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HomeMy Public PortalAbout5530-5605 TEMPLE CITY BLVD_Plumbing__ 7BAee7�9CE-817)-4/7E \T ' A APPLICATION FOR PLUMBING PERMIT {� COUNTY OF LOS ANGELES LJ DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING MA KE CHECKS PAYABLE TO ADDRESS 6-82 N Te le Cit Blvd HARVEY T BRANDT, COUNTY ENGINEER LOCALIT' FOR APPLICANT TO FILL IN IPRINT OR TYPE) NEAREST CROSS ST NUMBER FIXTURE OR ITEM ® FEE 4 MAIL WATER CLOSET 1 75 OWNER Ron McClosky 13 BATH TUB 1 75 ADDRESS 870 East Mariposa 3 SHOWER 1 75 CITY TEL NO LAVATORY 1 75 CONTRACTOR SINK 1 75 ADDRESS 4265 North Baldwin Avenue .15 DISHWASHER 1 75 95— CITY El Monte TEL NO �� 8 1i CLOTHES WASHER 1 75 STATE LIC LICENSE NO ,2 CLAS$ 6 SWIMMING POOL RECEPTOR 1 75 DISTRICT N G P Z E PROCE BY LAWN SPRINKLER SYSTEM 1 75 WATER HEATER � � 1 75 'N PTARPAPROVAL GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD V OUTLETS OVER 5 PER SYSTEM 30 p W d N Z Plan Check lee See R.Y.,.. PLUMBING PERMIT ISSUING FEE S 3 00 TOTAL FEE APPROVALS TE w ec7oR T IrNArJRe Plan Check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel NO GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATC THAT THE ABOVE IS CORRECT AND ACRE! TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUM BI NO GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS RED URE O BY B ANGELES COUNTY AND STAT! OF CALIFORNIA OR THAT 1 A E LEO L OWNER OF AND INTEND TO RESIDE IN THE ABOVE DE IS ENTIAL P PCR FINAL t� SIGNATURE L OF PERMITTE *" PERMIT VALIDATION CK M 0 CASH PLAN CHECK VALIDATION CK M 0 CASH u,w 8 0 9 7H SP 28 5D 6 0.7 5- + TOABBS (CE-817)-4/72 �. ',APPLICATION FOR PLUMBING PERMIT {J COUNTY OF LOS ANGELES �J DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO BUDDING ADDRESS i HARVEY T BRANDY. COUNTY ENGINEER LOCALITY Te le Cit FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST NUMBER FIXTURE OR ITEM ! FEE. WATER CLOSET 1 75 /. 00 MAILOWNRon McClogjg BATH TUB 1 75 6 ADDRESS 8'70 East Mariposa SHOWER 1 75 O CITY TEL NO J/^ LAVATORY 1 75 CONTRACTOR SINK 1 75 26 ADDRESS 4265 North Baldwin Avenue DISHWASHER 1 75 S CITY MonteIU TEL NO —OO 78 CLOTHES WASHER 1 75 .f' STATE try�7i_1 LIC `"jb LICENSE NO J 41 CLASS SWIMMING POOL RECEPTOR 1 75 DISTRI T N(1� GROUP E BY LAWN SPRINKLER SYSTEM 1 75 �U$7gI L (/J�' y WATER HEATER 1 75 IND- WASYE APPROVAL py GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD S OUTLETS OVER q p� 5 PER SYSTEM 30 1111017 (� .Q K S yy Z Plan check tee See Reve.Ge PLUMBING PERMIT ISSUING FEE S 3 00 TOTAL FEE 6'O APPROVALS DATE ePmro + elTvenBc Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City i Tel NO GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE ID CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING GAS TEST 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 THAT I AM J.HE LEG L OWNER OF AND TEND TO RESIDE IN THE ABOVEDEB OED R ILTIAL P PER FINAL SIGNATURE OF PERMITTEE n PERMIT VALIDATION cK o• CASH PLAN CHECK VALIDATION c . 