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Home My Public Portal About5355 SANTA ANITA AVE_Plumbing__ / YWORKERS'COMPENSATION'DECLARATION I et'.Dy affirm that I have a certificate of corisent to self irr• 26 667 DPW 4y' APPLI.CATIO,IV ,�®'� PLUMBING PERMIT �bA667A ;surefbr a certificate of Workers'Compensation Insurance,-or a CE B•17(REV.8/86) certified copy the'feb�(`d'ec. 3800, Lab. C.)' 989449 = ' ' COUNTY OF LOS.AN.GELES MEPT. OF.PUBLIC WORKS' Policy No. Company-Reppbj i'C T_nriamn.ity' Certified copy,is hereby furnished. . FOR APPLICANT TO'FILL IN(PRINT OR TYPE) BUILDINGS,' i. I� Certified copy is filed with the couhty building inspection ADDRESS 5355 SantaL= Aii.i;ta;Avg. '�Y•. department. NUMBER FIXTUREOR.ITEM @ FEE ` `} LOCALITY I •.Tem .le Cit):• Date % 6/89_APP lican I, 3 HWATER CLOSET(TOILET) 6,O. 1.8, Q NE4RE5T• f BATTUB CROSS ST. -Raines 'CERTIF&TE OF EXEMPTION FROM'WORKERS' 1 COMPENSATION INSURANCE. owNERRoccoSanello` (This section need not be completed'if the work involved by 1 SHOWER 6. DIG the errMt is for one hundred dollars fob)or less. LAVATORY MAIL ` P ( ) ) ADDRESS ', 10:102'La Rosa Dr.., I"certify that iri the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so 1 6• Q CITY T nj. le, City TEL. .43-5777 as•Yo become subject to the Workers'Compensation Laws. 1 DISHWASHER , 6. Q CONTRACTOR Frank Marrone..& Sans Inc. Date Applicant- CLOTHES WASHER ADDRESS 9860 -Lower Azusa `Rd. 'NOTICE TO'APPLICANT- If; after making this Certificate..eof Ex- SV%IMMING POOL RECEPTOR • mption,you should become subject to the Workers' Compen- CITY { •sation provisions of;the Labor Code,'you must for comp- LAWN SPRINKLER SYSTEM El monte TEL,N(YI C}L}_25l}$ :: i ly with.such provisions or this permit shall be deemed revok- STATE i LIC. . 'ed• .1 WATER HEATER 6• Q LICENSE NO: 397884 CLASS.1/36 ' LICENSED CONTRACTORS DECLARATION' DISTRICT NO. C PR ESSED BY, I hereby affirm that I am licensed under provisions of Chapter 1 GAS SYSTEM 5,;OUTLETS 6, Q, �'^��. 9(commencing with Section 7000)of D'ivision.3 of the Business OUTLETS OVER ;�� and Professions Code, and my license is in full force-and•ef- 5 PER SYSTEM FINALVALI IATI feet. 39788.4 Ci 36 DATE License•Nurnber Lic. Class 0 • • FI ' � Cont-actorF• Marrone & S.onEate: 12/89 O I 0 .I.am,exempt Under Sec.., i I :xY BigI a_ ', dL B.&P.C..for this reason. Ca Plan check fee ate: 3/23/89 PLUMBING PERMIT ISSUING FEE$ 1O 50 Sigriatu orTOTAL FEE SII GLE. AMILY ` HOME OWNER-BUILDER DECLARATION Plan Pcheck-applicaint I hereby affirm that I am exempt from the Contractor's License Name y Law for the following reason (Section 7031.5, Business and ;�it:.t.i Professions Code): Address ❑ I, as owner'of'the property, will'do the work and the City I Tel. No. fy :SIC structure'isnot intended or offered;for sale(Section 7044, Business and Professions Code). o, ® ii.i.' CONSTRUCTION LENDING AGENCY 94.50 I hereby affirm that there is a construction lending agency forr• ;:+i, C. the performance of the work for which this permit is issued { `' "i ' ` . (Sec. 3097, Civ. C.). I n Lender's Name I.)I 4-fir' 4/lo/8-l a53 Lender's Address J 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 ® I authorize representatives of this County to enter upon the above-mentioned roperty for inspection purposes. 