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Home My Public Portal About5630 ROSEMEAD BLVD_Plumbing__ r COUNTY OF LOS ANGELES APPLICATION FOR PERMIT . Departmentof County EngineerPLUMBING DIVISION OFFBUILDING & SAFETY WILLIAM J. FOX, County EnBlneel FOR APPLICANT TO FILL IN DISTRI P ZONE PERMIT e- r--'P_ riz/-T--,p PLUMBER / L 1 < RECEIVED BY READY FOR DATE ISSUED v aN f FIRST INSPECTION _31 1a ADDRESS it BUILDDITY TE '� 9 ADDRESS w O oft CDUN LOCALITY LICENSE Nl% EXPIRES v/Y �.. S,3 , NEAREST PERMIT FEES CROBS ST. NUMBER TYPE OF FIXTURE CR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) 0.50 S 44(99 ADDRESS BATH TUB @ 13.50 CITY TEL. No. T SHOWER Q 13.513 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS L4VATORY (WABH BASIN) @ 13.50 D APPLICATION AND BTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK ® 13.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB 13R TRAY ® 13.513 ANO LE COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY ABOVE. GAS SYSTEM OUTLETS @ 0.50 SIGNATURE 13F WATER HEATER 0.50 PERMITTEE SLOP SINK 0.513 INSPECTION RECORD FLOOR SINK 13.50 _ FLOOR DRAIN @ 0.50 DISHWASHER @ 13.50 �• ��'-' DRINKING FOUNTAIN @ 0.50 �'�'T URINAL 13.50 �A �'® !ti/ ��Oa+e -j Q HOUSE SEWER 0.50 C ./vYs7 �'�• Z MISCELLANEOUS G4P /S r O O APPROVALS DAT ��]] INSPECTOR'S NAM,E R13UGH PLUMBING 19410 ...,__.-G. / i.J�q 7 GAS PIPING GAS VENT CESSPOOL @ 1,013 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT 1.D13 GAS TEST TOTAL FEE I UTILITY CO.NOTIFIED / nA f FINAL 76A66T DBS.#17 6-52 v ` 76A667 17 2SM BETS 7-4B APPLICATION FOR PERMIT DEPARTRIENT,OF BUILDING AND SAFETY.- COUNTY OF LOS ANGELESpLV�i BIND WM.J.FOX.CHIEF ENGINEER NATURE OF INSTALM"ATION DIWFRlcr NO. GROUPI ZONEPERMIT O. 3 14C ROUGH FIXTURES COMPLETE /�'2-- 21Z97- HEATER -- rHEATER CESSPOOL 1-1 SEPTICTANK. RECEIVED HY READY FOR DATE ISSUED MISCFIRST INSPECTION ELLANEOUS APPLICANT_ FILL IN HEAVILY OUTLINED PORTION ONLYJOB ..G G NAME! f�. bd:�� sYd ADDRESS 1�7 - , ADDRESS y/G /�/�I .(�'/,/ LOCALITY a 1 III JQ�� NEAREST 16 CITY /A - `� TEM N�ld .1'79/ CROBS 8T.BOUNTY LIC N9E ND. EXPIRES A e"07 5 NAME �// 2i�r-^i>., LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL 3 ADDRESS NORTH O CITY TEL.-No. 1 AM THE LEGAL POSSESSOR- OF THE ABOVE LOS ANGELES COUNTY CERTIFICW ORIPALIFICATICH. PI.uNBER I AM THE LEGAL OWNER F THE PROPERTY DESCRIBED �y�yqq ABOVE. Ol OWNER '11 CORRECTIONS 7- -7d -eel a ti a tS f ti stIr SOUTH J DESCRIPTION OF WORK z BATH TUB FURNACE LC HOWER DISHWASHER ' Q Two, Z___LsVATORY REFRIGERATOR ITCHEN SINK WATER SOFTENER QLOOR SINK BAND TRAP SLOP BINK - F-OOR DRAIN WASH TRAY URINAL APPROVALS _WATER CLOSET *DRINKING FOUNTAIN DATE INSPECTOR'S NAME _• ffi+d WATER'N;A ER }ENTAL LAVATORY ROUGH PLUMBING RTE: SODA FOUNTAIN GAS PIPING - 'GAS VENT CESSPOOL I TOTAL NUMBERL0PFI)XCrURES O SEPTIC_TANK CES8P001 PTIC TANK SEWER B 0-6 UTILITY CO.NOTIFIED i TOTAL FEE �- FINAL 76^667 17 2SM SETB'7-4B APPLICATION FOR PERMIT (DEPARTMENT OF BUILDI-NG AND SAFETY COUNTY OF LOS ANGELES PLUMBING r WM.J.FOX.CHIEF ENGINEER NATURE O INSTALLATION DISTRI�N�O. GROUP -2- P RMI NO: ROUGH FIXTURESCOMPLETE HEATER CESSPOOL H SEPTIC TANK RECEIVED'BY READY FOR DATE ISSUED FIRST INSPECTION GAS- MI CELLANEOUS - 1.3 APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY d, NAME M. C. NOTTINGHAM' M ADDRESS / o ADDRESS 1�2�3`N*o.. -l�o/�v_erly Ave. LOCALITY LLCITY T�M�� CMV, CRosa�s•1•. COUNTY t LICENSE NO. EXPIRES ' NAME. LOCATION OF SEPTIC TANH, OR CESSPOOL z MAIL 3 ADDRESS NORTH O CITY TEL.No. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGEL7 COUNTY CE I I T RI TION. Pfflimsm M THE LEGAL OWNER OF THE PROPERTY DESCRIBED OV A E. 3 OWNER CORRECTIONS / SOUTH /V CG `Vs A DESCRIPTION OF WORK' z_` ATH TUBFrURNACE � . tti MOWER DISHWASHER 0 -AVATORY REFRIGERATOR KITCHEN SINK -WATER SOFTENER "OR SINK - SAND TRAP' LOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE /I�N-SP[CTOR'B MANS WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER GAS ------SODA FOUNTAIN GAS PIPING I I OUTL I c;Aa YFaN•r CESSPOOL I TOTAL NUMBER OR RiXTUR ,� (J SEPTIC TANK I I CESSPOOL SEPTIC TANK � a� SEWER S UTILITY CO:NOTIFIED I TOTAL FEE / S?