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Home My Public Portal About6202 SULTANA AVE_Plumbing__ 78A887-CE#817 10-82 APPLICATION FOR- PLUMBING PERMIT COUNTY OF LOS ANGELES. .DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS WILLIAM A.JENSEN, SUPT OF BUILDING �s LOCALITY FOR APPLICANT TO FILL INNEAREST — s CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER C WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS SHOWER ��-� 1.25 7- Ile CITY TEL. NO. `` LAVATORY 1.25 CONTRACTOR ! v zG'a�•1. SINK 1.25 ADDRESS - DISHWASHER 1.25 CITY�� f�oa�( TEFL. NOIWC �j LAUNDRY TUB 1.25 REGISTRATION NO. �B T COUATE ❑ COUNTY ❑. CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PROCESSED Y WATER-HEATER 1.50 � 6j-oy x' / c5-77:r GAS SYSTEM OUTLETS 1.50 y INDUSTRIAL WASTE APPROVAL OUTLETS OVER S`PER SYSTEM .30 PECTION RECORD 4U z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK f �� ` ROUGH PLUMBING ,�I OTAL FEE„ GAS PIPING 1 1 HEREBY ACKK WLEDOE THAT -_.. "READ THIB APPLICATION GAS VENT AND STAYS THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REG 7ND INC PLUMBING. HOT WATER HEATER I+HEREBY CERTIFY THAT' 1 R P.ERL EGISTER IOR PLUMBING FIXTURES E LICENSED AS REQUIRED 0 NGELE LINTY AN ATE OF GAS TEST CALIFORNIA ORI THAT I T LEGA O ,A NTEND TO RESIDE ON,THE ABOVE REG, P Y. UTILITY CO.NOTIFIED 1 SIGNATURE OF PERMITTE. FINAL 1lA�. ✓� ALIDATION ROBERT A.WOOD CK. M.0. CASH SUPERVISING MECHANICAL ENG'R La0 6- 6 2 JUN 30 5 D3.2*5194 - �' WORKERS"'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT t hdMby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 iq'ure,,or a certificate of Workers'Compensation Insurance, 76A667A ora certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS Policy No. 1129468-S&mpany CNA Ins. Co. Certified,copy is hereby furnished. 1'- F.OR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING® ti ADDRESS 6202 Sultana Certified copy is filed with the county building inspec- NUMBER FIXTURE OR ITEM � FEE tion department. LOCALITY Temple City 6-5-92 Owen Bros. Mg. WATER CLOSET Date Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS— BAT}I TUB CROSS ST. COMPENSATION INSURANCE - M_Murray t SHOWER OWNER Pat (This section need not be completed if the work Involved by MAIL 3606 N. Rio Hondo the.permit is for one hundred dollars(9100)or less.) LAVATORY ADDRESS I .certify that in the performance of the work for which this _J_y_5 permit is issued,.I shall not employ any person in any manner SINK CITY Rosemead TEL.NOA43-1579 so as to become subject to the Workers'Compensation Laws. DISHWASHER cONTRAC OROwen Bros. Plumbing, Inc.. Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this. Certificate of 4265 N. Baldwin Ave.. Exemption, you should become subject to the Workers ! SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLERSYSTEM CITY E1 Monte TEL. N0443-0078 with comply with such provisions'or this permit shall be STATE 231 741 LIC. C36-20-16 deemed revoked. WATER HEATER / LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm-that I am licensed under provisions of Chapter GAS SYSTEM ` OUTLETS z .0 f/ (commencing with Section 7000)of Division 3 of,the Business OUTLETS OVER �+ and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VALIDATION 'License Number 231 741 Lic. ClasDATE 8j 3�� Cs C36-20-16 rr FINAL ` / - ContractorOwen Bros. P1b9.Date 6-5-92 BY N -•r•- 1 Ilk 1 .} oma C ❑ I am exempt under Sec. -;770:. ..075 B.BP.C. for this•reason &L Plan.check fee � v Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE I 11,216-5 Pian check applicant i )I_: SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name %; EHL 112 o 05 I hereby offirrri that I am exempt from the Contractor's License -.�„-r•r ;.,n ;,�. Law for the following reason (Section 7031,5, Business and Address Professions Code), City Tel. No. f{ j+�±;E I't i ❑ "�'- 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). 6 11D :y CONSTRUCTION LENDING AGENCY ti r, �-�+a' I hereby affirm that there is a construction lending agency for `1113` t I •.i+•ie 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 ufhori�e representativ of this County to enter upon the ntioned'•rop r for inspection purposes. SEE REVERSE.FOR EXPLANATORY LANGUAGE 6-5-92 Signature of Perm tee Date