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Home My Public Portal About5108 PERSIMMON AVE_Plumbing__ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer PLUMBING 1 FOR APPLICANT TO FILL IN STRI: _` O. GROUP I ZONEPERMIT NP. 15'X/ PLUMB OULEVARD PLUMBING CO. REC 1. EED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS TVALLEY BLVD. ?1'I.. �' 7 ��✓ CITY sEMnEAD TEL.No. AT. 2-279 ADDRESSCOUNTY (BUILDING f-/oOar LICENSE NO. 93M EXPIRES 6-130- LOCALITY 4 NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER `II MAIL WATER CLOSET(TOILET) a 0.50 61 ADDRESS BATHTUB a 0.50 CITY TEL. Na. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN BINK 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE-LEGAL OWNER GAS SYSTEM OUTLETS @ 0.50 OF THE RESIDENTIAL PROPERTY DESCRIIIBB / ABOVE. WATER HEATER0.50 SIGNATURE OF TE SLOP SINK S 0.513 INSPECTION RECORD FLOOR BINK 511 0.50 FLOOR DRAIN 0 0.50 DISHWASHER a 0.90 DRINKING FOUNTAIN ® 0.50 URINAL 0.50 J a HOUSE SEWER @ 0.90 Z_ M19 ELLAN O S M Ir O APPROV S TE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL 1.00 CESSPOOL SEPTIC TANK. SEPTIC TANK DRAIN ( ) PIT ( ) 1.00 SEWER PERMIT . 1.1313 GAS TEST TOTAL FEE $ ® VA UTILITY CO.NOTIFIED FINAL .--ed", 7GA667 DBS#17 6-52 Ic/ 76A667.0 E#81 7 10-62 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING 4 JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST_ e P NUMBER FIXTURE OR ITEM EACH FEE. OWNER WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDAES. SHOWER 1.25 CITY T . NO. LAVATORY 1.25 CONTRACTOR SINS 1.25 ADDRES 45�;t� DISHWASHER 1.25 C TEL. 140. LAUNDRY TUB 1.25 COIrSTATE EGIS RATIO N N0. Cl(Q / COUNTY ❑ CLOTHES WASHER 1.25 DISTRICT NO. GROUP Z E P ESSED BY WATER HEATER 1.50 S7 0 O� 2_ f --GAS SYSTEM OUTLETS 1.50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .90 INSPECTION RECORD _ W H APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT S 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL.FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE D RIBED R SIDE oPERTr. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEE r FINAL 1Z.-I Am&wJ�bC+m" CCK. M.ATION ROBERT A.WOOD ki /K• M.O. CASH SUPERVISING MECHANICAL ENG'R LAAO 3 4 1 5 1 SEP 1 5 D 3.5 0!_ COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY PLUMBING WILLIAM J. FOX, County Engineer DISFOR APPLICANT TO FILL IN TR NO. R P O ^I, j� 7•- PLUMBER VALLEY B0111 EVARD P1 I IMBINQ Ca RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS BUILDING CITY ROSEMEAD TEL.No. ADDRESS LICENSE IENE NO. 93M EXPIRES LOCALITY tell / NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) Q 0.50 0 ADDRESS BATHTUB Q 0.50 CITY TEL No. SHOWER a 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY 0.50 ANGELES COUNTY LICENBE, OR I AM THE LEGAL OWNER GABSYSTEM_ OUTLETS 0.50 Or THE RESIDENTIA PROPERTY DESCRIBED OVE. WATER HEATER ® 0.50 BIGlIPERMIITEOATURE F SLOP BINK 0 13.613 INSPECTION RECORD FLOOR SINK 0 0.50 FLOOR DRAIN 0 0.50 DISHWASHER 0 0.50 DRINKING FOUNTAIN Q 0.50 URINAL 0.50 J Q HOUBE SEWER 0.50 _Z MISCELLANEOUS 3 0 APPROVALS DATE INSPECTOR'S NAME • ROUGH PLUMBING GA5 PIPING GAS VENT CESSPOOL Q 1.00 CESSPOOL SEPTIC TANK. SEPTIC TANK DRAIN ( ) PIT ( ) 1.00 SEWER PERMIT • 1.013 GAS TEST� �j �s UTILITY CO.NOTIFIED C /.' TOTAL FEE FINAL ` V 76A667 D118#17 6-52 WORKER'S I have a coSATION DECLARATION �8PB67A eft APPLICATION FOR PLUM ING PERMIT Ll I hereby affirm that I have a certificate.pf conaegt to self Insure, �, e6RKS or a certificate of Worker's Compensation Insurance, or a certified copy thereof(Sec.3800 Lab.C.) COUNTY OF LOS ANGELES IPT.OF PUBLIC DEPT.OF-PUBLIC WORKS DIV. Policy No. Company dertified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ❑ Certified copy is filed with the codnty building Inspection ADDRESS. department. NUMBER FIXTURE OR ITEM G FEE LOCALITY Date.. Applicant WATER CLOSET RESTNEA CERTIFICATE OF EXEMPTIONBATH TUB.FROM WORKERS' CROSS ST. 5�-e CO SESSOR COMPENSATION INSURANCE AS - (This section need not be completed if the work Involved by the SHOWER MAP BOOK PAGE PARCEL permit Is for one hundred dollars($1'00)or less.) OWNER I certify that in the performance of'the work for which this permit LAVATORY V2/ �IJU�/�/�f /Z1W/3/f Is issued, I shall not employ any person in any manner so as toSINK ADDRESS become su ject to .he WorkersComp ion L s. � aa DISWASHER CITY TEL.NQ7 Datg� Applicant CLOTH 1 NOTICE TO APPLICANT: If, aft making this Certificate of CONTRACTOR Exemption,you should become sub)eat to the Workers'Compensation SWIMMING POOL RECEPTORADDRESS provisions of the Labor Code,you must forthwith comply with such y0 provisions,or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM' LICENSED CONTRACTORS DECLARATION WATER HEATER CITY dee ` TEL.N � a I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business and STAGAS SYSTEM OUTLETS LICENSE SE NO.w��G 0/ CLCASS CJ W V Professions Code,and my license-Is In full force and effect. OUTLETS OVER DISTRICT NO. PROCESSED BY O /- 5 PER SYSTEM License Number Lie.Class ( V FDATE INAL r VALIDATION a Contractor Data - (A ❑ I am exempt Under.See. BYZ :ALU41 B.&P.C.for this reason ) Date: Plan check fee ► ✓ q Signature PLUMBING PERMIT ISSUING FEE$ TOTAL FEE ,I SINGLE FAMILY Plan.check applicant 'I �, � , HOME OWNER-BUILDER DECLARATION Name •C��*To? I hereby affirm that I am exempt from the Contractor's License Law ) ,;,�j),g . 41.85 for the following reason (Section 7031.5, Business and Professions I Address ITEMS � Code): ' City Tel.No. ;s TOTAL 41 o ❑ I,as owner of the property,will do the work and the structure ; 85 is not Intended or offered for sale(Section 7044, Business CHECK 41.85 and Professions Code). CHANGE 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.3997, 00I0-0001 7/29/9,4 Civ:C.) 6299 1 M122-41 Lender's Name Lender's Address I certify that I have read this application and state that the above I information is correct. I agree to comply with all County ordinances .� and State laws regulating Plumbing, and hereby authorize representatives of thi Coun .to enter upon the a ove-m ntioned propert e S. SEE REVERSE FOR EXPLANATORY LANGUAGE ' .qICA&U& of Permittee Da WGRKERV COIF OENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT ' iere ,N ffirm°'.that I have a:Certificate of consent •to self 76A667A ins�a'♦ertificute of Workers'Compensation Insurance; CE 817(REV. 10/81) n,6rw;cersiified copy thereof(Sed. 3800, Lab. C.) i� COUNTY OF LOS ANGELES BUILDING AND SAFETY 00 C s ` dt e �Cy No.�,:tG.�., Conipany_3� ;KJJ4 Certified copy is hereby.furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING �e ❑ Certified copy is filed with the county building inspec- ADDRESS f d Y e A tionpart ent. ENUMBER FIXTURE OR ITEM 40 FEE ` n ,LOCALITY vkmkh. (IM Date 7Applicant - J0% 4? t� WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST.. COMPENSATION INSURANCE: OWNER SHOWER r 3C-N/4 !'w OI (This section need not be completed if the work Involved by MAIL e� the permit is for.one hundred dollars($100)or less.) LAVATORY -v ADDRESS I certify that in the performance of the work for which. this permit is issued;I-shall not employ,any person in any manner SINK CITY -re-.,ft Z G TEL NO. so as to become.subject to the Workers'Compensation Laws.. DISHWASHER. CONTRACTOR 4F ' Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS - �a� Exemption,, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the.Labor Code, you must forth- CITY TELN LAWN SPRINKLER SYSTEM m ! A y �� with comply with such provisions or this permit shall .be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. , CLASS LICENSED CONTRACTORS DECLARATION DISTRI,N0 ROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS ✓C (commencing with Section 7000)-of Division 3 of the BusinessOUTLETS OVER IL and Professions Code,and my license isin full force and effect. 5 PER SYSTEM FINAL •� � ' DATE `' � VALID I.ON OrJ License Number?`77 F Lic. Class CC ��pp _ IN O ContractorATR eA'Af• .Date r � B I am exempt under Sec. � B,BP.C. for this reason ►Plan'check fee ;!3027-A'Date: PLUMBING PERMIT ISSUING FEE$ Signature # 0 0 0 0 0 5 TOTAL FEE ' Plan check applicant 1 ° 03450 SINGLE FAMILY - 0 0 0 3 4 5 v HOME OWNER-BUILDER DECLARATION Name p 0 9 2 7'i 8 5 1 hereby affirm that)am exempt from the Contractor's License Address Low 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 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, C•iv. C.). Lender's Name + Lender's Address I certify that I. have.read this application and statethat the Pooabove 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 a mentioned pr rty for inspection,purposes: SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of Permittee DatO