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Home My Public Portal About6273 ROSEMEAD BLVD_Plumbing__ 76AS67 17 25M SETS 7-48 APPLICATION IC A TION FOSl �JY6LYSIY PERMIT DEPARTMENT OF BUILDING AND SAFE'T'Y 1�PLUMBING COUNTY OF LOS ANGELES WM. J. FOX.CHIEF ENGINEER V NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE a HEATER CESSPOOL I—I SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED _ ,/ /� Q FIRST INSPECTION GAS' MISCELLANEOUS 1 ` APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY /�} NAME / •,/1 ADDRESS /iy E v W �7,�_r o _� W ADDRESS �� —ti'll E1YtA.(/G _ LOCALITY AD D NEAREST C CITY - a J(.Q �i EL.NO. CROSS ST. LICENSE NO. EXPIRES CW NAME V) iQ/I<°Iti/ LOCATION OF SEPTIC T , OR CESSPOOL 3 MAIL ADDRESS NORTH O CITY f TEL.No. IAM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. ` PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK z BATH TUB FURNACE [7 lx _19ROWER DISHWASHER O LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER NEATER DENTAL LAVATORY ROUGH PLUMBING I I METER OAS AODA FOUNTAIN GAS PIPING I i A ouTt GAS VENT v�y v q CESSPOOL T AL NUMB FI ; ORES SEPTIC TANK I! I� I lV I IIS �i CESSPOO E TIC TANKSEWER SUTILITY CO.NOTIFIED I TOTAL FEE �� FINAL D.B.S.-17 25M SETS 12-45 APPLICATION. FOR PERMIT D,IEPARTMENT OF BUILDING AND SAFE'L'Y C0$TNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER 1 TUBE OF INSTALL ON DISTRICT N,O. GROUP Z�O1 NE PERMIT NO. ROUGH FIXTURES COMPLETE r __rI [ of 0 NEATER CESSPOOL I—I SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION GAS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY .LOB / lz NAME CM _42ef-- ADDRESS / ADDRESS.2L ,� _. �� __ LOCALITY a �_ 3 /�/y NEAREST J CITY ��„s`/9/��_ le-V TEL.Ngodge -� CROSS ST. - COUNTY CERT.No. S'" EXPIRES m i NAME e 4&S �p LOCATION OF SEPTIC o HANK, OR CESSPOOL O ADDRESS CITY TEL.No. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICA F QU IC t PLUMBER I AM THE LE OWNER OF THE PROPERTY D S [BED ABOVE. A a O OWNER 1 CORRECTIONS SOUTH a DESCRIPTION OF WORK � ATH TUB FURNACE M SHOWER DISHWASHER O LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK ,Z—SAND TRAP SLOP SINK FLOOR DRAIN T a S �y -WASH TRAY URINAL APPROVAL �L.—WATER CLOSET DRINKING FOUNTAIN _ DATE,/ 6NSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I ��)�Y I .�✓' METER GAS SODA FOUNTAIN GAS PIPING OUTL Z yJ� GAS VENT CESSPOOL I II TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOL ,/G—gEPTIC TANK ® SEINER I I $ —s I TOTAL FEE 1 �d UTILITY CO.NOTIFIED I `� rt� y✓ I � tp'py i FINAL l� 76 A 667 - CE 817 7-69 , f' t APPLICATION FOR -.PLUMBI.N.G PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION UILDING JOHN A. LAMBIE, COUNTY ENGINEER BADDRESS J �/iL✓f'I COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST .y CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 1.50 !HAIL BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY TEL. NO. LAVATORY 1.50 CONTRACTOR d tv L a✓„„ SINK 1.50 ADDRESS 7 !i-L,-4 DISHWASHER 1.50 CITY A /' .p TEL. NO. Ar ,CLOTHES WASHER 1.50 STATELIC LICENSE NO. /O ¢' J CLASS ec.-SWr IMMING POOL RECEPTOR DISTRICT NO. GROUP �NE Pi CESS BY LAWN SPRINKLER SYSTEM WATER HEATER 1. INDUSTRIAL 0 WASTE APPROVAL GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD OUTLETS OVER .30 5 PER SYSTE - t� LLH N Plan check fee 25% of above. See reverse. PLUMBING.PERMIT ISSUING FEE 8 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Pl�n Check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City. Tel. No. HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR T AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE A V _j.. RIBED RESIDENTIAL PROPERTY. FINAL SIGNATURE JACK R. ALLEN, SU ERVISIN HANICAL ENG'R. OF PERMITTEE PERMIT VALIDATION CK. 6. CASH PLAN CHECK VALIDATION CK. M.O. CASH 14 D N 76 A 667 — CE 817 7-69 t APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING yy BUILDING AND SAFETY DIVISION ADDRESS �; Z � 1-n A `p S ID 0"JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST NUMBER FIXTURE OR ITEM. EACH FEE CROSS ST. OWNER WATER CLOSET 1.50 MAIL BATH TUB 1.50 ADDRESS r ` SHOWER 1.50 CITY TEL. NO. LAVATORY 1.50 CONTRACTOR La ! oZ A. A ,oy V SINK 1.50 ADDRESS ♦♦/? ', (�� OF C--/l/STV .J �j4Vp DISHWASHER 1.50 CITY s,A TEL. NO. CLOTHES WASHER 1.50 STATE LIC LICENSE NO. ® G �,—r CLASS C^ 3 6 SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE CESS D Y LAWN SPRINKLER SYSTEM 2.00 1 —9 Z WATER HEATER 1.50 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.50 75 INSPECTION RECORD u OUTLETS OVER 30 O 5 PER SYSTEM N� 9e Cn Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 00 TOTAL FEE 7 . APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel. No. HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR TH AM THE LEGAL OWNER OF,AND INTEND TO 42 RESIDE IN,THE A VE D GCR I BED RESIDENTIAL PROPERTY. FINAL SIGNATUREJACK R. ALLEN, SUPERVISIN E ANICAL ENG'R. OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.0. CASH CuLAC0 2 2 7 9 SFP , 5 D 4.7 5 N 76A66 - CE8''Z,5/70 �-a I APPLICATION FOR PLUMBING PER T COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FWDR&G. JOHN A. LAMBIE. COUNTY ENGINEERCOLEMAN *:JENKINS. SUPT. OF BUILDING FOR APPLICANT TO FILL IN(PR NT OR TYPE) NUMBER FIXTURE OR ITEM EACH FEE '7:1--)(A oft- 6---�. WATER CLOSET bum y ' NLAII. BATH TUB 1.50 ADDRESS e� SHOWER 1.50 CITY TEL.NO. t-�:- LAVATORY �0 CONTRACTOR /�I `S, ( ( p/ (� SINK 1.50 ADDRESS' r', �� V� �„C. Il 17- 0 A /Jt.4, DISHWASHER 1.50 CITY Lg�. TEL. NO. CLOTHES WASHER 1.50 STATE / �- LIC LICENSE NO. G-C 3� CLASS C "j SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE Pp OCESSED BY LAWN SPRINKLER SYSTEM 2.00 �..J WATER HEATER 1.50 DiDUSTRULL WASTE APPROVAL ��,: '� � GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD OUTLETS OVER 5 PER SYSTEM .30 /1f A ' ` VD _OA Epv-iv Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE .8 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNA URE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING 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 AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF - CALIFORNIA OR TNA 1 AM THE LEGAL OWNER OF.AND INTEND TO RESIDE IN,THE AB SCRIBED RESIDENTU\L PROPERTY. FINAL / SIGNATURE (fib''\.. JACK R.ALLEN, SUPERVISING HANICAL ENG'R. OF PERMITTEE PERMIT VALIDATION CK. M.0. CASH_ PLAN CHECK VALIDATION CK. M.O. CASH _ _ VVORK RS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT 'I hereby'affirm that I hk,e a certificate of consent to self 7 A667A insure, or a certificate of Workers' Compensation Insurance, E 817(REV. 10/81) or a certified copy thereof (Sec. 3800, Lob. -L,,ob. C.) r COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company .• '�6f' � Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS 4;1V7It tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY r� WATER CLOSET Date Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by SHOWER r� the permit is for one hundred dollars ($100)or less.) MAIL /�y 1J 19 I, I certify that in the performance of the work for which this LAVATORY ADDRESS permit is issued, I shall not employ any person in any manner 51 SINK CITY �, e9 r"( TEL. NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER / /� CONTRACTOR �Ci' ,fib of Date Applicant CLOTHES WASHER ({/ ADDRESS /V L% P NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- CITY �N -� TEL. NO. �e �\G LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE �j �°p LIC. deemed revoked. WATER HEATER a LICENSE NO. ✓ ® 1Y CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. CESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER — :!�_ and Professions Code, and my license is in full force an ffect. 5 PER SYSTEM tEL. FINAC��6Q DATE Z-7- e� VA DATION License Number Lic. Class � FIN O Contractor Date BY ❑ I am exempt under Sec. v/ B.&P.C. for this reason Plan check fee Date: 101. PLUMBING PERMIT ISSUING FEE$ SV Signature Jo ,} TOTAL FEE SV SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address -'3 7 7.9 A Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. #f o 9 o o o 5 ❑ I, as owner of the property, will do the work and the o 0 5 5 0 structure is not intended or offered for sale (Section 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY o o o 5 a 5 0 66 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued Q 1. 