HomeMy Public PortalAbout5423 ROBINHOOD AVE_Plumbing__ r
78AMU-CM7-11 7
APPLICATION FOR -PLUMBING PERMIT 1 '
OOUHfY OF LOS ANGSI•ES
DUA "cm OF COUNTY ENGacmH
BUIMING AND SAFETT DIVISION BULLDEKG
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CASEATr D. �FIIfpt ad bc>i"d>aq LbCALIZ
FOR APPLICANT TO FILL IN
7NUbILBMRFIXTvr&m momURE OR ITHMowmm
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PERMIT ; 00 ROUGH PLUMPING
TOTAL FZE 1, do GAB PIPING
I NEREBT ACY11QIFLEDGE 7/{T I HAVIS READ Ajrl. C TIOR "`B VENT
AND ST TE THAT THE AB01�E fd CORRECT AND AGRRE t0 CO[P1T HOT WvkTHR HI*ATSR
WITH ALL COURTT OPDINAACES AND $'PATE LAWS REGULATIRG
PLU[BIRG, PLUMBING RIXTURI<§
I HILUM CERTIFT THAT 1 AN PR P®tLT REGISTERED AND/OR GAB TEST
LICENSED AS REQUIRED BT LO ANGELES CQURTT MD STATE OF
CALIFORMIA OR THAT I A7 Q LEGAL 0 KEQ QF THE ABOVE U-nLITY CO.NOTIFIED
DESCRIBRD RESIDFJffIAL PROT)
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ROBERTA.WOOD.
(P' VAI,IIIATIOA SUPERVTSING MKgHANICAL.ENGA
aa. ■.o. Can
M7069.9 NOV 28 5 A 12.00 �
- -CDB17I?.,,% TEMPLE CITY
APPLICATION FOR PLUMBING PERMIT �
- UUMDING
CO OF �.QSANIG�a-
DG Exw r ADDEM o Q 1 N
W AIS sENS"i, Suri OF BUILMING y
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FOR APPIJCJ M FIFILL IN C ++.
NUM19HR FUCTIJRE OR TT¢( OWI b
WAS CLOSET
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CLOS WAIN= DISTRICT NO ca ZONE BY
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PERMIT ; Y 00 UNDEIR 8L.1B WORK
TOTAL FEEROUGH TL BUNG
1/01_ 11LI OAS PIPING
Alm STAR TQ�/l11H.� ADOYA Ilt COSSICi AlD 1�iR1�1b COITLT GAS VENT
LITH ALL CODITT dRDIWCit AID STAT[ LAWS MULATING HOT WATHR HRAT'KR
Llr
CWn FT THAT I AN PROP<SLT IM AND/OR PLUMBING FIXTI7RMS
M QIQOIM EY LOS A99XLU OWN" AND .STATK OF
! THAT I THI LLW OWM OF THIS ADM G"TENT -
U CO. FIICD
$ �I
F I NAL
0 VA=ATlQROBERT A. W' 06D,
G=. 1.0. a►a SUPEInnSING MECHANICAL ENQ•IZ
1 -2 2 -0 An 3 5 D 6.00
- -M17 12,59 TEMPLE CITY
APPLICATION FOR PLUMBING PERMIT
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L{>CALITT �
FOR APPLICANT TO FILL IN XTARINr
canes sr. 1.