3%23/89. SEE REVERSE FOR EXPLANATORY LANGUAGE Sig ture P r ttee Date � / YWORKERS'COMPENSATION DECLARATION 20' APPLICATION FOR PLUMBING PERMIT ,t-% �1 ' er-..q,, affirm that I have a certificafe of consent to self in- 26 DPW 4/87 76A667A ,sure/br a certificate of Wophers'Compensation Insurance,ora CE 817(REV.8/86) certified copy thefeof(tec. 3800, Lab. C.) ., Policy No 989449 Company Repiihl i r Tntiamnity COUNTY OF LOS ANGELES 'DEPT. OF PUBLIC WORKS Certified copy is hereby furnished. , FOR APPLICANT TO FILL IN(PRINT OR.TYPE) BUILDING , ' Certified copy is filed with the county building inspection ADDRESS 5355 '5anta:•. A�ni.ta Ave. department. NUMBER FIXTURE OR ITEM Q FEE LOCALITY ` \• I Temple Cit Date. / 6/89 Applican 3 WATER CLOSET(TOILET) 6.OC 18. )0 NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' 1 BATH TUB CROSS ST.I Daanes COMPENSATION INSURANCE OWNER ROCCo Sanel lo` (This section need not be completed if the work involved by 1 I SHOWER 60MAIL the permit Is for one hundred dollars(;100)or less.) LAVATORY ADDRESS 110.102 La Rosa .Dr. I certify that in the performance of the work for which this per- SINK CITY ' TEL. N mit is issued, I shall not employ any person in any manner so 1 6.00 Temple Cit %.43-5777 as to become subject to the Workers'Compensation Laws. 1 DISHWASHER 6, Q . CONTRACTOR Frank Marrone & Sons Inc. Date Applicant 1 CLOTHES WASHER 6- 710 NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESS 9860 Lower Aznsa Rd. tion,you should become subject to the Workers'Com en- SWIMMING POOL RECEPTOR em P Y I P CITY I E1 mon.te TEL. N44_2548 sation provisions of the Labor Code,'you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC.. ed. .1• WATER HEATER 6. )0 LICENSE NO: 397884 CLASS C/36 LICENSED CONTRACTORS DECLARATION DISTRICT NO. PR ESSED B I hereby affirm that I am licensed under provisions of Chapter 1 GAS SYSTEM 5 OUTLETS 6. 310 D S7 9(commencing with Section 7000)of Division'3 of the Business OUTLETS OVER f� and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL .� VALIDATI Lice. 397884 . C/36 DATE IL License Number Lic. Class (� ' FI ContractorF• Marrone & Sonq)ate 12/89 O I am exempt under Sec. LU B.BP.C. for this reason ► Z Plan check fee ate; 3/23/89- PLUMBING PERMIT ISSUING FEE$ 10 50 Signature TOTAL FEE SI GLE ILY HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name -• Law for the following reason (Section 7031.5, Business and tt_•�• , AL Professions Code): Address I, as owner'of the property, will•do the work and the City Tel. No. i -;;_t•(r_ structure is not intended or offered for sale(Section 7044; Business and Professions Code). ► i ? ,, 94 .50 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 r�".5131. Lender's Address I 24, 1` i 7 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 roperty for inspection purposes. 3/23/89 SEE REVERSE FOR EXPLANATORY LANGUAGE Sig azure 49ff P r ttee Date 76AG67-CENS17 2-66 APPLICATION FSR PL' UIWBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FNEAR — L JOHN A. LAMBIE. COUNTY ENGINEER �' COLEMAN W. JENKINS. SUPT. OF BUILDING FOR APPLICANT TO FML IN NUMBER FIXTURE OR ITEM EACH FEE J OWNER 97-CI-41 �/V ' WATER CLOSET $1.25 MA BATH TUB 1.25 ADDRESS 3L Liz �QiC/ SHOWER 1.23 CITY PL L. NO. LAVATORY 1.25 CONTRACTOR L UC_S SINS 1.25 ADDRESS O DISHWASHER 1.25 CTfY A TEL. NO. LAUNDRY TUB 1.25 STATE LIC LICENSE NO.. [Z CLASS CLOTHES WASHER 1.25 DISTRICT NO. GR P ZON PR=ICESBYWATER HEATER 1.50 �D GAS SYSTEM OUTLETS 1'� -INDUSTASTE RIAL, ROVAL o OUTLETS OVER 5 PER SYSTEM .30 INSPECTION.RECORD, � cLj _ W K APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT S 