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Home My Public Portal About6157 RENO AVE_Plumbing__ 76A667 -CL'81,T 5/ip APOL.ICATION FOR PLUMBING PERMi COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGDnM WILDING AND SAFETY DIVISION nnnRDESS 1r� [ v . JOHN A.LAMBIE. COUNTY ENGINEER ,,�j COLEMAN W.1 JKNKINS. SUPT. OF BUILDING Locum '7r /e G. ><q FOR APPLICANT TO FILL IN PR NT OR TYPE NEAREST •�✓ GROSS ST. +G. NUMBER FIXTURE OR.ITEM EACH FEE OWNER WATER CLOSET 1.. 0 BATH TUB 1. d ADDRESS • A1911110 AAE SHOWER 1. 0 CITY TEL"NO.: I R LAVATORY 1. 0 CONTRACTOR SINK 1. 0 ADDRESS DISHWASHER 1. ,0 CITY TEL. NO. CLOTHES WASHER 1. 0 STATE LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR 1. 0 DICT ivLQ T 7!F_ PRO04 BY LAWN SPRINKLER SYSTEM 2.10 WATER HEATER 1: 0INDUSTRIAL 101 r APPROVAL GAS SYSTEM OUTLETS 1. 0 INSPECTION RECORD OUTLETS OVER .30 5 PER SYSTEM ta z Plaxi cheek fee 25%of above. See reverse. PLUMBING PERMIT ISSUING FEE.$ 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City. Tel. No. HOT WATER HEATER 1HEREBY ACKNOWLEDGE THAT t HAVE READ THIS APPLI'CAtON AND STATE THAT THE. ABOVE IS CORRECT-AND AGREE TO•COMPLY PLUMEIMQ FIXTUPI,ES -WITH ALI, COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. - [ 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 D SCRIBED RESIDENTIAL PROPERTY. FINAL �.v� �►" SIGNATURE .JACK R.ALLEN, SUP RVISING MECHANI L ENG OF PERMITTE PERMIT VALIDATION C K. M.O C ASH PLAN CHECK VALIDATION CK. M.O. CASH 7 4 1C-_' JLIL30 D - . 1525- i AWMIM +wj . ,' is Rs'COMPENSATION DECLARATION APPLICATION FOR P�IJMBING PERMIT I•-hrtreby'affirm that I have a certificate of consent to self' �I 76A667A irr�e, oi (t certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) .� r a cet*#(ed copy thereof(Sec. 31300, Lab. C.) { COUNTY OF LOS:ANGELES,. l i / BUILDING AND SAFETY Policy'No. Compan ❑ y Certified copy is hereby furnished. BUILDING Certified copy is filed with the county building inspec- FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS tion department. I NUMBER FIXTURE OR ITEM @ •FEE �y � LOCALITY Date Appligant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE i OWNER (This sectionneed not he completed if the work.involvedby SHOWER The permit is for one hundred.dollars($100)or less.) LAVATORY MAIL ADDRESS ArAdo oeia&ll I certify that in the performance bf the work for which this SINK CITY TEL.NO: permit is issued, I shall,not employ any person in any manner •ONTR ,.. so as to become subject to the Workers'.Compensation Laws. DISH%kASHER. CONTRACTOR Date pplicant. CLOTHES WASHER ADDRESS NOTI TCI_ AP I NT: If; after.making'this Certificate-of \* Exemptio you. should become subject to the Workers' '•I SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth= ' CITY TEE;;NO. LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be. STATE _ _- ,U&- deemed revoked. WATER HEATER LICENSE NO.: CLASS LICENSED-CONTRACTORS DECLARATION DISTRICT NO. OCESSE[Z BY I hereby'affirm that I am licensed-under provisions of•Chapter 9 ' GAS SYSTEM OUTLETS (commencing with.Section 7000)of Division.3 of the Business.' OUTLETS OVER and Professions Code,and my license is in'full force and effect. i 5 PER SYSTEM FINAL =.j DATE VALIDATION 0 License Number Lic. Class II 09 FINAL ®: Contractor Date BY k ❑ I am exempt under Sec. ' 1 ` B.BP.C.. for this reason i 'Platt Check fee Date: �I T, Signature PLUMBING PERMIT ISSUING FEE$ Q• C7 �/ V i( TOTAL FEE _ ` Plan check applrcant. r yt 14 t • SINGLE FAMILY { ` '% r• o o` o o F HOME OWNER-BUILDER DECLARATION Name , I hereby affirm.that I am exempt from the Contractor's License 1i ` 2 0• Law for the following reason (Section 7031.5, Business and ! Address L'o 0 Professions.Code): City,, Tel, No. 00 i E Q El 1, as.owner of the.property, will do the work and the 9n �' _�'l� structure is riot intended or offered for sale (Section �' 7044, Business and Professions Codo). CONSTRUCTIOWLENDING AGENCY I hereby affirm thatthere-is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ'.'C.). Lenders 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 ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection pur oses. JA SEE REVERSE FOR EXPLANATORY LANGUAGE. ignature of erm` ee Dat. ! y WORKERS'COMPENSATION DECLARATION ' APPLICATION FOR PLUMBING PERMIT hereby affirm that I have a certificate of consear.to self - 76A667q ;nsure, or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) ' ? or a certified copy thereof(Sec. 3800, Lab. C.) q' COUNTY OF LOS ANGELES / - BUILDING AND SAFETY acyNo�FIP827693COmPany Freemont Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS 6157 Reno Certified copy is filed with the county building inspec- NUMBER FIXTURE OR ITEM @ FEE tion department. LOCALITY Temple City Date — Appligant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WBATH TUB CROSS ST. '- COMPENSATION INSURANC KE SHOWER OWNER Willard Bauman (This section need not be completed if the work Involved by MAIL the permit Is for ono hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Thompson ' s Pool Plumb . Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of 1332 N . Miller Exemption,. you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY TEL. NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM Anaheim38-2710 with comply with such provisions or this permit shall be STATE '200803 83 080 LIC. C 4 4 deemed revoked. WATER HEATER LICENSE NO. 7 CLASS, LICENSED CONTRACTORS DECLARATION DISTRICT NO. P CESSED BY I hereby affirm that I am licensed underprovisions of Chapter 9 GAS SYSTEM OUTLETS. �/ (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER e and Professions Code,and m license is in full force and effect. 5 PER SYSTEM IL my VALIDATION IL License Number 289803 Lic. Class C 4 4 40 1 olar Domestic S Ste ,26 FINAL Im Contractor Thompson Po�lte 9-25-84 BY a ❑ I am exempt under Sec.. F 0 9 7.5 A B.&P.C. for this reason to Plan check fee ► o o c o 0 5 Date: PLUMBING PERMIT ISSUING FEE$ 5 0 1 0 o j a 5 0 Signature TOTAL FEE 5'C) o 0 0 3 a 5 C v Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name IG29-84 1 hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and Professions Code): City Tei. No.. ❑ 1, 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, 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 ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioroperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Per ttee Date