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Home My Public Portal About5540 PAL MAL AVE_Plumbing__ 7EAE67-CZAS17 X1-E4 CITY OF TEMPLE CITY 11522 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTbIENT OF COUNTY ENG21M JUI MG SlcFETY MSION nADDRESBRAMA JO A IE OUNTr NGINlERal Mal Ave, COLEMAN W JENKINS,SUPT OF BUILDING FOR APPLICANT TO FILL IN Li;e Oak NUMBER FIXTURE OR ITEM EACH FEE Donald r)mmk4nm WATER CLOSET 1125 BATH 7BS 125 Sxowea 125 CITY TEL NO LAVATORY 125 CONTRACTOR General Installation Co. BIN[ 125 ADDRESS 8588 West Blvd. DISHWASHER 125 CTR Los Angeles TEL NO FL 5-2841 ATE LAUNDRY TBE 125 CONTRACTORREGISTRATIO8 o C -36 181889_ 787COUNTYY WARNER pI DIaT IC GROUP x N[ P [[o[O Br WATER HEATER IN GAS SYSTEM—OUTLETS— I w APPROVAL OVAL OUTLETS OVER 5 PER SYSTEM .10 INSPECTION RECORD Ca 1 water softener 1 50 Ready for Inspection Now 0 44 FP v W EL z 2 APPROVALS DAT! IMSPECTOR S SIGNATURE PERMIT f 2 Oa UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE 3 O GAS PIPING I HERESY ACKNOWLEOGE THAT I HAYS READ THIS ATLICATIOM GAS VENT AMD STATE THAT THE ASCYS IR CORRECT AND AORI[ TO COMPLY WITH ALL COUNTY ORDINANCES AND STAYS LAWS IMOULATINO PLU Ma HOT WATER HEATER I HERSMY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICINS[O AS REOU111[D RT LOS ANGELES COUNTY AND RAIL 01 GAB TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND IMTVID TO REGIO[ IM THE ASOYE oEStRIEED REL wI/yIED 'P UTILITY CO NOTIF SIGNATURE (�f(�J�//7��/'D^EE✓ OF P[RMIrrEE FINAL y �P1�LIDATIC+N OBERT A W OD <R M o CMH SUPERVISING NO MECHANICAL ENG R ALo419. 9n :-n 30 5 D 3$0- 76A667 CE61712/59 TEMPLE CITY APPLICATION FOR PLUMBING PERMIT 'I DEP C IIPTfY OpF COS ANpGjEII��jfF$�Sj]QNE�Q{ B�7�1 O�ENa1NEBR DREW WILLIAM A JENSEN SUP T OF BUILOIHG LODA117`7 FOR APPLICANT TO FIM IN muff 08088 ST NUMBER FIXTURE OR ITEM OWNER WATER CLOSICT b= BATH TUB ADD TEL N9cOUwr SHOWER LAVATORY CONTRACTOR BINK ADDRESS DISHWASHER CTR TEL N CONTRACTOR LAUNDRY TSR REGISTRATION No CLOTHES WAS DISTRICT NO GROUP ZONE P EBBED WATER HRATER GAS RlSTEN INDUSTRIAL WARTS APPROVAL RTBPRcnoN ERcoRD S 0 U m C APPROVALS DATE INSPECTOR S SIGNATURE PERMIT f $ OO UNDER BLAB WORK TOTAL FEE 3 ROUGH PLUMBING GAB PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAB VENT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING NOT WATER HEATER 1 HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS EST CALIFORNIA OA 7 AM T LEGAL OF In ABOVE DESCRIBED RES UTILFTYCO NOTIFIED OP PH I SIGNATU FINAL 1 f 0r 1MATION ROBERT A WOOD. a ■ 0. CAE* SUPERVISING MECHANICAL ENG R LU;D 9 2 6 7 i-GV 3 0 5 D 3.0 0 7BA667-CE817- 11-57 APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BIIH ERE 7(Pat) ]d:L TORN A. LAMBIE. County. En inM ADUHE9SM.CASSATT D. GRIFFIN. Sup t of Building LOCALITY Templa City FOB APPLICANT TO FILL IN NEARESTCROSS ST.NUMBER FIXTURE OR ITEMOWNER J. Oven-qWATER CLOBRT MAILBATH TUB ADDRESS SHOWER CITY LAVATORr coNTBACToR Earlsom ADDRESS 2019 RDISHWASHER CITY 81 Mo GI )+1559LAUMRY TM REGIS�TRAAT'IION NO. STA CLOTHES WASHER DISTRI GROUP SONE �I 8EAI)1F0RIN5PECTIOH WATER HEATER /,�L// GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD APPROVALS 1 0 o$DDU ' DATE INSPECTOR'S SIGNATURE 1*00 UNDER SLAB WORK PERMIT S 00 ROUGH PLUMBING TOTALFEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GASTEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTI FI ED DESCRIBED RESIDENTIAL OPER SIGNATURE FINAL OF PERMITTE ROBERTA.WOOD. 0, VALIDATION SUPERVISING MECHANI LENG'NI L M.0. CASN : .1Y r. 5 A 3.0 0 r I Worm ttha I havNSATwNcate of APPLICATION FOR PLUMBING PERMIT I hereby oHum that I have o certificate of consent to self ZO-0ORB DPW 6/97 I aura or a certificate of Workers Compensation Insurance, 76AG67A or a certified copy thereof (Sac 3800, Lab C ) COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS policy No 'kampany &r—Ana6 r'JND UCertified copy Is hereby furnished DING 13Certified copy is filed with the county building impec• FORAPAlCAM70FILLw(PIKMORTYPE) ADDRMS 40 VqL MALRVC tion department NUMBER FIXTURE OR ITEM O FEE Date�O� LOCALITY 1^Applhant 1�CA C'AA4i-CLAN$-r WATER CLOSET T CERTIFICATE OF EXEMPTION FROM WORKERS' BATH NB CROSS ST L-- 1 V I D R ^M 1 LETT} ly COMPENSATION INSURANCESHOWER OWNER T2 LDS (This secot,e need net be conies"R the ererk I wells by yz the M^ep Is for ens,hundred dollars(E100)or leu) MAIL AWM S,At M I certify that In the performance of the work far which this t� ',L permit Is Issued, I shall not employ any Person In any manna SINK CITY TIF MP LIF CITY TEL 0 E— 447 so Ot to become subject to the Workers Compensation Lows DISHWASHER CONTRACTOR COA5T CO T Date Applicant CLOTHES WASHER NOTICE TO APPLICANT If, after making this Certificate of ADDRESS Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor , you must forth LAWN SPRINKLER SYSTEM seri V 41..