HomeMy Public PortalAbout10666 ROSEGLEN ST_Plumbing__ COUNTY OF LOS ANGEL" APPLICATION FOR PERB T
�t Department of County Engineer
DIVISION OF BUILDING & SAFETY PLUMBING �
WILLIAM J. FOX, CamstY E[/1[
GRaUP ZONE PERMIT NILI.
FOR APPLICANT TO FILL IN . _� / - I /-
PLUMBER VALLEY Rol 11 EVARn pi UMpING Co. ]READY FUR
FIRST INSPECTION DATE ISSUEDADDRESS
ROSEME
■UILDINO
Crnr TEL.No. ADDRE�
COUNTY
.. LOCALITY
N MAR EST
PERMIT YEM CROaM MT.
Ptu w NZA TYPE OF rixTURE O111Tiw EWNER �
MAIL
WATER 13LOaET(TUILYT) 0.60 M ADDRESS
BATH TUB 0-913 CITY TEL No.
SHOWER 0.60 1 HERESY A13KNEWLEDMIL THAT 1 HAVE READ THIS
LAVATORY (WASH MABIN) 0.60 APPLICATION ANO STATE THAT THE AMOVE IS CORRECT
AND ADR[[ TO COMPLY WITH ALL COUNTY ORDINANCES
KITOHFN MINK EL50 AND STATE LAWS REOULATINO PLUMSINO.
1 CERTIFY THAT 1 PDMK= THE ABOVE VALID I OS
LAUNDRY TUB OR TRAY 0.60 ANOELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
OAS HY1TE UTLLTB 0.613 OF THE REMID[NTI PROPERTY DEMCRI■ ABOVE.
■I O NATU RlE OF
WATER HEATER 0.no PERMITTE
SLOP MINK D.Ma INSPECTION RECORD
FLOOR BINK 0.50 ,
FLOOR DRAIN 0.613
DISHWASHER 0.513
DRINKING FOUNTAIN Q 0.513
URINAL 0.60 -J
Q
HOUSE SEWER 0 0.SO Z
M 1 SO M-L.AN E OU■ 0
It
0
APPROVALS
DATE i r �■ wAw[
ROUGH PLUMBING
OAS PIPINS
GAS VENT
13ENSPOOL 1.00 OEMPOOL " f
SEFTIO TANKI SIPTI13 TANK
DRAIN ( ) PIT ) I.no SEWER .f
J
PERMIT 1.00 GAM TTJiFT
TQTAL
UTTI
UTILITY DO.NOFIED
FEE M �5
Fri NAL, w
T&"ST DBS$#1T 8-02
DEPARTMENT OF COUNTY ENGINEER PLUMBING 1
DIVISION OF BUILDING AND SAFETY VS-D PERMIT APPLICATION
` COUNTY OF LOS ANGELES BUILDING
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS
F R APPLIC NT TO FIL N LOCALITY
BUILDING NEAREST
ADDRESS CROSS ST.
DISTRICT NO. GROUP ZONE PERMIT NO.
LOCALITY
NEAREST ` Is
(;ROSS ST. RECEIVED BY Ready for Inspection DATE ISSUED
OWNER
NOW
MAIL INDUSTRIAL
ADDRESS Same WASTE APPROVAL
CITY TEL.NO. INSPECTION RECORD
PLUMBER GENERAL INSTALLATION CO.
ADDRESS 311 E. 80th Street
CITY L.A. 3 TEL.NO. Pleasant 3-2541
C 36-123470 ❑STATE
LICENSE NO. 787 F7 COUNTY J
PERMIT FEES a
z
:1imP.ER TYPE OF FIXTURE OR ITEM FEE U,
WATER CLOSET(TOILET) @ 0.80 $
O
BATH TUB @ 0.80
SHOWER @ 0.80
LAVATORY(WASH BASIN) @ 0.80
KITCHEN SINK @ 0.80
LAUNDRY TUB OR TRAY @ 0.80
SLOP SINK @ 0.80
FLOOR SINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
GAS SYSTEM..............OUTLETS @ 1.00
WATER HEATER @ 1.00
MISCELLANEOUS
WATER SOFTENER 1 co APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE 21 00 GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN-
ER OF THE ABPXE DESCRIBED REAIDENTIAL PROP TY.f UTILITY CO.NOTIFIED
SIGNATURE f
OF PERMIT ------- ----------- - •--- .. .--
FINAL
76A667 DBS 17 1/53
7eAee7-cENe n a-aa
APPLICATION FOR PL MBING_ RMIT
COUNTY OF LOS ANGELES
4EPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION IUIIAI14 7ppllrRose .ell lO y
JOHN A. LAMBIE, COUN-rr ENGINEER ADD
COLEMAN W. JENKINS. SUPT. OF BUILDFNG —
FOR APPLICANT TO FELL IN NEA2a7
CRO"RT.
NUMOER rjigmft OR rrKm [ACH FRE
Owls $
wl�TER CLosEi u Jt3 NAM
RATH ICITY Temple City rm_ NO.
