11 or a certified copy thereof(Sec. 3800.1 Lab. C.) .I COUNTY OF LOS.ANGELES BUILDING AND SAFETY Policy No. Company' Certified copy is hereby furnished. BUILDING 7/ ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS .fQ�G Scs GaCOjJ Certified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM @ FEE LOcnLiTY Date Appliqant 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 SHOWER the permit is for one hundred dollars($100)or less.) MAILi Li4VATORY ADDRESS certify that in the performance of.the work for which :this permit is issued, I shall not employ.any person in any man r SINK CITY TEL.NO. so as to become subject to the Wor rs'C p tion s. ` DISHWASHER I CONTRACTOR Date/�'Sd .ppl(cant ` CLOTHES WASHER i NOTICE TO APPLICANT: If, after making this Certificate of I ADDRESS rr,,ption, 'yu should subject e Workers' SWIMMING POOL RECEPTOR Exe,, oshldbest tthWk I I' CITY TEL..NO.. Co .pensation provisions of the Labor Code, you must forth- LAWN comply with such provisions.. or this LAWN SPRINKLER SYSTEM p y p permit shall be � .STATE LIC. dee ed revoked. I WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. BACCESSED BY I hereby affirm that I am licensed under provisions of Chapfer,9 GAS.SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business ! OUTLETS OVER >. and Professions Code,,and my license is in full force and effect. 5 PER SYSTEM i IL "} 11 VALIDATION VALIDATION 0 License Number Lic. Class p� 1FIN Contractor - DateEl BY I am exempt under-Sec. � B.&P.C. for this reason " Z Plan.check,fee A .141te: PLUMBING PERMIT ISSUING FEE'$. � ('�' Signature TOTAL.FEE Plan check applicant 3 7 A SINGLE FAMILY j HOME OWNER-BUILDER DECLARATION Name t 0-0 0. o o I.hereby affirm that I-am exempt from the Contractor's License Address ' Law for the followingreason Section 7031.5, Business and { ? o . 222.5o Prof ssions Code): City Tel. No. I, as owner of the property, will do the work and the j r, 6 .a 2 2,55 0 6 structure is not intended or offered for sale (Section )' '' 7044, Business and Professions Code). n 0 9 1 2783 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency.for 4 i 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 I 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 ove-mentioned prop for ' spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 4 Sign Pure ofPermittee Date e 76A667-CE817 12/59 TEMPLE CUTY APPLICATION FOR- PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ByILDINGG�iND S�FETY VWSION BUILDING OHb A. MBIE. OUNTY NGINEER ADDRESS WILLIAM A.JENSEN.SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM OWNER WATER CLOSET BATH TUB ADDRESS .p , ' cITY TEL NO. SHOWER LAVATORY CONTRACTOR c i ME: ADDRESS DISHWASHER CITY P A TEL NO.✓ �p CONTRACTOR'S -y STATE LAUNDRY TUB REGISTRATION NO. / 3 /- COUNTY ❑ N' :e: CLOTHES WASHER DISTRICT NO. GE20— ZONE PR SEED BY WATER HEATER �' Q GAS SYSTEM IIIDIISTNU WASTE APPROVAL INSPECTION RECORD O U m 0 F U W a w W OR O0'mmFIXTU88 $ I ' � .• " APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2100 UNDER SLAB WORK TOTAL FEE ROUGH PLUMBING GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS A PLICATION GAS VENT AND. STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY LDrESCRIBED COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER . Y CERTIFY THAT I AM PROPERLY REGISTERED. AND/OR PLUMBING FIXTURES AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST A OR THAT I AM THE LEGAL WNER OF THE ABOVE RESIDENTIA ROPERTY: UTILITY.CO.NOTIFIED RE + " AITTE FINAL ALIDATION ROBERT A.WOOD, ;lam� r •(// � cx, M.p, cmu SUPERVISING MECHANICAL ENG'R 7 6 3 7 GUI � 4 5 D