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Home My Public Portal About5126 PERSIMMON AVE_Plumbing__ 76AG67AsCE 817131-11/76 .APPLICATION FOR PLUMBING PERMIT J ' BUILDING AND SAFETY DIVISION FWATER OR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ' FIXTURE OR ITEM ® FEE ADDRESS 5126 Persimmon CLOSET LOCALITY T&m 1 e City NEAREST TUB CROSS ST. Freer SHOWER OWNER Diane Davis LAVATORY MAIL ADDRESS 5126 Persimmon 444-4555-x211 SINK CITY Temple City TEL.NO. .441-r,488 DISHWASHER CONTRACTOR E. L. PAYNE COMPANY CLOTHES WASHER ADDRESS 166 W Live Oak Ave n e SWIMMING POOL RECEPTOR ' CITY Arcadia TEL'NO-446-61 18 LAWN SPRINKLER SYSTEM STATE ' LIC. WATER HEATER LICENSE NO. 120228 CLASS C-20 1 GAS SYSTEM 1 OUTLETS 3 00 DISTRICT NO. G UP ZONE �CESSED OUTLETS OVER 5 PER SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD a ZO-8967A � Plan check fee # ° ° ° ° ° 5 PLUMBING PERMIT ISSUING FEE$ 7 00 2 ° 0 1 0.00 TOTAL FEE 10 00 Plan check applicant °'O 01 u o o� APPROVALS DATE INSPE 'TOQ'S IGNAZURE Name UNDER SLAB WORK U . 1 _O Address ROUGH PLUMBING City Tel.-No. GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT THAT THE'ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND.STATE LAWS REGULATING PLUMBING. HOT WATER HEATER I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED.AS PLUMBING FIXTURES REQUIRED BY LOS ANGELES COUNTY STATE OF CALIFORNIA OR THAT I AM THE GAS TEST LEGAL OWNER OF,A D INTEND T ESI E IN THE ABOVE D RIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PER TTEE FINAL PLAN CHECK VALIDAT N CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH Os 7GA667C (CE-8178) -9/75 , APPLICATION FOR ,PLUMBING PERMIT BUILDING D SAFETY DIVISION FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM @ FEE ADDRESS LOCALITY 1, WATER CLOSET 2 J NEAREST BATH TUB CROSS ST. SHOWER OWNER LAVATORY MAIIL er� ^ ADDRESS . SINK CITY CTE jY 0. s� DISHWASHER CONTRACTOR CLOTHES WASHER / j ADDRESS 6�[ 64 SWIMMING POOL RECEPTOR r ` CITY �� TEL. NO. '5 LAWN SPRINKLER SYSTEM STATE LIC f WATER HEATER LICENSE NO. l CLASS / GAS SYSTEM OUTLETS DISTRICT NO. GROUP ZONE CESSED BY CD G� CD OUTLETS OVER , J _ 6 ��- ' L 5 PER SYSTEM INDUSTRIAL. - WASTE APPROVAL O/I OBJ INSPECTION RECORD Z I Plan check fee PLUMBING PERMIT ISSUING FEE $ � TOTAL FEE Z Plan check applicant Name APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK Address ROUGH PLUMBING City Tel. No./,q.2� 2 GAS PIPING 1 HER BY ACKNOWLEDGE TH RAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE I 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 I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED SIGNATU RE ' /p A OF PERMITTE FINAL R-Rd nly � Tr PLAN CHECK VALIDATIO CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 5.7 7 ti06T . 7 ;5 D',' 2 2.5 0t3 pia " 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 DISTRICT O. GROUP I ZONEc PLUMBER READY FOR PiUmBINORECEIVED BY DATE ISSUED a FIRST INSPECTION / a ADDRESS i 9 CITY ROSEM TEL No. ADDRE89 4 I {I COUNTY LICENSE NO. 93M EXPIRES LOCALITY !� NEAREST PERMIT FEES CR089 ST. NUMBER TYPE OF FIXTURE OR ITEM FEE • OWNER MAIL WATER CLOSET(TOILET) Q 0.50 $ 1 ADDRESS BATH TUB a 0.50 CITY TEL. No. SHOWER Q 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THISN LAVATORY (WASH BASIN) Q 0.50 APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREETO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN BINK 0 0.50 AND STATE LAW13 REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY Q 0.50 ANGELES COUNTY LICENSE, OR I AM THE -LEGAL OW ER OF THE RESIDENTIAL PROPERTY DESCRIBED ABUV GAS SYSTEM_ OUTLETS a 0.50 i o WATER HEATER 0.50 SIGNPE MRITTEF SLOP BINK @ O.BD INSPECTION RECORD FLOOR BINK ® O.BO FLOOR DRAIN 0.60 — DISHWASHER 0.50 DRINKING FOUNTAIN 0.50 URINAL ® 0.50 Q HOUSE SEWER 0.90 Z MISCELLANEOUS 5 O APPROVALS DA yE IN9PECTOR•9 NAME ROUGH PLUMBING �p •G� GAB PIPING I GAS VENT CESSPOOL 1.00 CESSPOOL SEPTIC TANK? j SEPTIC TANK DRAIN ( ) PIT ( ) 1.OD i SEWER PERMIT 1.00 I GAS TEST