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Home My Public Portal About5742 ROWLAND AVE_Plumbing__ 76AGS7A (C;6 01719) -a '/ ��jj�.....//////\\ -APPLIC�TION FOR PLUMBING PERM RM ' S BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(.PRINT OR TYPE) BUILDING �. t NUMBER FIXTURE OR ITEM ® FEE ADDRESS WATER CLOSET LOCALITY BATH TUB NEAREST CROSS ST. SHOWER OWNER //` LAVATORY MAIL ADDRESS SINK CITY TEL. - DISHWASHER INSTALLERS IZ��II,p ApLL,p ER�1Q� CLOTHES WASHER fle SWIMMING POOL RECEPTOR TEL. LAWN SPRINKLER SYSTEM LIC. WATER HEATERLICENSE NO. CLASS GAS SYSTEM OUTLETS. DISTRICT NO. �j UP Z NE CESSE BY OUTLETS OVER L CD 5 PER SYSTEM INDUSTRIAL C.7 WASTE'APPROVAL INSPECTION.RECORD W d N Plan check fee PLUMBING PERMIT ISSUING FEE$ TOTALfEE O Plan check applicant Name APPROVALS DATE INSPECTOR'S SIGNATUR UNDER SLAB WORK Address ROUGH PLUMBING City Tel.No. GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE GAS VENT THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST ,LEGAL OWNER OF.AND I ND TO RE IN THE ABOVE DESC_ IBED.RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE O O O. OF PERM(. FINAL �O O O, O Q - j PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIATIAI Q a 'It, M.O.. CASH J O O o 00 o O cn a CH , 7 7 51384.7 12/59. / APPLICATIO FOR PLUM INCA PIERMIT COUNTY OF LOS ANGELES DEPARMENT OF COUNTY ENGINEER F' Ei G BUILDIIIGSAFETYMSION Ess 7y2JOHN I COUNTY NGINEERWILLIAM A.JENSEN.SUP!T'OF BUILDING =FOR APPLICANT TO FILL IN ESY 101 CROSS ST. NUMBER FIXTURE OR ITEM OWNER WATER CLOSET BATH TUB A DDA DD S 7 2. a rn SHOWER CITY TEL.NO. 761^, OF LAVATORY CONTRACTOR SRS ADDRESS DMMASMM CITY NO. CONTRACTOR' STATE ❑ LAUNDRY TOB REGISTRATION NO. COUNTY ❑ CLOTHES WASHER D18 CT GROUP ZONE PROCESSED BY 7 1 us,,� WATER HEATES 0 GAS SYSINDUSTRIAL TEM WASTE APPROVAL DiSPECTION RECORD / pq _ e"i-v' lea G.e�M �.��-� r— Aftivrr f�hln lcvl? 17S wo j ! w51.00 PER zTEM p E i�Af A5 MI/Y P/ 4, /A(/// 08 FI7CT[JSE �� APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2100 UNDER SLAB WORK TOTAL FEE I Ido ROUGH PLUMBING GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE BEAD THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY.LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTE c FINAL /Z 1L d ®p VALIDATION ROBERT A.WOOD, CK. M-0. GASB SUPERVISING MECHANICAL ENG'R 3 3 2 6 JUL g 2 D 3.0 0 ' " r 76A607-CTilltil'110-m APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINMEMP BIRMIS An SAFETY DIVISION RUUMING M _A E, COUNTY ENGINEER ADDRESS W WILLIAM A. JENSEN, SUPT OF BUILDING IN LOCALITY NEAREST FOR APPLICANT TO PILL IN CROSS ST. ;v" NUMBER FIXTURE OR ITEM OWNER WATER CLOSET BATH TUB CITY _Z ogle et TEL.NO, SHOWER CONTRACTOR efow--w-e LAVATORY ADDRESS Smx CITY TEL NO. DISHWASHER CONTCTs LAUNDRY TUB. REGISMRA21OR0NNO- COW CLOTHES WASHER DI87 RICTtdNO- WATER BEATER 8 BY INDUSTRIAL SYSTEM WASTE APPROVAL > INSPECTION RECORD 8 0 0 Sim OR 10 ve . OD APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK - ROUGH PLUMBING TOTAL FEE _? 07 GAS PIPING C I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE is CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER il 15ol6i PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANDIOR PLUMBING FIXTURES LICENSED As REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE , DESCRIBED RESIDENTIAL P oPzRTY. UTILITY CO.NOTIFIED SIGNATURE OF PERM.. FINAL Z' VAMATlON,-----aOBERT A.WOOD CK. M.0. -AL ENG'R _PUPERVISING MECHANIC 5 2 0;9WV 28 5 B 300 WORKERS'COMPENSATION DECLARATION a' CK 61 ` ) APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have certificate of consent to self ce a17 z-eo insure,or-a certificate of Workers'Compensation Insurance,or 'fl a certified copy thereof(Sec.3800,Lab.C.) ' COUNTY OF LOS ANGE LEST BUILDING AND SAFETY Policy No. 38415.2. Company 'M1 - I 0 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE ADDRESS 5742 N. Rowland dip 29 2 n,.,.. .P1bg. WATER CLOSET f LOCALITY ty Date �F Applicants Bros. NEAREST BATH 7U6 ETA � �...�� CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER John Zis.ka MAI L (This section need not be completed if the work involved LAVATORY ADDRESS 5742 N. Rowland a by the permit is for one hundred dollars ($100) or less.) SINK 0 CITY Temple Cilie TEL.No. 287-939 v I certify that in the performance of the work for which this DISHWASHER O permit is issued, I shall not employ any person in any manner CONTRACTOROwen Bros.Plimibing so as to become subject to the Workers'Compensation Laws. CLOTHES WASHER - V ADDRESS 42.65 N. Baldwin Ave. Date Applicant SWIMMING POOL RECEPTOR LL CL NOTICE TO APPLICANT: If, after making this Certificate of CITY E1. Monte TEL.NO. �F�k3_007 try Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. z Compensation provisions of the Labor Code.,you must forth- WATER HEATER LICENSE NDZ31. 7.41. CLASS C36-20 with comply with such provisions or this permit shall be deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. PR CESSEQ BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER �� f I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL _� ness and Professions Code, and my license is in full force and DATE � "' VALIDATION effect. License.Number 23I' 741 Lia ClassC36-20 FINAL ContractOilJWClI Breff_PlbgDate! 