• 1 N�.4- TEL No 1-7 —3+13 with comply with such provision or this permit shall be deemed evoked WATER HEATER N PW CLASS CL LICENSED CONTRACTORS DECLARATION DISTRICT NO! D �p PROCESSED BY I hereby offlrm that 1 am licensed under provisions of Chapter 9 OAS SYSTEM gLlRET6 d• �/ L icy (commencing with Seatlon 7000)of Divlsbn 3 of the Business pUTLETS R and Profession Code,and my license is In full force and effect 6�R FINAL aMAUDATION 6: License Number-" 764-1 Uc Clau fib DATE - .. A ConnoetorRlW CaA,,rira KThnI. —Z']- �" FINAL �, `I%•T �_�.`'� o ❑ 1 am exempt under Sec - 1 - LIE 8 LIE B 6P C for this reason _ Plan check fee j-f� $`} - 911=_r m 110 Z fit° PLUMBING PERMIT ISSUING FEE$ a :µEly --•�� SlprgNre ._l. TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name Ric- H cocopoiST- lCl_L'-l�l,l_1 :12< K I hereby affirm that 1 am exempt from the Contractor's Licenser.-C Law for the following reason (Section 7031 S, Business and Address 66( MA PLEG•12.OVE AVE ' ��t.I� 1 Ft)'i I. 1- Professions Code) Gty l_. a OA Tel Na 17 -34 13 ❑ I, as owner of the properly, will do the work and the structure is not intended or offered for sale (Section 0070" Business and Professuons 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 (Sac 3097, Gv C ) Lender's Name Landers Address I certify that I have rood this application and state that the 110,above information is correct I agree a comply with all County ordinances and State laws regulating Plumbing, and hereby authorize reprelentatrv°s of this County to enter upon the above-mentioned For perry for Inspection purposes f r- SEE REVERSE FOR EXPLANATORY LANGUAGE Signor r of Perm ttee Dote (YORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 20.0026 DPW 6/07 insure or a cernficate'of Workers Compensation Insurance 76AB67A or o certified copy thereof(Sec 3800 Lob C ) COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS Policy No Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRIM OR TYPE) ❑ = Certified copy filed with the county building mec- Inon department NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Appl,gcnt WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST COMPENSATION INSURANCE SHOWER (This section need net be completed if the work Inve)wd by "permit Is for one hundred dollars ($100)or leu ) LAVATORY MAIL ADDRESS 1 certify that to the performance of the work fa which this permit is issued,I shall not employ any person in any manner SINK CRY xS •� TEL w as to become subject to the Workers'Co n owe DISHWASHER CONTRACTOR,//Dole �– ZzAppliccint CLOTHES WASHER NOT TO APPLICANT If after m art cote of ADDRESS ¢ C 4,r7 /AGS Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR �, 3/O Compensation provisions of the Labor Code you must forth 7 �.ZTEL NO – 1% with comply with such pe LAWN SPRINKLER SYSTEM p y provisions or this permit shall be $TATE UC deemed revoked WATER HEATER LICENSE NO 30,3 CLASS G-e-190—4fk6> LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby oNnrm the I am licensedunder provisions of Chapter 9 J GAS SYSTEM OUTLETS A (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER . D fi y and Professions Cade,and my license N in full force and effect S PER SYSTEM FINAL VALIDATION y License Number tic Class `C0–C$'O DATE O / = – FINAL U v Contractor Date BY ❑ I am exempt under Sec B&P C for this reason _ _ Plan check fee to Date PLUMBING PERMIT ISSUING FEE$ •j Z Signoturo TOTAL FEE Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name _ I hereby affirm Nat I am exempt from the Contracta`s License Address Law for 03 the following reown (Section 71 S Business and Professions Code) City Tel No – ❑ 1, as owner of the property, will do the work and the _ 1 structure is not intended or offered for sale (Section 39 - 30 7044, Business and Professions Code) Poo CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work far which this permit is Issued (Sec 3097, Civ C ) Lender's Name Lender's Address I certify that I hove rood this application and state that the above information is correct I agree to comply with all County ordinances and State lows regulating Plumbing and hereby authorize reprellentahves of this County to enter upon the above mention roe for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signa a —� Dote