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Home My Public Portal About10641 OLIVE ST_Plumbing__ WORKERS'COMPENSATION DECLARATION 76AS67A I hereby affirm that I have a' certificate of consent to self CE 617(:-6e) APPLICATION FOR PLUMBING PERMIT insure,or a certificate of Workers'Compensation Insurance,or a ce fied csipy thereof ec.3800 C.) I 7 �a � COUNTY OF LOS GEL B D SAFETY Po icy filo Com an Certified copy is hereby furnish � /, FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ertified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE ADDRESS department. LOCALITY WATER CLOSET Date Applicant NEAREST r ' BATH TUB CROSS ST. f ,,} V CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER LAVATORY MAIL d (This section need not be completed if the work involved ADDRESS } by the permit is for one hundred dollars ($100) or less.) SINK CITY STEL.NO. 3 syo0a I certify that in the performance of the work for which this DISHWASHER U permit is issued, I shall not employ any person in any manner CONTRACTOR _ V so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER ADDRESS&.:1 Date Applicant SWIMMING POOL RECEPTOR NOTICE TO APPLICANT: If, after njaking this Certificate of CIT TEL.NO. SS- Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. N Compensation provisions of the Labor Code,you must forth- LICENSE NO. C-3 CLASS .3a with comply with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. SSED B LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 15 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL VALIDATION ness and Professions Code, and my license is in full force and DATE effect. FINAL License Number Lic.Class 36 BY Contract ' ,MP g I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ 100 acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section 7031.5, Busi- Cit T.I.No. ness and Professions Code): ❑ I, as owner of the property, am exclusively contracting 3 3 5 �% A with licensed contractors to construct the project (Section 7044,Business and Professions Code). ft.0 0 0 0 o ti CONSTRUCTION LENDING AGENCY 2 o o 0 n Q I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is o 0 0 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby aut rize epresentatives of this County to enter upon the ab v Toned prop rinspection purposes. Sf9hature of Perm ee Date 76A867-CE#8.17 2-62 ' APPLICATION FOR PLUMBING ""PERMIT COUNTY OF LOS ANGELES. DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDBESS• WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE r OWNER WATER CLOSET $1.25 MAIL BATH TUB 1.25ADDRESS ljf SHOWER 1.25 CITY TEL.NO. —og LAVATORY 1.25 f CONTRACTORDONF SINS 1.25 c ADDRESS 1 DISHWASHER 1.25 CITY Arcadia, Calif.'E- N LAUNDRY TUB 1.25 CONTRACTOR'S STATE REGISTRATION NO. COUNTY CLOTHES WASHER 1.25 DISTRICT NO. GRO P ZONE ESSED BY WATER HEATER 1.50 GAS SYSTEM OUTLETS 1.50 INDUSTRIAL WASTE APPROVAL __/__fOUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD o ,! 1 �� !I. T/9/i��/ ,I.-y'A//JLf4! f 'I/ `A•i."'LY�'� /� b • C/ II.IJ pllGl ,� ( S'r'{�S f—�£�t.v3t�t✓a-� E�'r_;'�",'�.�--+cf,tlr � APPROVALS b DATE f INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING /,�� G�fi lam^.�.=`i.•'. �>'1+• TOTAL FEE GAS PIPING r I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE' IS CORRECT AND AGREE TO COMPLY GAS VENTAn- 4, `y f •�yy ,.Y WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 7l' HOT WATER HEATER PLUMBING. - -^ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUM BI NG FIXTURESLICEN CALIFORNIA ORAS ETHAT ED BY EANGELES II AM THELEGALOWNER OF AND INTEND TO GAS TEST .' _ .1/ ��. fit'`.. •�� RESIDE IN,THE ABOV ESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED ✓ F SIGNATURE OF PERMITTEE r FINAL ALIDA�_'ION -ROBERT A.;WOOD . (CK_ M.0.1 CASH' •`SUPERVISING MECHANICAL'ENG'R �,�� 0 7 9 0 1,21 FEB 1 �. 5 0 ' 1 0.0 0'" ;�' -7- G� 76A667C (C6-8178) -975 APPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN (PRINT OR TYPE) ADILDING 0641 E. Olive St. NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 03, Q D LOCALITY Tem le Cit 0 d pv NEAREST BATH TUB CROSS ST. SHOWER OWNER / LAVATORY G �. d V MAIL ADDRESS SINK CITY TEL.NO. DISHWASHER CONTRACTOR CLOTHES WASHER SWIMMING POOL RECEPTOR ADDRESS1135-5 Center Dr. LAWN SPRINKLER SYSTEM CITY of Industry TEL NO..965-6636 STATE LIC WATER HEATER LICENSE NO. 290313 CLASS O DISTRICT NO. GROUP Z NE R SSED BY v GAS SYSTEM OUTLETS � 10Is I x pj , O OUTLETS OVER K• 5 PER SYSTEM INDUSTRIAL W WASTE APPROVAL ti INSPECTION RECORD Z Plan check fee PLUMBING PERMIT ISSUING FEE $ TOTAL FEE Plan check applicant Name APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK Address ROUGH PLUMBING City Tel. NO. GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL R PERTY. UTILITY CO. NOTIFIED SIGNATURE OF PERMITTE FINAL PLAN CHECK VALIDATION CK. M . CASH PERMIT V IDATION cK. M.O. CASH . 76A667(CE-817)- 6/73 APPLICA WFOR PLUM N NG PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING. ADDRESS 10641'E• Olive St• HARVEY T. BRANDT, COUNTY ENGINEER -LOCALITY Temple City' FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. El Monte Ave. NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 1.75 OWNER E. Hannan MAIL BATH TUB 1.75 ADDRESS ' same SHOWER 1.75 CITY TEL. NO. 443-5072 LAVATORY 1.75 CONTRACTOR pacific,Installexs SINK 1.75 ADDRESS. 10920 E.-Grand DISHWASHER 1.75 CITY Tem le Coity TEL. NO. 442-7070 CLOTHES WASHER 1.75 STATEQn LIC LICENSE NO. 211698 CLASS SWIMMING POOL RECEPTOR 1.75 DISTRICT NO. GROUP �!VC ESSE BY LAWN SPRINKLER SYSTEM 1.75 � q Q WATER HEATER 1.75 INDUSTRIAL > WASTE APPROVAL GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD C3 OUTLETS OVER 5 PER SYSTEM .30 0 CD v W Cn G7 • Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE 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 _ iHEREBY 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 ,. 6 v 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 DESCRIBED RES[DE:g PROPERTY. FINAL SIGNATURE OF PERMITTEE PERMIT VALIDATION CK. M.0. CASH PLAN CHECK VALIDATION CK. "03 4AI+t-jinn ^ r �� AL IEP Is AD Y 0, R 7BA887-CE#817 10-82 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING �� JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS WILLIAM A.ANSEN,SUPT OF BUILDING �j LOCALITY M Ce CIT CA- r FOR APPLICANT TO FILL AN NEACROTT. U� NUMBER FIXTURE OR ITEM ` EACH FEE Y �� 'OWNERYJ , p WATER Q9SET ,. $1.25 �^ MAIL BATH TUB 1.2$ ADDRESS G -600 CITYC—(__,,TEL.NO. SHOWER 1.25 LAVATORY 1.25 ,CONTRACTOR • SINE 1.25 ADDRESS DISHWASHER :1.25 _ ' CITY TEL. NO. LAUNDRY TUB 1.25 CONTRACTOR'S STATE Cl REGISTRATION.NO. COUNTY ❑ CLOTHES WASHER 1.25. DISTA=NO. GROUP ZONE PROCESSED BY WATER HEATER 1.50 (� r A—I U GAS SYSTEM OUTLETS 1.50 INDUSTRIAL > WASTE APPROVAL 0 OUTLETS OVER 5 PER SYSTEM .90. INSPECTION RECORD 0 . ety • - w z ti !rP0RDATE INSPECTOR'S SIGNATURE �r UNDER SLAB Wb K PER IGIIT S 2 00 ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ATE LAWS REGULATING HOT WATER,HEATER PLUMBING. - I HEREBY CERTIFY THAT 1 AM PROPS LY REGISTERED AND/OR PLUMBING FIXTURES. _ LICENSED AS REQUIRED Y LOS NGELE COUNTY,AND STATEOF GAS TEST - - CALIFORNIA.OR THA-Al THE EGAL HER OF,AND INTEND TO _ RESIDE IN,THEA E BE RES NT L PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTE L FINAL )11)'�,'P I% �" v'"w �.i•_• •{f VALIDATIO ROBERT.A:WOOD CK. M.O., CASH SUPERVISING MECHANICAL ENG'R J GZ2 it l 31 �. .3.50' 1_ito . . fi