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HomeMy Public PortalAbout5116 ROSEMEAD BLVD_Plumbing__ DEPARTMENT OF COUNTY ENGINEER PLUMBING 1 DIVISION OF BUILDING AND SAFETY ' PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDING WILLIAM J. FOX, COUNTY ENGINEER ADDRESS FOR APP NT TO FILL I LOCALITY I �r BUILDING /y NEAREST ADDRESS Pm Pa CROSS ST. A DISTRICT;N�Ow GROUP ZONE PERMIT NO. LOCALITY /'4 !/T 762­6 NEAREST d S P�I�� RECEI ED BY Ready for Inspection DATE ISSUED y CROSS ST. C' Q CJ OWNER• � Q , AAP) 7— MAIL 7; . INDUSTRIAL ADDRESS {/ •le /jCl,s(� WASTE APPROVAL CITY 1- e O TEL.N0. J INSPECTION RECORD PLUMBER !VI (D/GCs t" vA&/ AS ADDRESS /� CITY TEL.N0. /l 6 ) X V STATE LICENSE NO. J j CCOUNTY PERMIT FEES 11 - � g-0@+��' ACC rj v&�C� ''° a TYPE OF FIXTURE ❑R ITEM FEE ` fu F r'A x WATER CLOSET(TOILET) @ 0.80 $ C'`� `�� �IS� ZX O BATH TUB @ 0.80 SHOWER @ 0.80 ���.� r�J /y7 f1PP*AnJ6 CvA L k'ujL LAVATORY(WASH BASIN) @ 0.80 00 �H KITCHEN SINK @ 0.80 CFO I LAUNDRY TUB OR TRAY @ 0.80 'D SLOP SINK @ 0.80 FLOOR SINK @ 0.80 FLOOR DRAIN @ 0.80 DISHWASHER @ 0.80 ( DRINKING FOUNTAIN @ 0.80 �d / URINAL @ 0.80 / GAS SYSTEM... --.--OUTLETS @ 1.00 QO WATER HEATER @ 1.00 v MI CELL NE S / h lmowd7 kzy APPROVALS DATE INSPECTOR'S,SIGNATURE a UNDER SLAB WORK , PERMIT $ 1 00 ROUGH PLUMBING TOTAL FEE Jilid GASPIPING IHEREBY 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 I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVE DESCR ED R ENTIAL PROPE TY. UTILITY CO.NOTIFIED SIGNATURE /f�Jt t OF PERMITTEE- {/ .........- FINAL 76A667 DBS 17 1/53 PLUMBING 1 DEPARTMENT OF COUNTY ENGINFF'R, :.DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER FOR APPLLr.,ANT TO FILL IN LOCALITYBUILDING p CR SS ST. I/ �✓ ADDRESS 41a_v NEAREST 4� DISTRICT NO. GROUP ZONE PERMIT NO. LOCALITY r'C" /A—/ "��7\� NEAREST „, RECEIVED BY Ready for Inspection DATE ISSUED CROSS ST. - r r-__ / OWNER I;6 „,rt `'~ / ``a J MAIL �J �' INDUSTRIAL ADDRESS C. �,�`j4' WASTE APPROVAL CITY EL. o Gf® �CB INSPECTION RECORD PLUMBER C ADDRESS CITY aSC4 .,�e C.&G( TEL.NO. S y ❑STATE LICENSE NO. �2GC� ❑COUNTY PERMIT FEES a _z NUMBER TYPE OF FIXTURE OR ITEM FEE U, WATER CLOSET(TOILET) @ 0.80 $ it O BATH TUB @ 0.00 SHOWER @ 0.80 LAVATORY(WASH BASIN) @ 0.80 KITCHEN SINK @ 0.80 LAUNDRY TUB OR TRAY @ 0.80 SLOP SINK @ 0.80 FLOORSINK @ 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 APPROVALS DATE INSPECTOR'S SIGNATURE UNDERSLABWORK s /”/* Fc�d J PERMIT $ 1 00 ROUGH PLUMBING TOTAL FEE GAS PIPING LEBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER LY WITH ALL COUNTY ORDINANCES AND STATE LAWS TING PLUMBING. PLUMBING FIXTURES EBY CERTIFY THAT I AM PROPERLY REGISTERED LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST TE OF CALIFORNIA HAT I AM THE LEGAL OWN- HE ABOV SIDENTI PROPERTY. UTILITY CO.NOTIFIED REMITTEEF7. .._ _ .10.......................................... FINAL 76A667 DBS 17 1/53 76'A fi67=cj 817 8/68 _. r APPLICATION FOR -'PLUIMBING" PER IT COUNTY OF.LOS ANGELES DEPARTMENT'OF COUNTY ENGINEER BUILDING' AND SAFETY DIVISION F a,; JOHN A. LAMBIE. COUNTY ENGINEER -Boulevard .COLEMAN W. JENKINS. SUP'T.'OF BUILDING emple City FOR APPLICANT TO FILL IN(PR NT OR TYPE) 20 A NUMBER `FIXTURE OR ITEM EACH FEE - - - OWNER Spanish Seven Da Ad.Churc WATER CLOSET" � -1,50 - BATH TUB 1.50 ADDRESS .5116 Rosemead Boulevard SHOWER 1.50 CITY Temple, City TEL, NO. LAVATORY 1.50 CONTRACTOR Owen Bros.- Plumbing, Inc. SINK 1.50 ADDRESS 4265 North Baldwin. Avenue DISHWASHER 1.50 CITY El Monte TEL. No. 443-0078 ' CLOTHES WASHER 1.50 - STATE 231 741 J. LIC C 3 LICENSE NO. CLASS SWIMMING.POOL RECEPTOR 1.50 DISTRICT NO. GROUP 'ZONE CESSED BY a LAWN SPRINKLER SYSTEM 2.00 v WATER HEATER 1.50 - INDUSTRIAL - Zo WASTE APPROVAL 1 G'AS SYSTEM, 4 OUTLETS 1.50 1 0 INSPECTION RECORD w OUTLETS'OVER 5 PER SYSTEM .30 sl ,� ®,A/ kQl-�r Plan check fee 25% of above. See reverse.' r PLUMBING-PERMIT ISSUING FEE_ 8 2 00 DOTAL FFE 3 50 APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB.WORK Name ROUGH PLUMBING ` GAS PIPING Address . GAS VENT City Tel. No., .HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND THIS TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST '70, PLUMBING. - ,1 HEREBY CERTIFY THAT I 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 RESIDE IN, THE ABOVE GC RIBED SIDE NTIAL PROPERTY �-4-701 /-7.Q ` �, a FINAL (e+ SIGNATURE JACK R. ALLEN,-SUPER V ISIN E HANICAL ENG'R. OF PERMITTEE / a��_ PERMIT VALIDATION cK. M.o. CASH PLAN CHECK VALIDATION CK. M.O. CASH p(� ' WORKERS'COMPENSATION DECLARATION0-0026 APPLICATION FOR PLUMBING PERMIT I hereby, affirm