I UTILITY CO.NOTIFIED TOTAL FEE FINAL Y 76A667 DBS$ 17 6-5E COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING Bic SAFETY WILLIAM J. FOX, County Engineer PLUMBING 1 PERMIT NI3. FOR APPLICANT TO FILL IN STR NO. IZO P ONE PLUMBER VALLEY BOULEVARD PLUMBING CO. RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS 8300 EAST VALLEY BLVD. CITY ROSEMEAD AT. 2-2719 TEL No. ADDRESS=-_0 COUNTY LOCALITY 1! LICENSE NO. 93� TEXPIRES 6-30- NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE ON ITEM FEE OWNER MAIL WATER CLOSET(TOILET) 0.50 91 ADDRESS BATHTUB 0.50 CITY TEL No. SHOWER O.5o I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) Q 0.50 APPLICATION AND STATE THAT THE. ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK ® 0.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID Log LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER GA9 SYSTEM —OUTLETS 8 0.50 OF THE RESIDENTIAL PROPERTY DESCRIBED OVE. WATER HEATER 0 0ATURE F.50 BIGNPERMITTE ° � '! 2''`� GLOP SINK 0.50 INSPECTION RECORD FLOOR BINK (III O.BO - FLOOR DRAIN 0 17.50 DISHWASHER 0 O:SO DRINKING FOUNTAIN 0 0.50 URINAL 0 13.313 Q HOUSE SEWER 0 0.50 Z MIBCELL4kNEOUS @4 M z Ir0 APPROVdS DATE, INGPEwrowssAAME ROUGH PLUMBING ^ GAB PIPING GAS VENT CEBSPOOL 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) 1.00 SEWER PERMIT . GAS TEST • UTILITY CO.NOTIFIED TOTAL FEE FINAL "f1�^.s'C.✓.�4� CC/� �� 76A667 DBS#27 6-58 - WORKERS'COMPENSATION DECLARATION6A at7p +: APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a' certificate of consent to self ce at7(z-eo) insure,or a certificate.of Workers'Compensation Insurance,or .� a certified copy thereof(Sec.3800,Lab.C.) dr�„ _ I COUNTY OF LOS ANGELES � ' ' BUILDING AND SAFETY Policy N&JC J5_4__ pany MT�STnN TNS Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ® Certified 5126 N. PERSIMMON �d copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE Date1f ue h1 Applicant PATTY KERRY WATER CLOSET LocALITYI'EMPLE CITY NEAREST ZJ CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER ANNE DAVIS (This section need not be completed if the work involved LAVATORY MAIL ADDRESS EL by the permit is for one hundred dollars ($100) or less.) SINK0 clTv►I'EMPLE CITY TEL.NO. 443-548 I certify that in the performance of the work for which this DISHWASHER permit is issued, I shall not employ any person in any manner CONTRACTOR SWAN POOLS OO so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER ADORES§61 N AZUSA AVE. U Date Applicant SWIMMING POOL RECEPTOR d NOTICE TO APPLICANT: If, after making this Certificate of CITY COVINA TEL.N0966-863 to Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. Compensation provisions of the Labor Code,you must forth- LICENSE NO. 254846 CLASS C-53 with comply with such provisions or this permit shall be WATER HEATER deemed revoked. 1 GAS SYSTEM OUTLETS DISTRICT NO. P OCESSED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER ��d I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL / —� ness and Professions Code, and my license is in full force and 1 POOL PIPING S DATE VALIDATION effect. License Number 2534846 Lic.Class r-51 FINAL BY Contractor cu7nrT 120 _c Date 4/30/81 I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE 1131 Lic,or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name z 508.0A I hereby affirm that I am exempt from the Contractor's Address + License Law for the followingreason Section 7031.5, Busi- o o o 0 o 5 ( City Tel.No. ness and Professions Code): 2 0 0 1 3.00 ElI, as owner of the property, am exclusively contracting with licensed contractors to construct the project 0 0 0 1 3.0 C^,3: (Section 7044,Business and Professions Code). CJ 05,04-81 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 Nam es'ASH Lender's Address CASH 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 authorize repre entatives of this County to enter upon the above- ti me property for inspection purposes. 7 6 Signature of Permittel.^ Date