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Home My Public Portal About5541 ROSEMEAD BLVD_Plumbing__ 71AG97C ICe-eoBl -9/T! I APPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN (PRINT OR TY PEI BUILDING NUMBER FIKTURE OR ITEM FEE ADDRESS J WATER CLOSET LOCALITYNEARE �p�F BATH TUB CROSS ST .QD/S D Lf/JP SHOWER OWNER GE /A/6r LAVATORY MAIL ADDRESS SINK 3 o CITY TEL NO DISHWASHER CONTRACTOR $ CLOTHES WASHER ADDRESS ��/IJ � 6x4,Da SWIMMING POOL RECEPTOR CITYCg�I ONQOuT ,vATEL NO 3sf7-3xa LAWN SPRINKLER SYSTEMSTATE QJ /] WATER HEATER D LICENSE NO 22-� CLASS G• A o GAS SYSTEM OUTLETS DISTRICT NO GROUP 7-00 RO ED BY • V �oCi, UUTL5 PER SYSTEM STOVER I�Sy qqO��v 1�,,�R O WASTE A UOVAL�V• pAwTJA 3 /7 —7 y 42M-0 INSPECTION RECORD 2 OVM JAG Plan check fee PLUMBING PERMIT ISSUING FEE $ TOTAL FEE / Plan check applicant 19 , Name APPROVALS DATE INSPEATON a BIG NATURE UNDER SLAB WORK Address ROUGH PLUMBING City Tel NO GAS PIPING 7 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE ID CORRECT AND AGREE TO COMPLY . F WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING I HEREBY CENT[" THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LIC CMBEDAS REOUIRED BY LOS ANGELES COUNTY AND STATE DI GAS TEST CALI IO RMPA OR THAT 1 AM THE LEGAL OWNER AND INTEND TO RESIDE IN THE ABO ED 15ED RESIGEMTI P OPERTY UTILITY CO NOTIFIED DI ONATU RE OF PERMITTE FINAL /'? PLAN CHECK VALIDATION CK M D CASHPERM( VA DATION CK M O cAex a 7 2�F 5 0 1 95 0 76 A 667—CE 817 8/68 r APPLICATION FOR PLUMBING PERMI COUNTY OF LOS ANGELES _ DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISIti aDnec .c�- JOHN A LAMBIE COUNTY ENGINDHGB.�,J COLEMAN W JENKINS SUPT of BUCyty�n FOR APPLICANT TO FILL IN PR NT ORAREST mST NUM6ER FI%TURF OR ITEM EACXNER lJ WATER CLOSET I50 BATH TUB 150 Dllpva SHOWER 1 50 CITT NO n LAVATORY 1 50 CONTRACTOR SINK 1 So ADDREBB DISHWASHER 1 50 CTTf TEL NO CLOTHES WASHER 1 50 STATE LIC .. LICENSE NO CLASS Gr SW{M[tING POOL RECEPTOR 150 DIBTR{[i Np,/ GROUP [ P PV O LAWN SPRINKLER SYSTEM 2 00 NATER HEATER 150 MUSTRIAL = WASTE APPROVAL IV GAS SYSTEM OUTLETS ISo INSPECTION RECORD W OUTLETS OVER D- 5 PER SYSTEM 30 = Plan check fee 21% of above Sce reversITO PL UNIBING PERMIT ISSUING M EF 00 IOTNI FFF APPROVALS DATE IM[IECTaw 6RIONATUR[ Plan check ippllrant UNDER SLAB WORK Name ROUGH PLUMBING Addres, GAS PIPING GAS VENT City "fel NoHOT WATER HEATER I NERNRY ACKNOWLEDGE THAT I MAY[ READ THISICATION AND STATE THAT THE[ AEOVE IN CORRECT AND COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCE[ AND STATE ULATING GAS TEST PLUMOINO I H[RENr uRrlPr THAT I AM PROPERLY REGISTEREDAHD/oR UTILITY CO NOTIFIED — SIR AE REQUIRED NY LOS AMG[LCE COUNANDAT[ OF / GLIFCRNIA OR THAT I AM THE L[G/LL OWN" OEMD TORESIDEINTH[AROV D R[EID[MTl L PRFINAL SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL OF PERMITTEE ' PERMIT VALIDATION CK M o Ae PLAN CHECK VALIDATION CK M o CASH I_t � W121r -0 3 9 2121 5 0 4.00- v 76'AX667 - Cjr@17 7-59mow APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEERF'A'DDRE"SS'BUILDING AND SAFETY DIVLSION5541 RosemeadBlvd.JOHN A LAMBIE, CouNTr ENGINlER COLEMAN W JENKINS SUPT OF BUILDING Temple CityPOR APPLICANT TO FILL IN PR NT O TYPENUMBEfl FI%TURF OR ITEM EACX FErger ging c o 1st FloridaWATER CLOSET 1 50BATHTUB Iso 1 Rosemead Blvd• SHOWER 1 So CITY TEL NO LAVATORY 150 CONMACTOB Specialty Plumbing Co. SINK I so 3 00 ADDRESS Garfield Ave DISHWASHER 1 50 cm Paramount TEL 11o634-6796 CLOTHES WASHER 1 50 TATE LIC LICENSE NO 209110 CLASS C-36 SWIMMING POOL RECEPTOR 