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Home My Public Portal About5036 ROSEMEAD BLVD_Plumbing__ -7lfX667 +7- $'SO KD APPLICATION FOR PERMIT -DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES P L O I WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. PLUMBER RECEIVED BY READY FOR DATE ISSUED T� FIRST INSPECTION ADDRESS �'� n G•- d BUILDING 0� CITY TEL, NO. ADDRESS COUNTYplat ? LOCALITY LICENSE NO. EXPIRES cr NEAREST PERMIT FEES CROSS ST. P OWNER NUMBER TYPE OF FIXTURE OR ITEM FEE MAIL p leo 1 WATER CLOSET (TOILET) @ 0.50 1 5 I ADDRESS BATH TUB @ 0.5011 CITY TEL. NO. 1 SHOWER @ 0.501 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS 1 LAVATORY (WASH BASIN) @ 0.50 I APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND 1 KITCHEN SINK @ 0.50 STATE LAWS REGULATING PLUMBING. 1 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PR9 ERTY DESCRIBED ABOVE. 1 GAS SYSTEM--OUTLETS @ 0.501 1 SIGNATURE OF WATER HEATER @ 0.5.0 PERMITTEE SLOP SINK @ 0.50 111 INSPECTION RECORD 1 FLOOR SINK @ 0.50 1 FLOOR DRAIN @ 0.50 1 DISHWASHER @ 0.501 1 DRINKING FOUNTAIN @ 0.501 1 URINAL @ 0.501 1 J 1 HOUSESEWER @ 0.501 I Q MISCELLANEOUS 1 1 0 I� APPROVALS 1 DATE INSPECTOR'S NAME 1 ROUGH PLUMBING 1 GAS PIPING GAS VENT ICESSPOOL @ I.00 1 CESSPOOL 1 SEPTIC TANK: , 1 I SEPTIC TANK ,^n DRAIN ( ) PIT ( ) @ 1.00 1 SEWER PERMIT 1.00 GAS TEST _ UTILITY CO. NOTIFIED III TOTAL FEE $ 454) FINAL 17 s-49® APPLICATION FOR PERBOT EPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELESp , a WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN L DISTRICT NO. GROUP ZONE rPERMIT NO. PLUMBER ,�C�. S,i ��+ Cy i-- RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS ) 4-?-OA- E, VqLaq gWj® j�'' AA ry ,^(,•� / �7,/�c7 BUILDING �• nGr�� ,p,�� CITY ,"V Do U�'1 U TEL. NO. �� W6 i 0 ADDRESS (/its ✓7-7 COUNTY B / �,11 LOCALITY �� LICENSE NO. &l6 �`r EXPIRES NEAREST PERMIT FEES CROSS ST. O NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER S®c � MAIL WATER CLOSET (TOILET) @ O.SO $ 6 ADDRESS BATH TUB @ 0.50 CITY TEL. NO. SHOWER @ 0.50 1 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 SQ APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ 0.50 �Q STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 O ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER 1� OF THE RESIDENTIAL PROPERTY DESCRIBEDA BOVE. GAS SYSTEM OUTLETS @ O.50 ��✓ SIGNATURE OF PERMITTE WATER HEATER @ 0.50 �D -•� �� i-��C%��I� SLOP SINK @ O.50 I INSPECTION RECORD FLOOR SINK @ O.50 FLOOR DRAIN @ 0.50 I _ DISHWASHER @ 0.50I DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 ;] HOUSESEWER \ @ 0.501 Z MISCELLANEOUS O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING /• + �� /a.,' GAS VENT "v CESSPOOL @ 1.00 I CESSPOOL ' SEPTIC TANK: SEPTIC TANK. I DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT . . I 1.00 GAS TEST O /! UTILITY CO. NOTIFIED C'• / TOTAL FEE $ 4 FINAL A 7BA667 17 3-50 0 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING �� ' COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE P ILIO. PLUMBER �RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS BUILDING CITY TEL. NO. ADDRESS 7 3,2I COUNTY LOCALITY LICENSE NO. EXPIRES NEAREST t PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET (TOILET) @ 0.50 $ ADDRESS BATH TUB @ O.50 ! CITY TEL. NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND LAVATORY (WASH BASIN) @ 0:50 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. KITCHEN SINK @ 0.50 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.501 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PRO RTY ESCRIBED ABOVE. GAS SYSTEM--OUTLETS @ 0.501 WATER HEATER @ 0.50 SIGNATURE OF PERMITTEE I SLOP SINK @ 0.50 INSPECTION RECORD`` FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.501 DISHWASHER @ 0.501 DRINKING FOUNTAIN @ 0.50 URINAL @ 0.501 „J 1. HOUSE SEWER @ 0.501 Z MISCELLANEOUS 1 �- 0 I I � I� I� I I I APPROVALS (II DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING CGAS VENT CESSPOOL@ i.00 CESSPOOL SEPTIC TANK: I SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 - SEWER PERMIT . 1.00 GAS TEST UTILITY (. NOTIFIED TOTAL FEE $ FINAL d `: I WORKERS"COMPENSATION"DECLARATION APPLICATION FOR PLUMBING .PERMIT 7A66 ^'I herb affirm that l have a certificate of consent to self in- 20-0026DPW4/87� Y% 6 sure ora certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) certified copy thereof Sec. 3800, Lab. C.:)Policy Nob /0 'Pomp COUNTY OF LOS,ANGELES DEPT; OF PUBLIC WORKS �"[ anyEtlf� { Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING �_ Certified copy is filed with the county building inspection ADDRESS- 50,33 J9 department. NUMBER FIXTURE OR ITEM @ FEE P LOCALITY Date Applicant .CJ` WATER CLOSET(TOILET) pC NEAREST �� p-�-- CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB' / DO CROSS ST. �lv. r r �_ _ COMPENSATION INSURANCE OWNER Lu�i-4 �F\/AJ J iAtj SHOWER (This section need not be completed if the work involved byr MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY a J ADDRESS I certify that in-the performance of the work for which ihis per.- , ®, mSINK is issued,I shall not employ any person in any manner so CITY /�4� g N� TEL NO. 1C O .. as to become subject to the Workers Compensation Laws. DISHWASHER , D- CONTRACTOR !TpiV:.f-In s ( >:b„l SJ Date Applicant CLOTHES-WASHER � ni NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESS �® , �Ale, em tion,you should become subject to the Workers'Com en- SWIMMING POOL RECEPTOR / P Y I P CITY T L NO.(1/�� sation provisions'of the Labor Code,-you must forthwith comp- LAWN SPRINKLER SYSTEM �G�5 +vO,V�' ly with such provisions or this.permit:shall be deemed revok- STATE f f uC. ed 1 WATER.HEATER• LICENSE NO. J6 CLASS. LICENSED CONTRACTORS DECLARATION ® DISTRICT NO. RROCESSED BY I hereby affirm that I-am licensed under provisions of Chapter GAS SYSTEM 5 OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER rj fed Professions Code, and my License is in full force and ef- 5 PER SYSTEM FINAL VALIDATION DATE _ License Number" Lic. Class °' V C ' FINAL Contractor ate BY O F 'I am exempt under Sec. Q B.'U.C. for this reason ► Plan check.fee Date: PLUMBING PERMIT ISSUING FEE$ Lo Q e Signature TOTAL FEE SINGLE FAMILY 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 .= Professions Code): Address y t ii_ s c fi_ I, as owner of the,property, will the work and City Tel. No. s oy structure is not intended or offered for sale r (Section 7044, s Business and Professions Code). ► a CONSTRUCTION LENDING AGENCY . I hi reby.affirm that there is a construction lending agency for the performance.of'the work for which this,permit is'issued ,_({I y31 (Sec. 3097, Civ' C.). ` Lender's-Name Lender's Address I certify that I have read this applicaiion 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 abov -menti ned property for inspection purposes. r-- SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date