NUM91iR FIXTURE OR ITZW Owls
46
WATER CL01=
BAS TUB RM 3 �► •
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C= �, a TEL NO. Gi/ 6 3 2 0
LAVATOSir cmwLcro
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LAUNDRT Tim SEa TIOA N0. COUNFT El
CLOS WABB319 MaTFUCT 140. ZQN1% DY
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WAM APPROVAL
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APPROVALo DATE I1IEPECTOR'II dIOHATURa
PERMIT ; 2100 UTIDSR B-A5 WORK
TOTAL FEE &J=3 RouGH PLUMBING
I HUASY AC1<AORIK091 YH;T I HAY[ FT
READ THIS ALICAn01 awl plPiNfi
AAD STAT= THAT THE ADOY1 11 CORRECT AHD.A TO COIFLY GAB VL14T
WITH ALL 0DUaTf OSDIIAICES AND STATE LAWSREWLATISS HOT WATIDt HLA'I'SFt
FLUIDI�f
I HKRM CIRnFT THAT I AN PE9fQLY RLOUTt m AIDJOS PLU11EINO FIXTURES
LCIAGLStFUOL�p�AAf RagT[�1num � LOSAM �AI�S OITT AAD STATL OF QAg TES[
DIzCRISm DitT1AL FNDIfRTf.�" Of TH= ABOVE
um CO.140TIFPIKD
41A FtEJ_a
OF PERMI
FINAL
m� VALIDAIZQN-1 ROBERT A fsto6D,
CS. ■.0. SUFHJtV18INGi M$C]iANiCAL Q4O'R
goss �c13 5 D 3.00
WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING P E RM I T
I hereby affirm that I have a certificate of consent to self 7d4.667A
Insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81)
or a certlfted copy thereof(Sec, 3800, La C.)
Policy / 0 0 —,,f 4&
COUNTY OF LOS ANGELES BUI G AND SAF
icy No. Company
Certified copy.is hereby furnished.
`�--� FOR APPL1E.vJT TO RLL IN(PRINT 04Z TYPE). BU IUN NG
�a 3
�4 Certtfibd copy Is filed with the county build nspecADDRESS
-
WWW tion department. NUMBER FIXTURE OR ITEM O FEE LOCALITY
Date ApplIgant WATER CLOSET NEAREST
CERTIFICATE OF D(EMPTION WORKERS' BATH TUB CROSS ST..
COMPENSATION INSURANCE SHOWER OWNiER
(This section need not be completed If the work 11 robed by MOUL
the permH V for one hundred dollars (:100)or less.) LAVATORY ADDRESS 7
I certify that In the performance of the work for which this
S D T9 �,_ p�
permit Is Issued, I shall not employ any Person In any manner
to as to become subject to the Workers Compensatlon Laws. DISHWASHiR
CONTRACTOR
Date A-11cant ¢OTHES WA -IER ADDRESS
NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEFIOR
O -
Exemption, you should become subject to the Workers' Crry TEL NO
Compensation provisions of the Labor Codd, you must forth- LAWN SPRINKLER SYSTEM
with comply with such provisions or this permit shall be STS tJ0 LlU
deemed revoked. 1NAT92 FEATERCLASS
LICENSED CONTRACTORS DECLARATION DISTRICT BY
I hereby affirm that I am licensed under provislons of Chapter 9 GAS SYSTEM
(commencing with Section 7000) of Division 3 of the Buslnea OUTLETS
and Professlora Code,and my license is in full force and affect. 5 PER SYSTEM FINAL
� VALIDATION
DATE v
License Num lc. Class_L — r C, ad
FINAL ..� O
Contractor Datavw�wBY a
❑ I am axe W
d
B.BP.C. for this reason
Plan check feQ
Date. PLUMBING PERMIT ISSUING FEE; (�
S 19 Hato r
TOTAL FEE
Plan check applicant
SINGLE FAMILY
IiOME OWNER-BUILDER DECLARATION Name 0 2 Q 5 A
I hereby affirm that I am exempt from the Contractors License
Low for the following reaxod t5ectlon 70131.5, Business and Address # o 0 0'0 o 5
Professlpns Code): City Tel.No. )❑ -.- 34,50
I, as owner of the property, will do the work and the
structure Is not Intended or offered fpr sale (Section , 10.0'0 3 Q,5 0 2
7044, Business and Professions Code},
CONSTRUCTION LENDING AGENCY .0304-83
1 hereby affirm that there Is a cornstructloR lending agency for
the performance of the work for which this permit Is Issued
(Sec. 3097, CIv. C.
Lenders Name
Lender's Addrou
I certify that I have read this application and state that the N11111.above Informatiod Is Correct. I ogr"to comply with all County
ordinances and State laws regulating Plumbing, and hereby
authorize represof this County to enter upon the
abov�-metloned�fffor In
apectlon purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
51
rmittee