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Home My Public Portal About4959 ROBINHOOD AVE_Plumbing__ 76A 667,(G E-817)-8-71 a APPLICATION FOR PLUMBING-PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISIONBUILDING ADDRESS U959 Robinhood LOCALITY Temple City FOR APPLICANT TO FILL IN (PRINT OR TYPE) 4 NEAREST NUMBER FIXTURE OR ITEM @ 5 FEE: CROSS ST. WATER CLOSET 1.75 0 OWNER Milton - BATH TUB 1.75 � Ey ADDRESS 20 Birchcraft SHOWER 1.75 j' CITY Arcadia TEL. N0. "6-1658 LAVATORY 1.75 /D CONTRACTOROwen Bros. Plumbing Inc. SINK 1.75 ADDRESS h265North Baldwin Avenue f DISHWASHER 1.75 7 CITY El Monte TEL. NO. 443-0078 CLOTHES WASHER 1.75 �Jl STATEr�r'-q LIC 41 LICENSE N0.231 CLASS C36 SWIMMING POOL RECEPTOR 1.75 DISTRICT NO. GROZONE ROCES Y LAWN SPRINKLER SYSTEM 1..75 ` d WATER HEATER 1.75 ?J INDUSTRIACLJ WASTE APPROVAL GAS SYSTEM OUTLETS 1.760 INSPECTION RECORD (� OUTLETS OVER ' 30 5 PER SYSTEM P 0 In 96 H z Plan check fee See reverse. PLUMBING PERMIT ISSUING FEE $ 3 X00• TOTAL FEED ✓ APPROVALS PATE SPECTOWP 9IGNATURE Plan check applicant UNDER SLAB WORK W7 1 Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO -COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 0,9 PLUMBING. GAS TEST 13 A I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/ORUTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE S ED RESIDENTIAL PROPERTY. FINAL SIGNATURE OF PERMITTEE PERMIT VALIDAT r CK. M.O. CASH PLAN CHECK VALIDATION CK. M.0. CASH ij'� 0 1 5 573 M 22 5 D 2 0,5 0, 14667 (CRE-817)-8-71 APPLICATION FOR PUMBING• PERMIT {� z - LJ COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADDRESSihood LOCALITY Temple City FOR APPLICANT TO FILL IN (PRINT OR.TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 1.75 OWNER Milton Bade BATH TUB 1:75 ADDRESS 20 Birchcraft SHOWER 1.75 CITY Argadia. TEL. NO. LAVATORY 1.75 CONTRACTOR SINK •1.76 ADDRESS 1265 North Baldwin Avenue DISHWASHER 1.75 CITY El Monte TEL.'NO. —0078 CLOTHES WASHER 1.75 STATE LIC LICENSE NO. 211 CLASS C. 6 SWIMMING POOL RECEPTOR 1.75 DISTRICT NO. GROUP ZONE PROCESSED BY LAWN SPRINKLER SYSTEM 1.75 16r,69 6 IA-1 r � WATER HEATER 1.75 INDUSTRIAL WASTE APPROVAL 0 GAS SYSTEM r OUTLETS 1.75 INSPECTION RECORD V OUTLETS OVER 30 ®_ 5 PER SYSTEM F. ' W �1. m Plan check fee See reverse. PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING ,City Tel. No. GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ 'THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED Cp LICENSED AS R.0U IRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DEP01BEFESIDENTIAL PRO RTY. FINAL SIGNATURE - OF PERMITTE PERMIT VALIDATION 0-... CASH PLAN CHECK VALIDATION C-K. M.O. CASH 0 1 7 673 MAR 23 5 D4;75N 76A867 (CE-817)-4/72. APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING ADDRESS HARVEY T. BRAND.T, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN.(PRINT OR.TYPE) NEAREST NUMBER FIXTURE OR ITEM @ FEE CROSS ST. WATER CLOSET 1.75 OWNER MAIL BATH TUB T.75 ADDRESS SHOWER 1,75 CITY TEL. NO. LAVATORY 1.75 CONTRACTOR;", �' SINK 1.75 ADDRESS 00 O DISHWASHER 1.75f TEL. NO. CLOTHES WASHER 1.75 E LIC A NSE NO. �� CLASS G�..'��rD SWIMMING POOL RECEPTOR 1.75 ISTRICT NO. GR.O.UP E PR ESSED Y LAWN SPRINKLER SYSTEM 1.75 ( ` WATER HEATER 1.75 IN E 'PPROVAL o� GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD C7 OUTLETS OVER. 80 p� 5 PER SYSTEM W 0- COD Plan check flee See Reverse PLUMBING PERMIT ISSUING FEE $ a 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI�CATION HOT WATER HEATER AND STATE THAT THE ABOVE Is CORRECT. AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. I HEREBY CERTIFY THAT 1 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 —17 RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL SIGNATU RE OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH { AP,. 3 2 2 1 73 SEP 17 5 D 4.7 5 d 1 WORKERS'COMPENSATION DECLARATION I APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I have a certificate of consent to self in- :20-0026 DPW 4/90 sure,or certificate of Workers'Compensation Insurance,or a i 76A667A certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company ❑ Certified copy is hereby furnished. BUILDING Q' /' a FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS / /`�• (��J�'f�oc9 Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM FEE department. LOCALITY Ddte Applicant WATER CLOSET(TOILET) NEAREST / G�• CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE OWNER 5 SHOWER � (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK CITY TEL. NO.yyY��p mit is issued, I shall not employ any person in any manner so as to become sub' ct to the Workers'Compens tion Laws. DISHWASHER CONTRACTOR Date � Applicant CLOTHES WASHER f NOTIC TO APPLICANT: If, after ma ng this Certificate of Ex- ADDRESS em tion,you should become subject to the Workers'Com en- SWIMMING POOL RECEPTOR �`� q't7f/�?6 P Y I P CITY TEL.N sation provisions of the Lah•3r Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS /�/ ly with such provisions or this permit shall be deemed revok- STATE /p�� ed. A7ER HEATER LICENSE NO. 46f CLASS CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY 1 hereby affirm that I am licensed under provisions of Chapter TEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER O and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION `� y. fect. f��A HOSE BIB DATE a License Number'"` � Lic. Class v i // f BY 0 V Contractor Date! J BY I am exempt under Sec. 5 V B.&P.C. for this reason .��+J f f ut• .e W Plan check fee ► �.� �f _ a Date: / 37 '. 41.,ZA PLUMBING PERMIT ISSUING FEE$ (O ITEMS iL.tR Signature TOTAL FEE UZ SINGLE FAMILY ?0TH-H-L g• 1 ® 85 HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and CHANGE �llll Professions Code): Address I, as owner of the property, will do the work and the City Tel. No. t.,.__._t)s F; _ structure is not intended or offered for sale(Section 7044, c1D0 1 =_IJ 1 i 1/ k`-/ 4 Business and Professions Code). ► 774-7AM 11.=2.2=y 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 appJication 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 rope t for inspection purp ses."V l f SEE REVERSE FOR EXPLANATORY LANGUAGE Signa& r bf Permittee Efate