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Home My Public Portal About9526 PENTLAND ST_Plumbing__ 76A667 CES1712159 TEMPLE CITY APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUIL�ING AM ,MFETY RMSIONTADDRM sJO AI_.4 BI OUNTY NGINEERWILLIAM A JENSEN SulT OF BUT Ha FOR APPLICANT TO FILL IN NUMBER FIXTURE OR ITEMWATER CLOSET MAILBATH TOB SHOWER CITY 4/ TEL N (� Y IAVATOBT coNTaxc7oa ` �Gu� Sm ADDRESS DISHWASHER CITY ZTEL NO ?�"Ll5.5 CONTRACT9M S v STATE LADNDRY TOB REGISTRATION NO COUNTY CLASHES WASHER D111�ICT NO GR E P O S BY WATER HEATER 1O GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD y w O U R O r U w 0. yN O • 71OR rIXr HREEP7 s f APPROVALS DATE INSPECTOR 951GXATURE PERMIT § 2 GD UNDER SLAB WORK TOTAL FEE P ROUGH PLUMBING GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ TH19 APPLICATION GAS VENT AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND BTA7! LAWS REGULATING PLUMBING HOT WATER HEATER 1 MEREST CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF i CALIFORNIA OR THAT 1THB VGAL OWNER OF THE ABOVE GAS TEST DESCRIBED RESIDENTIAL P UTILITYCO NOTIFIED SIGNATUREAI� OF PERMITTEE L FINAL ®T VAI. =. ROBERT AI WD OO tlt A 0 p /(6play SUPERVISING MECHANICAL ENO R X05546 : NOW 29 5 0 300 76A667-CE817 12159 TEMP-LEI CITY APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER AT1 IEO BUILDING BIO NIAG I OUNTY NGINE'OER� ADDHE98 WILLIAM A JENSEN Bop T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS B7 NUMBER FIXTURE OR ITEM /I OWNER U' WATER CLOSET �L BATH TUB ADDRESS RHowER crrY TELal LAVATORY CO O8 SINE ADDRESS a DISHWASHER CITYCONTHi O8S LAUNDRY TUB BEGL4 TION NO CLOTHES WAS® DISTRICT NO GROU WATER HEATER .,.� - . O GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD a O U 0 rO. U W a m b / 0 V.00 PEM ITEM APPROVALS DATE INSPECTOR S SIGNATURE PERMIT § $ 00 UNDER SLAB WORK TOTALFEE DO ROUGH PLUMBING GAS PIPING 1 HEREBY ACICNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AMO GAB VENT STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY ��1) iyM PWITH LT ALLING COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER 'I/ i14 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES CE LIMBED AS REQUIRED BY LOB ANGELES COUNTY AND STATE OF GAB TEST / CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED REBIDEN7IAL PiUTILITY CO NOTIFIED I I' i SIGNATURE h T w l A-1' OF PERMITTE _ FINAL I S r��f/ �� UUU✓r'`� ®r VALMATIO ROBERT AI WOODI CI ■ 0 / Ga/l J SUPERVISING MECHANICAL ENG R UIC,so5 110 3 5 o 300 76A667 CE017 22/59 TEMPLE CHTY APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUaGL�ESA�FETYIVLSION BanDmc LL d J A M I OUNTV NGINEER ADDREB9 t.T/G��Q�✓ WILLIAM A JENSEN SUPT D� BUILO NG ' LOCALITY FOR APPLICANT TO FILL IN v a NEAREST CROSS ST %AV��'� A , NUMBER FIXTURE OR ITEM OWNER WATER CLOSET MAIL ��T G L BATH TUB ADDRESS .Ta2 /'0PNIwo �iOWEH CITY e I! C,4y TEL NO LAVATORY CONTRACTOR ,4N c- Ea SINK ADDRESS 2,2ZKN (- DISHWASHER CITY / R.,y .t. TEL NO CONTRACTOR HKATY LAUNDRY TUB REGISTRATION NO /-To.'fo o coDNrY CLOTHES WASHER DISTRI NOGROU ZONE P ESbED BY WATER HEATER GAS SYSTEM INDTlB1. ` WASTE APPROVAL INSPECTION RECORD a O U w PO. U w a N a 81 DOPER ITEM 7 OR FE87URE Gd, APPROVALS PATM