412B182 I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ ;73 acting,in my professional capacity (Section 7051, Bus- iness anal Professions Code). TOTAL FEE 112 'Lid.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section 7031.5, Busi- City Tel.No. ness and Professions Code): I, as owner of the property, am exclusively contracting 13 8 2 6 A with licensed contractors to construct the project (Section 7044,Business and Professions Code). # 0 0 0 0 0 5 CONSTRUCTION LENDING AGENCY I 2o 0 1250 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is ; 00012"L50=0 'issued(Sec.3097,Civ.C.). Lender's Name I 04,29-82 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 C .�nty I SEE REVERSE FOR EXPLANATORY LANGUAGE. ordinances and State laws regulati Plumbing, and reby author' repres ntatives of his ty to enter upo the i ab ve entio d operty fo 'ns cti n pur oses. 4 26 82 ignature of Permittee Date I WORKERS'COMPENSATION DECLARATION, I = APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to.self ?6A6679 b insure,or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) 1 �� or a certified copy thereof(Sec. 3800, Lab. C.') { I+ COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No, Company Certified copy is hereby furnished. BUILD16N /� 06f) I�iT El Certified APPLICANT TO FILL IN(PRINT OR TYPE) "/ Certified copy is filed with the county building inspec- tion-department. NUMBER FIXTURE OR ITEM @ FEE L LOCALITY tom/ Date APP li ant WATER CLOSET NEAREST 4. CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE OWNER (This section need not be completed If the work Involved by SHOWER the permit is for one.hundred dollars($100)or less.) LAVATORY MAIL ADDRESS I certify that in.the performance of the work for which this permit isissued, I shall not employ any person In any manner SINK CITY TEL:NO. so as to become u6iect to the orkers'Compensation Laws:. -D ISHWASHER CONTRACTOR ��• r.`7r Date pplicant CLOTHES WASHER. ADDRES 74 NOTI TO 7PLICANT: If, after making this Certificate of SWIMMING POOL. !Z 49E �C Exem tion, you should become subject to the- Workers' CITY C TEL.NO.��40 Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be. STATELIC. /* deemed revoked. WATER HEATER LICENSE NO.S,620' CLASS6 LICENSED CONTRACTQRS DECLARATION / DISTRICT NO.. P ESSED•BY 1 hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS '0 ,j (commencing with Section 7000)of Division 3 of the Business 20. OUTLETS OVER r! 11116 and Professions Code,and my license is in full forceand effect. 5 PER SYSTEM FINALVALIDATION V 0 DATE License Number Lic. Class yr OC ��U� / FINAL r` �r' Contract �/ to BY _' ri 1116 I am exempt under Sec. B.&P.C. for this reason Plan check fee Z(2- C Date: j ► 4 Yd J. PLUMBING PERMIT ISSUING FEE$, po J d Signature TOTAL FEE S,-I.ISO SINGLE FAMILY Plan check applicant ' � - , HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's LI'cense Law for the following reason (Section 70.31.5, Business and Address ',O 2 0,4 P Professions Code): City Tel. No:Oil f; o 0 0 0 0 ❑ I, as owner of the property,.will do the work and the structure is not intended' or offered for sale (Section o a 5,250 7044, Business and Professions Code): S CONSTRUCTION LENDING AGENCY I °,° o S 2F v 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued 0 1. 1 3— ( (Sec. 3097, Civ. C.). Lender's Name j Lender's Address I certify that I have read this application and state that the I 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 1 ve-mentione pro er for inspection pur A SEE REVERSE FOR EXPLANATORY LANGUAGE } Signature o Permittee DOIA COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9805190001 BUILDING•AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID:. FEES PAID BUILDING DRESS: TR: 6561 LT: 396 5742 ROWLAND AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802616 ASSESSOR INFO MATIO NUMBE : NEAREST CROSS STREET: 8587-034-016 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY 11 CLOTHESWASHER(S) 1.00 FIX 16.35 TENANT: 21 HOSE BIBB(S) 1.00 FIX 16.35 ISSUED ON: PROCESSED-BY.---PLAN BY: EXPIRES ON: 25 LAVATORIES/SINKS 1.00 FIX 16.35 06/03/98 UT 06/03/99 45 WATER CLOSET/URINAL 1.00 FIX 16.35 OWNER: TEL. NO: 47 WATER HEATER(S) 2.00 WTH 32.70 FINAL DATE FINAL BY; CODE: MORGAN GREGG D;BRENDA K - 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.35 5742 ROWLAND AV TOTAL FEES 142.20 TEMP 917802616 DESCRIPTION OF WORK PLUMBING FOR GUEST HOUSE �i/'/�T/�G• APPLICANT: TEL. NO: e. SAME AS OWNER - _- SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: F;: ' +,��' �ri';+� :'a APPROVALS DATE INSPECTOR ATURE SAME AS OWNER LIC. NO UNDER SLAB AORS WATER SERVICE 0 PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. NO: ROUGH PLUMBING LIC. NO: D GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIE CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508