1 50 DIST IC/ Yr, ROUP ZONE r D Br LAWN SPRINKLER SYSTEM 2 00 O�11 3 WATER HEATER 150 SANTE OV 1 GAS SYSTEM5 OUTLETS 1 50 OUTLETS1 50 nMPZCTf0N•SECO 5 PER SYSTEMTEM 30 ', s 6 00 Floor Drains 4 50 1 IDrk. Fountain ( 5. O Plea check tee 25% of above See reverse PLUMBING PERMIT ISSUING FEE $ 2 00 TOTAL FEE So APPROVALS DATE IN6 CTOR sl NATURE Plan check applicant UNDER SLAB WORK 1171 Name ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel No HOT WATER HEATER 1 HERSAT ACKNOWLEDGE THAT I HAV[ NSAD THIS w LIGATION AND STAT[ "AT TH[ ASOVE IS GOIURR AND AGRZK TO COMPLY PLUMBING FIXTURES WITH ALL COUNTr ORDINANCES AND ErAT[ LAWS SIGULATING GAS TEST PLUMSINO 1 HERIED AS ESY CZWI" THAT 1 AN into IIEOIERI"D "Dlotr UTILITY CO NOTIFIED uCEH11[OUIRSO SY LOS ANGELES COUNTY AND STATE or CALWORNIA OR THAT 1 AM THE LEGAL OWNER OF AND IMEMD TO 72 Ru1D[ IN THE MOVE D[SCRRISD RIESIORNITiAL n MRTV FINAL BIGNATURI [ • �4� JACK R ALLEN, SUP RVISIN OF PERMI7T [ NANICAL ENG R PERNUT VALIDATION H M o CASH PLAN CHECK VALIDATION cK M o cASH I �Ir 9 1 5 7ti X16 5 D 2 750 WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT +1`1;ere0y affirm that I hove a certificate of consent to self 7Me67A i Nsure, or a certrficate of Workers Compensation Insurance CE 817(REV 10/81) or a certified copy thereof (Sec 381 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDADDRENG SS Certified copy is filed with the county building inspec- ADDRESS � I tion department NUMBER FIXTURE OR ITEM ® FEE LOCALITY R U r• Dote Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST ✓d /11 G COMPENSATION INSURANCE (This section need not be completed R the work Involved by SHOWER OWNER the permit Is for one hundred dollars ($100)or less ) MAIL _OG I certify that in LAVATORY ADDRESS the performance of the work for which this � permit is issued 1 shall not employ any person in any rnner SINK CITY TEL NO �3Z so as 10 become subject to the Workers C pe a1jD la DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER NOTICE TO APPLICANT If after mokmg t is Certificaa of SV7IAN11NG POOL RECEPTOR ADDRESS Cy' e, Exemption you should become subject to the Workers Compensation provisions of the Labor Cade you must forthLAWN SPRINKLER SYSTEM Ot'J' Ory TEL /._� TEL NO wU111h comply with such provisions or this permit shall be SANO LIC nned revoked WATER HEATER U / CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER G and Professions Cade,and my license license is in full force and effect 5 PER SYSTEM FFIATE _ VALIDAT IINAL V License Number t 495 74/ZLic Class J // FIN 0 of Controctor L.L's/ �L 7 BY ❑ W I am exempt under Sec 6 N B 8P C for this reason Z Plan check fee $ 1 1 2 2 A t PLUMBING PERMIT ISSUING FEE$ U # s e s e e 5 Signature��4 TOTAL FEE 19 0 1 e e 1 b 5 0 Plan check applicant SINGLE FAMILY e e e 16 5O 6 HOME OWNER-BUILDER DECLARATION Noma 1 hereby affirm that I am exempt from the Contractor's License address 1 1.2 7—8 4 Low for the following reason (Section 7031 5, Business and Professions Cade) City Tel No ❑ I as owner of the property, will do the work and the , structure is not intended or offered for sale (Section , 7044 Business 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 it AAdress I certify that I have read this application and state that the ► obove mformohon is correct I agree to comply with all County ordinances and State laws regulatin Plumbing and hereby authorize repress talrve5 o is C un to enter upon e above mention opert or in cti rposes SEE REVERSE FOR EXPLANATORY LANGUAGE 5 notur of Perminee Dot