Loading...
HomeMy Public PortalAbout5509 RYLAND AVE_Plumbing__ �• WORKERS'COMPENSATION DECLARATION 200026 DPW 4/90 i4PPLlC�►TI®.N FOR PLUMBING PERMIT - \Lhereby,affirm that I•have a certificate of consent to self in- ' sure,ora certificate of Workers'Compensation Insurance,ora 76A667A certified copy thereof(Sec. 3800, Lab. C.) � .. ' COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company • i Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspection ADDRESS 9�6q LA r`I 0 AtX department. NUMBER FIXTURE OR-ITEM @ FEE LOCALITY Date Applicant WATER CLOSET(TOILET) ., NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' / BATH TUB CROSS ST. Ad.DWJ� A COMPENSATION INSURANCE SHOWER OWNER M CIN (This section need not be completed if the work involved by p 1 r1A the permit Is for one hundred dollars($100)or less.) LAVATORY ADDRESS ADRESS b LAV I certify that in the performance of the work for which this per- SINK r mit is issued, I shall not employ any person in any manner so CITY �El L C U ( TEL. NO.�P/yi ZML7-7 31 as to become subject to the Workers'Compensation Laws. DISHWASHER _ CONTRACTOR Date 2 A rApplicant .)s M er. �fy�'I CLOTHES WASHER ADDRESS NOTICE T APPLICANT: If, after making this-Certificate of Ex- emption,you should become subject to the Workers'Compen- T n (� b CITY � TEL.NO.GjI� g sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS YO ly with such provisions or this permit shall be deemed revok- STATE / LIC. ed. WATER HEATER LICENSE NO. r0 Q7 Z CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 2—D fi 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER O and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect. / HOSE BIB DATE 6 License Number v Lic. Class D O FINAL Cant ac r ASI bDb f—D tA, Date 41f— BY 5ic O I am exempt under Sec. A44r./'.Tes V B.&P.C. for this reason -� Plan check fee ® 3303 75.6% • D te: PLUMBING PERMIT ISSUING FEE$ i ITEMS Signature TOTAL FEE Q TOTAL 75 o 60 SINGLE FAMILY applicant HOME OWNER-BUILDER DECLARATION Plan check a PP• 75.68 1 hereby affirm that I am exempt from the Contractor's License Name FJJ_ 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. 0000-0001 9/21/95 structure is not intended or offered for sale(Section 7044, 24.08AM 9e0b Business and Professions Code). CONSTRUCTION LENDING AGENCY i 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 r Lender's Address T 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 abovp,rw nt, d property for inspection purpose c C q f' SEE REVERSE FOR EXPLANATORY LANGUAGE Sign re of Permittee ate 76 A 667- CE 617 7-69 APPLICATION FOR PLUMBI G PEMAT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION FNEAREST p� `� 1 JOHN A. LAMBIE, COUNTY ENGINEER �95� 1 ` `�� COLEMAN W. J•ENKINS.•SUP'T. OF BUILDING FOR APPLICANT TO FILL IN PR NT OR TYPE) 4e-:s NUMBER FIXTURE OR ITEM EACH FEE OWNER` � b WATER CLOSET 1.50 MAIL BATH TUB 1.50 ADDRESS 5'd2b�—=— SHOWER 1.50. CITY � ' TEL. NO. ")9 SLI LAVATORY 1.50 CONTRACTOR © Ne_;p%. SINK 1.50 ADDRESS DISHWASHER 1.50 5V CrrT TEL. NO. CLOTHES WASHER 1.50 STATE LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR 1.50 DISTRICT JVO. TP ZONE PRO E D BY LAWN SPRINKLER SYSTEM 2.00 WATER HEATER 1.50 �j WDUSTRIPPROVAL GAS SYSTEM I OUTLETS 1.50 0 INSPECTION RECORD OUTLETS OVER 30 O 5 PER SYSTEM led Lu H z Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE. S 2 00/p) TOTAL FEE v APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name �,f TA ROUGH PLUMBING Address c 2 7- 4wd GAS PIPING . 6-11&e � GAS VENT cit Y Q G-'/& Tel. No. J ✓7 HOT WATER HE_ATER 1 HEREBY ACKNOWLED 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 THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOV CRIBED REST NTIA PR ERTY. FINAL. SIGNATURE JACK R. ALLEN,. su,PERVISING MECHANICAL EN'G'R. OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION O. CASH /Z4g JUN 5 D V- • 4 78A887-CE#817 10-87 �7 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION RUMDINc JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS �. N• Ryland COLEMAN W' J.ENKINS. SUPT. OF BUILDING LOCALITY Temple City FOR APPLICANT TO FILL IN(PRINT OR TYPE) NEAREST CROSS ST. Bogue NUMBER FIXTURE OR ITEM EACH FEE OWNER R. Talor WATER CLOSET 1.50 yya BATH TUB 1.50 ADDRESS lY• land r� SHOWER 1.50 - CITY T• C• TEL. NO.2 (-9 9 LAVATORY 1.50 CONTRACTOR W, B, Graham SINK 1.50 ADDRESS 9127 Las Tunas Drrive DISHWASHER 1.50 CITY emple y TEL.NO.286/-9293 CLOTHES WASHER 1.50 L' ATE LIC TCENSE NO. 704466 CLASS C- 6 SWIMMING POOL RECEPTOR 1.50 DISTRICT�0.. GROUP F Pad 0PRROOCESSED BOYLAWN SPRINKLER SYSTEM 2.00 VV G. TSO d®�ti WATER HEATER -rep a 0.,50 INDUSTRIAL v WASTE APPROVAL CD GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD v OUTLETS OVER 30 a 5 PER SYSTEM rA Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE 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 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 THAT 1 AM THE LEGAL OWNER OF AND INTEND TO r . RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL EN'G'R. OF PERMITTEE �j.� PERMIT VALIDATION (c,.K .M.O. CASH -PLAN CHECK VALIDATION CK. M.O. CASH l�L----�� r. 8 3 6 7 0..FEB 1 5 m 76A667 17 8-50 it ''. APPLICATION FOR PERMT DEPARTNNIENNT OF BUILDING AND SAFETY y 'i /.APLUMBING�f COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER t FOR APPLICANT TO FILL IN' DISTRICT NO. GROUP ZONE. PERMIT NO. PLUMBER VALLEY BOULEVARD PLUMBING CO. RECEIVED BY READY FOR DATE isouED OG FIRST INSPECTION• � o ` r > V ADDRESS ..900 EAST VALLEY BLVD. sv ROSEMEAD AT. 2-2J 19 ADDRESS 2 :'ADDRESS CITY TEL NO. . '`` LICENSE NO.COUNTY 93M EXPIRES .v�o�•+'I LOCALITY -NEAREST ` PEMT FEES N CROSS ST. w��1t F2r a NUMBER TYPE OF FIXTURE.OR ITEM FEE OWNER MAIL WATER CLOSET (TOILET) O.s0S 1B ADDRESS 0,AID LrE'C BATH TUB @ 0.50 d• �{ jyJ(� . _ CITY fil. r / TEL. NO. SHOWER. (� 0.50 _ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS J LAVATORY (WASH BASIN.) @ 0:80': SQ APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO.COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK C.50 ' d .STATE LAWS REGULATING PLUMBING. I CERTIFY.. THAT I POSSESS. THE ABOVE. VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER OF THE RESIDENTI PROPERTY DESCRIBED ABOVE: GAS SYSTEM OUTLETS @ O.SO �� SIGNATURE OF WATER HEATER @ O.50 `b PERMITt 2 w ✓LG1 SLOP SINK @ 0.50 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL @. O.Sp. .1 HOUSE SEWER @ O.SU a Z.: MISCELLANEOUS 5 x R APPROVALS 1710/' DATE y1NSP,ECTOR•S NAME •ROUGkI PLUMBING J� moi/ GAS PIPING GAS VENT CESSPOOL @ 1.00 CESSPOOL Jf ` SEPTIC TANK: 'SEPTIC.TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER y PERMIT1.00 GAS TEST • UTILITY CO. NOTIFIED` TOTAL FEE $ Od 1 w FINAL �