� !~(NAL 76AG67A CE 6171REV.6/781 ' ®S APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY Al FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ADDR NUMBER FIXTURE OR ITEM ® FEE WATER CLOSET ` LOCALITY NEARESIC BATH TUB CROSS ST. SHOWER OWNER LAVATORY MAIL ADDRESS SINK CITY TEL. � J - DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITY LAWN SPRINKLER SYSTEM STATE LIC.. WATER HEATER LICENSE NO 3 CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING 0 0 GAS VENT V HOT WATER HEATER 0O PLUMBING FIXTURES GAS TEST s�duu Plan check fee UTILITY CO.NOTIFIED Z PLUMBING PERMIT ISSUING FEE$ "_-::p TOTAL FEE FINAL Plan check applicant PLAN CHECK VALIDATION ' Name. �.Jt�i'+'7 Address z r7 / 3-77 /��1eL y City Tel.No. r/ Urz I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE - -9 2 !,9.7 A THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION 1$ O D O O 4 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS ANGELES (.� REQU IRED BY LOS TE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF.ANDNTEND TO RESIDES IN THE ABOVE DESCRIBED RESIDENTIAL 2 O O I Q O O J PROPERTY. O O O 1 a O O F SIGNATURE OF PERMITT 0 2. 1 6-7 9 DISTRICT NO P ESSED BY V r 7 INDUSTRIAL WASTE APPROVAL ION Wbthat I have a certificate of consent to 7BAS67 DPW 9l89 APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self Insure, 7tiA557A or a certificate of Worker's Compensation Insurance, or a certified copy thereof(Sdc.3800 Lab.C.) COUNTY OF LOS ANGELES DEPT,OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No. Company ❑ Certified copy is hereby furnished. BUILDING Ar—,/ 10 ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS ✓ (l!;/ Certified copy is filed with the county building Inspection department. NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Applicant 3 WATER CLOSET NEAREST CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB �j .{ COMPENSATION INSURANCE MAP BOOK 7 PAGE,/2_f PARCEeJl' (This section need not be completed If the work involved by the SHOWER permit Is for one hundred dollars($100)or less.) LAVATORY OWNER I certify that in the performance of the work for which this permit MAIL is issued, I shall not employ any person in any manner so as to SINK ,/�►y�(J ADDRESS become subject to the Workers'Compensation Laws. DISWASHER CITY TEL.NO. Date v '� Applicant& L 13LOTHES WASHER CONTRACTOR 00, NOT CE TO APPLICANT: If, after making th s Certificate of Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS provisions of the Labor Code,you must forthwith comply with such /. Q. provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY �� TEL.NO: EL I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER a (commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS LICENSE NO. ! �C�� CLASS E LIC. V Professions Code,and my license is in full force and effect. OUTLETS OVER DISTRICT' d;�) PROCESSED BY C 5 PER SYSTEM License Number Lic.Class C—� � _ I FINAL VALIDATION LL' / W y ~l 16 - DATE a Contractor Date_ �,—,_ 1~3CCs 014 Cr ❑ I am exempt under Sec. gy AL ti{"` t 15.853 T' MIC B.&P.C.for this reason J.sT I ILS Da Plan check fee , I > L � � PLUMBING PERMIT ISSUING FEE$ s ® vtr Signet , .6`�' f HCECii 215.85 TOTAL FEE F18 CHANGE .GIS IN SGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name ;� I hereby affirm that I am exempt from the Contractor's License Law t rt Lj[I'" k��l l 3/23/95 for the following reason (Section 7031.5, Business and Professions Address Code): '=CSL F1 1, Tel.No. _ AN 9:47 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'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 above-mentioned propert for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE