HomeMy Public PortalAbout9226 ROSEGLEN ST_Plumbing__ 7114667{r/1117 2-86
APPLICATION FOR PLliMBIN PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENG1NIKER ADDRESS
COLEMAN W. JENKINS. SUPT. OR BUILDING LOCALITY
FOR APPLICANT TO FILL IN CROSS SS S
CRar.
NUMDTR FI R[OR ITEM EACH IF OWNER
It
WATER CLOSET 11.25 WULEL
LATH TUN 1.25 ADDEESS
SHOWER 1.26 CISY TEL NO
LAVATORT 1.25
SINI 1.25
DMHWAIlHER I_u AA TEL. NO.
LAUNDRY TIID 1 4f STATE LIC
LICENSE N� � )l CLA33
CLOTHES WASHER 1.2E DISTRICT N > � aZQNX
WATER HEATER 1.60
GAS sTarErK OUTLETd Iso ASTER APPROVAL
UffrAm
OUTLETS OVER 5 PER ZYBTEN .20 INSPECTION RECORD S
C)
0
APPROVALS DATE INSmcfOR•■■IONATURT
PERMff f 2 pQ UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HERInY ACKNCIWLZDGK THAT I HAVT RIAD THIS APPLICATION OAS VENT
MID STATE THAT THE ABOVE 1• CO RATCT AND AGR= TO COMrLY
WI'fli AI, COUNTY ORDINANCX§ AND STATE LAWS RTOULATINa HOT WATER HEATER
rLU MSINO.
I HT1®Y CERTIFY THAT I AM r*DPKRLY R=GIfTTI� AND�OR PLUMBING FIXTURES
Llmlam AS RToull� ■r LOS ANOTLu COUNTY AND STATI of OAS TEST
CAUFOAMIA OR THAT 1 AM THT LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE MOVE DTSCRISTD RLIDCMTIAL rROMRTY. UT-ILITY CO. NOTIFIED
SIGNATU
OF PER
FINAL 1-
AMATTON JACK R. ALLEN
cec M.o. CAnI SUPERVISING MECHANICAL ENGIR.
1 4 5 8Q; OCT30 5 D 3.50- s
APPLICATION FOR PLUMBING PERMIT 1
o..."lo.en
DFnMON OF B=ngG AND SAFETY
D"-xftmaat of C--t7 EaW—.0
Cowt7 o3 Los AnwiLy BUILDING
JOHN A. LAMBIE, CouNTY ENGINEER ADDRESS L
CASSATT D,GRIM",HUr'T OF CII,LDIMa
LOCAL ITS
FOR APPLICANT TO FILL IN NEAREST
CRQAIS
HS
OWNER A C, a DIGfRaCT NO. GROUP ZONi ataoT FOR ,rtP[crlor
MAIL
ADDREW
INDUSTRIAL
CITY TEL, N WAST[APPROVAL
g
PLUMBIER - a.Ileg rlumbin {mopp o. INSP=ON RECORD
ADDRESD 442 W. F1eotwood Pl.
arTY C. en ora TS:'L_ NO. Ed 5-129
LICEN"NO. 160847
11UY axt TYrC Or FD(TURI OR rrKw Fir
WATIR CLOS[T (TO LET) a ft.00
19ATH TUE a 1111.00
SHOWER 41.00
LAVATORY (WADH BASIN) $1.00
KITCHEN SINK !11.00
DISHWAIHER 1.00
LAUNDRY TUB OR TRAY $1,0o
CLOTHES WASHER Q fl.(>o
WATER HEATER @ •1.00
OAS HYlITEM a 1.00
APPROVALS
DATE INSPE GNATURE
UNDER ORK
PERMIT 4 00 ROUGH PLUMB4NO -
GAS PIPING
tOTAL FEE
OA6 VENT
1 HERHBT ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT W TER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1 H£REBT CERTIFY THAT 1 AN PROPERLY REGISTERED AAD/OR GASTESi'
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATt OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF' THE ABOVE UTILITY CO.N IFIED
DESCRIBED RF41DENTIAL PRQPERTY.
SIONATURE
OF PERMITTE L
JOHN A: LAMHIE. COUNTY ENGINEER VALIDATION ROBERT A.WOOD, CHIEF PL.BG. INSPECTOR
■.Q. CAM
�, -2 2 51R Fm 13 3 A_ 1 0.0 0 A
WQflKER8 ti:OFSPENSATION DECLARATION 20-DOW DPW 9189
hereby Wrro that I have a certtflcate of oonsent to self Insure, 7&&BVA APPLICATION FOR PLUMBING PERMIT (J
or a'oertiffoste of Worker's Compensation Insurance, or a oertlfled
oopy thereof(8eo.'3800 Lab.C.)
COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV.
Ponoy No. Company
❑ Certified oopy Is hereby tumbhed
FOR APPLICANT TO RLL W(PRINT OR TYPES❑
ADDRESS
DS To`d
deq—Ud copy is tiled with The county txilkftig frnrpeotfon r
departrnerrt. NUMBER FDCn1RE OR rrF]d • FEE LOCALITY
Data AP~ 77 WATER CLOSET NEAREST r
cm,n KATE OF EXE3APTION FROM WORKER& BATH TUB CAOB8 ST.
1;2-f /'0'. ASSESSOR
COAAPBJ8AT1(NI INSURANCE
(Thh section need not be oompMted H the work Invot ted by the / SHOWER o�% O YAP BOOK PAGE PARK✓n
permtt to for one hundred dollar(SIDO)or Mss.) OWPEA
I certify that In the performance of the work for whloh this permit LAVATORYMAn-
S di
Is Issued, I shall not employ any person In any manner so as to SZNK ADDRESS
be-comews
subject to the Workers'Compensation La .
DISWAS ER CITY TEL NO.
Dade r pPt CLOTHES WA8H3-=a ( TOR
NOTICE TO APPLICANT: If, after making this Certlfloate of
Exemption,you should beoome subject to the Workers'Compersrallon 8WIMMM POOL REC O
provelona of the Labor Code, you must forthwith comply with such ADDRESS
provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYBTEY ,
LIC IENSI D CONTRACTORS DECLARATION CITY TEL NO. 1'
I hereby affirm that I am Iloensed under provisions of Chapter 9 WATER HEATER a
(commencing with Section 7000) of DFNslon 3 of the Business and STATE �' S
Profseslona Code,end my Ilcense Is In full force and effecL GAS SYSTEM OUTLETS LF ENSE NO. CLASS
OUTLETS OVER Di87A1CT NO. PROC£SSFD BY (_
^ 6 PER SY8TE3,1 Q
License Nurnber Llo.Claes V
d
Z Z
DATE 3
contreolor Date DATE VALIDATION
FINAL
❑ I am auernpt under Seo. BY
B.BP.C.for than reason
oats- Plan check fee _,t ; = f,.,,
PLUMBING PEAMrr ISSUING FFt i
�( TOTAL� �
l��[J Plan 0hedc applbettt
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Name -• /�-�
I hereby affirm that I am exempt from the Contraotors Lloenee Law - -
for the following reason (Section 7031.6, Business and Profeeslons Address
Code):
I City Tet. No.
❑ I,as owner of the property,will do the work and the atructure
Is not Intended or offered for sale (Section 7044, Buelness ,
and Profession Code).
CONSTRUCTION LENDING AGENCY
I hereby a lrm that there Is a Don 3tru on lending agency for the
perform noe of the work for which thl permit Is Issued (Sec. 3097,
Lenders Name
Lenders Address
I certify that I have read this application and state that the above ,
Information Is cora roe to oompty with all County ordlruanoes
and State Is regu tin bing, and hereby authorize
' represents toe n the above- antler
Q--2 SEE REVERSE FOR E7PLAHATORY LANGUAGES Date /
r i COUfTT OF LOS ANQELEB, TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTM13(T OF PUBLIC WORKS 9701 LAS TURAS PL 0508 0503250024
BUILDING AND SAFETY / LAID DEVELOPMENT TEMPLE CITY CA 91780
PHONE; (626) 285-0488 EXT:
LEGAL ID:
TR: 24021 LT.: 13 Mi ROSEGLEN ST�
FEE DESCRIPTION: QUANTITY: UON: AMOUNT: TEMP CA 917803709
NEAREST CROSS STREET: ENCIWITAY
8590-029-006 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J5 LOCALITY: TEKPLE CITY, C
47 WATER HEATER(S) 1.00 YTH t6.20
TOTAL FEES 43,95ISSM PROCENM BY: PLAN BY: EXPIRES .
03/25/05JK 09/21/05 ..
92LROJESUS T-CARMEJM M (626) 287-705$- .
TEMP 917803709
REPLACE WATER HEATER
APPLICANT: TEL
SAW AS OWNER . : APPROVALS DATE IN"Turow
-
SPECIAL MR ITIONS'
SAME AS OWNER -
LIC. NO UNDER SLAB WORK
WATER SERME
PLASTIC Y/N METAL T/N
• -
LIC. NO:
GAS PIPING
GAS WENT
OT 99TER RUM-
PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
Cwv
REPORT ID: DPR263 ROUTE TO: BS0508