08—86 (Sec. 3097, Civ. C.). Lender's Name `'b" 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 abovned property for section purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE r Signature of Permittee Date ` -aWORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT 1,;he[Ally,affirm that I hate P cer;ifi ite of consent to self 76A667A .y .P }�`ror b cArtificate of Workers' Compensation Insurance, CE 817(REV. 10/81) ` o certified copy"thereof (Sec. 3800, Lab. C.) ,� COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy NoXK8767207Company Christ &Spa g Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS FEE LOCALITY Temple City C� NUMBER FIXTURE OR ITEM r tion department. Date '51 -7Applicant {( / WATER CLOSET Ik U NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' ! BATH TUB CROSS ST. COMPENSATION INSURANCE OWNS (This section need not be completed if the work involved by SHOWER �Ir. Fellkiari the permit is for one hundred dollars $100 or less. MAIL p ( ) ) LAVATORY ADDRESS 1343 Doverwood ; I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Universal Plumbing Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of 2631 Lee Ayp Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR 616 Compensation provisions of the Labor Code, you must forth- CITY TEL. NO. LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. .� deemed revoked. / WATER HEATER91 LICENSE NO. 386678 CLASS C36 — •, LICENSED CONTRACTORS DECLARATION 0 DISTRICT NO. �J SSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER Sid and Professions Code,and my license is in full force and effect. 5 PER SYSTEM A DATE FINAL VALIDA ON Q License Number 386678 Lic. ClossC36 JU0143mus.al Plumbing Date 5-8-85 BY ALdw I am exempt under Sec. f9i B.&P.C. for this reason Plan check fee Date: L,2OQ6 � PLUMBING PERMIT ISSUING FEE$ t 0 0 0 0 0 Signature 0 o 8 a 5 TOTAL FEE 0 0.0 8 Q 5 Q= U Plan check applicant SINGLE FAMILY 0 5 0 9-85 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and Professions Code): 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'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 property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 5 — 5 gnature of rmittee Date /ORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT ; he ffirm tRat I have a c rtificote of consent to self 76A667A Oisure,Zr certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof (Sec. 380 , Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY �,. d®1' PolicyyNo. �G 7 Company��iQi'`-a�GtiCc.� ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING " I IN Certified copy is filed with the coun buil in pec- ADDRESS (e ,L?L tion department. NUMBER FIXTURE OR ITEM @ FEE . LOCALITY Date �C �-�3 Applicant �/ WATER CLOSET NEAREST IF CERTIFICATE OF EXEMPTION ROM WORKER ' BATH TUB CROSS ST. �,� COMPENSATION IN RANCE OWNER `A:�1c..� (This section need not be complete if the work involved by SHOWER the permit is for one hundred dollars 5100 or less. MAIL p ( ) ) LAVATORY Q ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO. so as to become subject to the Workers Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS 3 Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY /�� TEL. NO.�+ 'j��(j� O with comply with such provisions or this permit shall be STATE- LIC. deemed revoked. WATER HEATER LICENSE NO. 3 LASS , LICENSED CONTRACTORS DECLARATION .DISTRICT N PRO SSED 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 and Professions Code,and my license is in full force ,,and -yeffect. 5 PER SYSTEM t. DATE L V LIDATION License Number 3 84 L-7 e Lic. Class r- 3 (1 �. f FINA Contractors Date O^I S� BY It— ❑ I am exempt under Sec. f� B.&P.C. for this reason Plan check fee ® ;9Z 1 2 8 A g PLUMBING PERMIT ISSUING FEE$ # o,o o 0 0 5 Signature TOTAL FEE j Q 10 0 2 a 5 Q Plan check applicant 2$ Jr Q= INGLE FAMILY o o o 6 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License I Q.1 4=8 Jr Law for the following reason (Section 7031.5, Business and Address ' Professions Code): 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, Bysiness 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 4abov dinances and State la regulating Plumbing, and hereby thorize repre s oft ounty to enter upon the one pr ' e y f ns ection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE nature of Per ttee Date