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Home My Public Portal About10616 OLIVE ST_Plumbing__ 085°710.55 ." APPLICATION F'OR PLUMBING PERMIT ,1 DIVISION OF BUILDING AND SAFETY 4 Department of County Engineer County of Los Angeles BUILDING JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS 10616 E. Olive CASSATTD,GRIFFIN..SUP'TOF.BUILDINo LOCALITY Temple City FOR APPLICANT TO FILL IN I NEAREROSSST. El Monte Ave. OWNER DuraBuilt 07onstruction DISTRICT NO. GROUP Z N READY FOR INSPECTION ADDRESS 923 Beverly Way I J- 0d� INDUSTRIAL CITY Altade.na TEL. NO. WA TEAPPROVAL PLUMBER Belvedere Plumbing Co. INSPECTION RECORD r ADDRESS 11900 E. Garvey -Ave. CITY E1 Monte TEL.NO. F0 89836 "'/" _F LICENSE NO. 54932 NUMBER TYPE OF FIXTURE OR ITEM FEE �>� • (� yO 2 WATER CLOSET (TOILET) @ $1.00. $ 60 41-* - 1 BATH TUB Q $1.00 SHOWER @ $1.00 2 LAVATORY (.WASH BASIN) @ $1.00 2.00. "/ `>'� 9 1•a G, /..� = i./- 1 KITCHEN SINK Q $1.00 1.00 ,ro / DISHWASHER @ $1.00 c LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 J 4 1 WATER HEATER @ $1.00 1.00 e/ GAS SYSTEM @ $1.00 _ J� ' I APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK , PERMIT S 1 00 ROUGH PLUMBING GAS PIPING TOTAL FEE ill-.0 GAS VENT 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT We1TER HEATER 1�f,a I A,,•1<<� C'ti✓i,+� WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES ,t I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST 9!A r :A%e ✓.,- -K J LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ' CALIFORNIA OR THAT I AM THE LEGAL OW OF THE ABOVE UTILITY CO.NOTIFIED y DESCRIBED RESIDENTIAL PROPERTY, f SIGNATURE OF PERMITTEE FINAL / OHN A.LAMBIE.COUNTY ENGINEER LIDATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR M.a. CASH 5 8 4 r- MAY 9 3 1 1 .0 0 L� nl0 WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure, o%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. BUILDING s rFOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspec- ADDRESS tion department. NUMBER FIXTURE OR ITEM @ FEE — LOCALITY Date Appligant WATER CLOSET 0— NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB. CROSS COMPENSATION INSURANCE OWNER - (This section need not be completed If the work Involved by SHOWER f _ ` the permit is for one hundred dollars($100)or less.) MAIL LAVATORY ! ADDRESS I certify that in the performance a ork'for hick this permit is issued, I shall not emplo erso an inner SINK CITY TEL.NO. �'� it so as to ecom subject to the W r 'Come ati Laws. DISHWASHER i CONTRACTOR Date ' pplicant CLOTHES WASHER ADDRESS NOTICE O 401CA- If, afte ki g this Certificate of SWIMMING POOL RECEPTOR Exemption, you should beta b' ct to the Workers' CITY a"�`y ELa NO. Compensation provisions of the Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deomed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO ESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (/y (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER 0. and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL el A ✓ VALI TION DATE r W License Number Lic. Class 09 FINAL O Contractor Date BY ElI am exempt under Sec. dus B.BP.C. for this reason10, $ Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ S 2 4&C R Signature TOTAL FEE X000005 Plan check applicant SINGLE FAMILY I o - 341.50 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address o 0 o J/ �.3 C c. Law for the following reason (Section 7031.5, Business and Pro scions Code):lm I City Tel. No. O 7, 1 6 5 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. Lender's Name Lender's Address I certify that I have read this application and state that tho pool mrr formati�> ' correct. I agree to comply with all County r ani State ws regulating Plumbing, and hereby a t r ze repr s tate s of this County )o enter upon the mention d op rty for inspection urpqsp�-_ SEE REVERSE FOR EXPLANATORY LANGUAGE i n lure of Permittee bate , WORKERS'COMPENSATION DECLARATION 76AG67A I hereby affirm that I have a7 certificate of consent to self ca 817(Z_ae) -APPLICATION FOR PLUMBING PERMIT �p insure,or a certificate of Workers'Compensation Insurance,or U a certified copy thereof(Sec.3800,Lab.C.) � .5t Z3�a COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy o. `Company =MA 0 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING WATER CLOSET Certified copy is filed with the ounty building inspection NUMBER FIXTURE OR ITEM • FEE ADDRESS +.�+((fi�eq�'t�1gg� LOCALITY Dates Applicant NEAREST BATH TUB CROS$ST. VLk CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER Q LAVATORY MAIL >_(This section need not be completed if the work involved ADDRESS 10W6 (L by the permit is for one hundred dollars ($100) or less.) SINK O CITY�� ` TEL.NO.2 U I certify that in the performance of the work for which this DISHWASHER permit is issued, I shall not employ any person in any manner CONTRACTOR �� I?CXAs+ O so as to become subject to the Workers'Compensation Laws. CLOTHES WASHER ADDRESS Date Applicant SWIMMING POOL RECEPTOR — W a NOTICE TO APPLICANT: If, after making this Certificate of CITY �IG>►� Gp .r-� TEL.Nd '�Z� y Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE — LIC. Z Compensation provisions of the Labor Code, you must forth- WATER HEATER LICENSE NO. �g5V02 CLASS C.S with comply with such provisions or this permit shall be deemed revoked. GAS SYSTEM OUTLETS DISTRIC,TT NO. PROCESSED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER V I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- ®FINAL VALIDATION ness and Professions Code,and my license is in full force and DATE r � r effect. FINAL License Number` vQ �� / Lic.Class �4S BY ContractociA061 Date I am exempt from the licensing.requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic,or Reg.No. Date Plan check applicant X501. 1 A HOME OWNER-BUILDER DECLARATION Name C � (�0 tel« ��o�¢ 4o o •o o a 5 I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section 7031.5, Busi- Cityry►; T.I.No. 2 0 - 20.50 ness and Professions Code): I, as owner of the property, am exclusively contracting o 0 0 2 0.5 C with licensed contractors to construct the project 0 7. 1 6-82 (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 'u I certify that I have read this application and state that the N on is rrect.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE St laws regulating Plumbing, and herebyse ives of this County to enter upon the perty for inspection purpo s.mittee a