KowaER i m tb
LAVATORY 123 CONTRACTOR
1J13 ADDIM 1vm Be 'Grand
DMHWABIM im CIT!Tbmple city TEL. NO. 44427Q1 QD
STATE LIC
LAUNDRT TUE IJCS LICENSE NO. GLASS
CLOTEOM WAS IJtj DI'TRICT H GROU ZO [ C ■Y
WATER BEATER 1.301 Q
GAS iYETE1[ OIITLLTe Izo MDONTMAL a
WAS[E APPROVAL O
OUTLETS OVER b PER STRTZX .2D BUIP11=0I RECORD U
Dc
O
a
Z
APP"OVALS DATE INsPiC bfus 219NATUIRL
FERMTT i 2 OP UNDER SLAB WORK
ROUGH PLUMBING
TOTAL REE GAS PIPING
1H[RLY ACKNOWL[DQ THAT I NAV[ RSAD THP• APPLICATION GAS PENT
AND STAT[ THAT THR ASOV[ 12 CO RRK T AND AGR1Q TO COMPLY
WITH ALL COUNTY ORDINANCX@ AND STAT= LAWS kKouLAnNO HOT WATER HEATER
PLUMSIIi O.
I 1Gm
HY CIRTIFY THAT 1 AM rRONSRLY RffG1aTRRm AMDIOR PLUMBING fi1XTU-RES
LIC[NR@ AS RKQUIIM WY LOS AMOK- COUNTY AND STAT1 OF
CAUFORNIA OR THAT 1 AM TM LaOAL OWHSR OF,AND INT[lID TO GAB TEST
Salo[ IN,THI ASOY[ I RK;TL PROr[RTY. UTILITY CO,NOTIFIED
SIGNATUR[ /�(/�/
OF rKRm11 a FINAL
�3AIMATION
M_O. GASH 7 3 6 31�-- FM 1 5 D z. 3.5 O'" 7
I _ T -1
r PERMIT
WORKERS'COMPENSATION DECLARATION
er ora1 /"�rPLIM l V
(�N FOR PLUMBING PERM
hfflrm thdt I have a certificate of consent to serf 76A667A
I a certificate of Workers'Compensation Insurance, (:t817(REV. 10/01)
oher
c a certified copy teof'(Sec 3Btl0, Lab.C.) "COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company -
El Certified copy it hereby furhlshed.
Certified.copy I;filed with the con b Ildln�In FOR APPtICAMtO FILL IN(PRINT OR TYPE) BADD�SS 1
tion departmdnt. -NUMBER FIXTURE OR nT,ML Q FEE LOCALITY `
Date_~�LVCAz pllgant WATER CLOSET NEAREST
CERTIFICATE OF EX5MPTION FROM WORKERS' BATH TUB eROSS ST.
GOMPENSAT1OfJ INSURANCE $L+�R OWNER -
(This W k)4 need hot be completed If the wreak In"Nod by
the perrhlit Is foe orfs ftundred dollars j*100),9r Is".) 1,AVATORY MAILESS
I certify that in the pefifocrngnce of the work for which this
permlt It Iqued, I thoilnot employ anyPerron In any manner SINK 7c/' TEL tJO.
sa as To become subrect to the Workers Compensation Laws. DISHWASHER
ooNTRACT4R
Data ______ATpIIcbnt { OTHF$WAStER
NOTICTO A'PPLICA'NT; If, after making this Certtficate of ADDRESS
F
Exemptipn, you should become wblett to the Workers' SWIPOOL �`
Compensation provitipns of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM �W��i T87
with comply with such pr6vislons 6r tl is perrolt shall,be STATE Lr
deemed revoked. WATER HEATER LASE CLASS
LICENSED CONTRACTORS DECLARATION DtSfk
`ICT yQ,� -BY
I hereby¢fflrm that I am licensed undef provisions ofChbpter 9 6. S SYSTEM OURErS V (//r QS/
{commenting with Section 7000)of Division 3 of thb ijualness OUTIIIETS OVER }
and Professions Code,and my Ilcease is In full force and effect, 5 PER SYSTEM FINAL
r�I / y O VALIDA 8License Number C Ic. Oct" � DatF 2 A 09'
Contra4lgF.T7,-'L a�,7"f t,/ e �7. C1 Q FI # 0 0 0 0 o 5 G
❑ I am exgmpt udder Sec. o•o 3 (1 5 0 d
so
B.&P-c for this reason a o 3 Q 5 0
Plan cFleck fee o
Dates
pLLJWING MHRm 7 ISSUING Fes; U 0 1,3 0,-01.3085
Signature ,
TOTAL FEE 305T
Plan check applicant
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Name
I hereby affrrm that I am exempt from the Contractor's License
Ow for the.followir)g rowan (Sectlop 7031.$, Soslness and Address
PPr�ro}}fesslbru Code): City Tel, No.
LI I, as owner of the property, WHI do the wock and the
structure 1s not Intended or 6ffered for sale (Section
7Q44, Business and prpfesslons Code).
CONSTRUC ON LENDING AGENCY
I hereby affirm that there is aconstruction lending agency for
th&performance of the work for which this permit Is Issued
(Sec. 3047, Civ.C.).
Lender's Name
Lende's,A¢dress
I certlfy that I have read this application and state that the ,
above Information Is correct. I agree to comply with air County
ordlmances cad Sratb laws regulating Plumbing, and hereby
aUthprlxp IppCDtantatives -Of to enter upon the
above- tlo pr Ion purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
i
6114P1,9
nature of LczItt Date