INSPECTOR S SIGNATURE/ PERMIT $ E OD UNDER SLAB WORK TOTAL FEE L 0 e ROUGH PLUMBING GAS PIPING I 1 HEREBY ACICNOWLEDGE THAT 1 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 PLUMBING HOT WATER HEATER 1 HEREBY CERTIFY THAT 1 AN PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR TH 1 AB THE LEGAL OWNER OF THE ABOVE DESCRIBED REBID PROPERTY UTILITY CO NOTIFIED I C SIGNATURE ` OF PERM ITTE FINAL ®� ALIDATION ROBERT A WOOD rs ■ 0 DARN SUPERVISING MECHANICAL ENO R LALo 9 5 2 0 Ftut 13 5 D 600 WORKERS COI have COMPENSATIONDECLARATION of ATION ..'.17 APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self c¢9n la ea) �• insure or a certificate of Workers'Compensation Insurance or a certified copy thereof(Sec 3800,Lab ' COUNTY OF LOS ANGELES UlWING AND ET Y /f ` Popsy No Company _ ' - C/ Certified copy Is hereby furnished FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Q ADDRESS / Certified copy+s filed with the county J mg mspectmn NUMBER FIXTURE OR ITEM FEE LOCALITY + -d Itm WATER CLOSET f Date pplmant NEAREST BATH TUB ' CROSS ST CERTIFICATE E EXEMPTION FROM WORKE S COMPENSATION INSU R$.NCE - SHOWER OWNER MAIL (This section need not be completed if the work involved LAVATORY ADDRESS } by the permit is for one hundred dotlm ($100) or less) SINK a CITY TEL NOZ,S/� 0- 70 I certify that m the performance of the work for which this DISHWASHERL) permit IS Issued I shall not employ any person in any manner CONTRACTO /0 / 2 so as to become subject to the Workers:Compensation Laws CLOTHES WASHER ADDRESS 0 Defeo •ApplicantSWIMMING POOL RECEPTOR L) NOTICE TO APPLICANT If after making this Certificate of CITY TEL NO 'Exemption j LAWN SPRINKLER SYSTEM STATE LIC �� Z you should become Subject to the Workers r Compensation provesmns°of the Labor Code, you must forth WATER HEATER ' LICENSE NO CLASS c _ with comply"with such provisions or this permit shell be � ESSED deemed revoked . GAS SYSTEM OUTLETS - DISTRICT NOPRO B LICENSED CONTRACTORS DECLARATION OUTLETS OVER sC3� I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Bus+ FINAL � / —Z''(/_pL VALIDATION ness DATE and Professions Code, and my license +s In full force and t? a effect FINAL Liceense Number Lic Cl.-(' r BY Contractor 1'�Data _ Plan check fee I am ex p ¢ensing requirements as I am e � licensed architect or a registered professional engmeer PLUMBING PERMIT ISSUING FEE$ or acting in my professional capacity (Section 7051 Bus mese and Professions Code) TOTAL FEE V Lie 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 city Tel No _ , ness and Professions Code) ' L'414.1 1 A I as owner of the property am exclusively contracting - I ` with licensed contractors to construct the project # • • S . + (Section 7044, Business and Professions Code) ' � • 1250 CONSTRUCTION LENDING AGENCY + l I hereby affirm that there is a construction lending agency 1 2.S O�cTS for the performance of the work for which this permit is _ _ issued (Sec 3097 Civ C) e 0 — $`2 _ Lender s Name ' Lender's Address + n I certify that 1 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 authorize representatives of this County to enter upon the above mentioned property f r inspection purposes - + Signature of"PArniRtee Date