that 1 have a certificate of consent to self in- 7PW 4/90 6A667A sure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof (Sec. 3800,Lab. C.) -COUNTY OF LOS ANGELES DEPT: OF PUBLIC WORKS Policy"No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county.building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET(TOILET) 6�Z> NEAREST ';. CERTIFICATE OF EXEMPTION FROM WORKERS' e5 BATH TUB CROSS ST. COMPENSATION INSURANCE` OWNER SHOWER (This section need not be completed if the work involved by 10MAIL the permit is for one hundred dollars (;100)or less.)' LAVATORY ADDRESS Gt/R '✓ I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so SINK CITY ELS as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTORo Date Applicant © CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen.- CITY TEL. NO. cation provisions of the Labor Code,you must forthwith comp- ' LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall b"e deemed re%ok- STATE' LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the BusinessOUTLETS OVER a21 and Professions Code, and my license is in full force and ef- 5 PER.SYSTEM �et� �O` FINAL VALIDATION fect. HOSE BIB DATE , License Number Lic. Class fL FINAL 3303 y26.10 U Contractor Date BY 1 ITEMS I am exempt under Sec. jG TOTAL 426 o 30 U B.&P.C. for this reason Plan check fee ` Boo. ca 426.309L 1.•Tl Date: PLUMBING PERMIT ISSUING FEE$ / CHANGE eZl}0 z Signature TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant WOO-0001 3/13/196 I hereby affirm that I am exempt from the Contractor's License Name �j'7�, 1 ` °g9 Law for the following reason (Section 7031.5, Business and Professions Code): Address I, as owner of the property, will do the work and the City Tel. No. structure is not intended or offered for sale(Section 7044, Pusiness and Professions Code). , 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 application 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 ,aboventione property for inspection_purpo S. �k Aif - (3 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date WORKER'S COMPENSATION DECLARATION 6DPW 9/89 APPLICATION FOR PLUMBING PERMIT 76A66 I heret�y affirm"that I have a certificate of corLgent to self insure, 76A667A or,e certificate of'Worker's Compensation Insurance , or a certified copy thereof(Sec.3800 Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV. Policy No. Company ❑ Certified copy is hereby furnished. (J r_1BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified coy is filed with the county building inspection depM&J—e / NUMBER FIXTURE OR ITEM Q FEE LOCALITY 6:" �` f/ t Date anes / WATER CLOSET NEAREST CROSS ST. V,,_ CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the work involved by the SHOWER MAP BOOK PAGE PARCEL permit is for one hundred dollars($100)or less.) OWNER I certify that in the performance of the work for which this permit LAVATORY is issued, I shall not employ any person in any manner so as toMAIL SINK �� ADDRESS become subject to the Workers'Compensation Laws. DISWASHER CITY TEL.NO. Date Applicant CLOTHES WASHER CONTRACTOR NOTICE TO APPLICANT: If, after making this Certificate of �LlZG� �sLo1�uC� Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such I I IIADDRESS provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.NO. I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER (commencingwith Section 7000 of Division 3 of the Business and STATE LIC: ) GAS SYSTEM OUTLETS LICENSE NO. CLASS U Professions Code,and my license is in full force and effect. OUTLETS OVER DISTRICT NO. PROCESSED BY 5 PER SYSTEM License Number Lic.Class FINAL DATE; VALIDATION Contractor Date (n ❑ I am exempt under Sec. BY AL B.&P.C.for this reason / r Date: Plan check fee , Signature PLUMBING PERMIT ISSUING FEE$ ❑ TOTAL FEE SINGLE FAMILY Plan check applicant c HOME OWNER-BUILDER DECLARATION Name �I,, I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Address3 33 t�o3tl] Code): 13? City Tel. No. EM I,as owner of the property,will do the work and the structure 3 I Gf tS is not intended or offered for sale (Section 7044, BusinessIi A�� ® 'fi3 and Professions Code). , L� ii`` ms . CONSTRUCTION LENDING AGENCY CHECK ms.4i I I hereby affirm that there is a construction lending agency for the CHANGE ,I313 performance of the work for which this permit is issued (Sec. 3097, Civ. C.) Lender's Name 0000-0001 12/22181 f 9 Lender's Address ??54 1 PM 12:02 I certify that I have read this application 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 property Xr inspection p rposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee/ Date