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE _S B pl GAS PIPING d I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT _ AND .STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER.HEATER PLUMBING. _ I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST GLIFORNIA OR THAT 1 AM THE'LEGAL OWNER OFj AND INTEND TO RESIDE IN.THE ABOVE DESCRIBED REBID TIAL PRO ERTY'. UTi LITY CO.NOTIFIED SIGNATURE OF PERMITTEE FINAL � LIDATION JACK R.ALLEN CK. M.0. CASH SUPERVISING MECHANICAL ENG-R. LRCO 0 0 6 2 AUG 14 5 D 5.00- APPLICATION FOR .PLUMBING .PERMIT r DB9;17��33 . �'ti�DIVISION OF BUILDING AND SAFETY .- Department of Caunty'Engineer t}� 1 County Of LOS Aageie8 BUILDING m�IG JOHN A. LAMBIE. COUNTY ENGINEER' ADDRESS CASSATT D,GRIFFIN;SUPT OF BUILDING - LOCALITY FOR APPLICANT TO FILL IN I NEAREST ; , CROSS ST. ,. OWNER DISTRICT NO. GROUP ZONE ADY FOR INSPECTION MAIL ADDRESS `mow INDUSTRIAL CITY 'eli3eTEL.NO. WASTEAPPROVAL• PLUMBER9=4 � /INSPECTION.RECORD ADDRESS CITY L.NO.' d9ti LICENSE NO. NUMBER TYPE OF FIXTURE OR ITEM FEB WATER CLOSET (TOILET) @ $1.00 $ BATH TUB @ $1.00•• SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $1.00 KITCHEN SINK @ $1.00 DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY Q 81.00.- CLOTHES WASHER 1,00 - CLOTHESWASHER Q $1.00 WATER HEATER @ $1.00 GAS SYSTEM @ $1.00 APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 100 -ROUGH PLUMBING • 4+�.✓y GAS PIPING TOTAL FEE OFIC GAS VENT I HEREBY ACKNOWLEDGE THAT 1 HAVE READ.THIS APPLICATION HOT WATER HEATER 'rte AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STgTE LAWS REGULATING PLUMBING. PLUMBING FIXTURES "`��j ��,E�Lf rtt•_ I HEREBY CERTIFY THAT 1 AM. PROPERLY REGISTERED AND/OR GAS TEST w� LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER. OF THE ABOVE 'UTILITY CO:NOTIFIED DESCRIBED RESIDENTIAL /ROOOP�ERTY.� IGNATURE SOF PERM TTEE /r G/ ,, �� FINAL OHN A.L4MBIE,COUNTY ENGINEER .VALIDATION. ROBERT A.WOOD.CHIEF PLBG. INSPECTOR • CN, a.'o. CASH E AC0 6 3'.,0- JUN 8 3 4.0 0 "6667 17 0-86 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING ' WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL 1N DISTRICT NO. GROUP I ZONE PERMIT NO. PLUMBER 4` 1 1` U�K1, I�•"�y� (UMC . RECEIVED BY READY FOR DATE ISSUED RR ,,//�� FIRST INSPECTION ' ADDRESS[OV ►`MVV. ADDRESS IV A��►3L QRI V e' BUILD CITY COUNTY1 � TEL. NO. 9' (. LICENSE NO. • EXPIRES L.CALIT d ,(J i\ie SGL(a NEAREST PERMIT FEES CROSS ST. r on NUMBER TYPE OF FIXTURE OR ITEM FE OWNER YV Y�r I MAIL S.+I'�II ' WATER CLOSET (TOILET) @ 0.50 ffi n I BATH TUB @ O.50 CITY a` G TEL. NO. SHOWER ® 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS I LAVATORY (WASH BASIN) 0..50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND I KITCHEN SINK O.SO. O STATE LAWS REGULATING PLUMBING. I 1 CERTIFY THAT 1 _ ESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 O ANGELES COUNTY OR S , AM THE LEGAL OWNER OF THE ID RTY DESCRIBED ABOV I I GAS SYSTEM---k-OUTLETS @ O.50 I O SIGNATURE O WATER HEATER @ 0.5.0 PERMI SLOP SINK @ 0.50 INSPECTION RECORD FLOOR SINK @ 0.50 n� r _ ��`` od)-vvY,• FLOOR DRAIN / DISHWASHER @ 0.50I DRINKING FOUNTAIN @ 0.50 URINAL @ 0.501 „J HOUSE SEWER @ 0.50 a Z_ MISCELLANEOUS (' O f APPROVALS DATE IIMBPECTOR'S NAME ROUGH PLUMBING11,00, GAS PIPING GAS VENT '/✓�I�� ' ■J CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC.TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER �s PERMIT . 1.00 GAS TEST 3 -1 ! UTILITY CO. NOTIFIED ■ A 6 TOTAL FEE $ Cf Tot FINAL 1/ •