0 CASH Law,8 0 9 3;3 SEP 28 s o 11 850 76AV7 ICE-617)-4/72 G . APPLICATION FOR PLUMBING PERMIT DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING MAKE CHECKS PAYABLE TO ADDRESS HARVEY T BRANDT, COUNTY ENGINEER LOCA— FOR APPLICANT TO FILL IN (PRINT OR TYPEI NEAREST CROSS ST NUMBER FIXTURE OR ITEM 0 FEE WATER CLOSET 1 7S OWNER Ron McClos -9241 MAI BATH TUB 1 75 ADDRESS 870 East Mariposa SHOWER 1 75 Q CITY AltadenaTEL N0798-0 LAVATORY 175 CONTRACTOR Owen Bras.Plumbing,In SINK 1 75 ADDRESS 4265 North Baldwin Avenue DISHWASHER 1 75 CITY El Monte TEL NO �78 CLOTHES WASHER 1 75 STATE LIC LICENSE NO 2 CLASS C36 SWIMMING POOL RECEPTOR 1 75 DIST ICT NO GROUP E BY LAWN SPRINKLER SYSTEM 1 7S D WATER HEATER Y 1 75 WASTE APPROVAL GAS SYSTEM OUTLETS 1 75 INSPE TION RECORD OUTLETS OVER 30 � L ��y r A® o 5 PER SYSTEM G' W ya Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE b 3 00 TOTAL FEE APPROVALS DATE Pctt R > a�rNATD FE Plan check applicant UNDER SLAB WORK 72 Name ROUGH PLUMBING CAe Address GAS PIPING City Tel NO GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND !TATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCE! AND STATE LAWS REGULATING PLUMBING GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REOUI RED MY LOB ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM E LEGAL OWNER F, AND TEND TO RESIDE IN THE ASOVE OE! BE ENTIAL PERT FINAL SIGNATURE OF PERMITTE �� PERMIT VALIDATION cK M 0 CASH PLAN CHECK VALIDATION CK M D CASH 9 4-4 SEP 28 ' 5 D 11 $,5 0- 75,6657 ICEF11171 4/72 1 APPLICATION FOR PLUMBINGPERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING AIA KE CHECKS PA YA 8L TO ADDRESS 5552-54 N Te HARVEY T BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST Tempje City CROSS ST NUMBER FIXTURE OR ITEM 0 FEE OWNER Ron McClos WATER CLOSET 1 75 MAIL . lW BATH TUB 1 75 ADDRESS 870 East Mariposa SHOWER 1 75 CITY AltadenaTEL NO 8--0 LAVATORY 1 75 CONTRACTOR Owen Bro-s-Plumb-ing.Tnin- SINK 1 75 ADDRESS 4265 North Baldwin Avenue DISHWASHER 1 75 Q CITY El Monte TEL NO 8 CLOTHES WASHER 1 75 STATE 231741 LIC L"j LICENSE NO CLASS SWIMMING POOL RECEPTOR 1 75 DISTRICT NO GR UP Z NE F O ES Y LAWN SPRINKLER SYSTEM 1 75 �7 I'LO y WATER HEATER t[�' 1 75 D INDU$WASTE APPROVAL G. GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD OUTLETS OVER 30 C 5 PER SYSTEM Plan Check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE Q APPROVALS DATE INAIIECI.R eiGx ATU Rc Plan Check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel No GAS VENT HOT WATER HEATER IHEREBY ACNNOWLEOOE THAT I HAVE READ THIS APPLICATION AMD STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES ANO STATE LAWS REGULATING PLUMBI MO GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COIN TY AND STATE OF CAL(IORMIA OR TXAT I AM E LEOAL WNER 01, AND INTEND TO REST OE IN THE ABOVE DES ED RES AL PROPERTY FINAL SIDNATU RE r� OF PERMITTEE PERMIT VALIDATION cK G CASH PLAN CHECK VALIDATION CK M 0 CASH uiw8 0 9 8: SEP28 5 D 3 1.00- Q > �i3 a 70A"7 (CE-817)-4/7Z APPLICATION FOR PLUMBING PERMIT {� COUNTY OF LOS ANGELES �J DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUI nlNc 6IA KE CHECKS PAYABLE TO ADDRESS O N• Temple Cit Blvd. HARVEY T BRANDY, COUNTY ENli1NEER LOCALITY Temple City FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST NUMBER FIXTURE OR ITEM ® FEE WATER CLOSET 1 75 OWNER Ron MaClos MAIL BATH TUB 1 75 ADDRESS 870 East Mariposa SHOWER 1 75 CITY Altadena TEL NO 8-0 LAVATORY 1 75 10 CONTRACTOR Owen Bros, Plumbing.1na. / SINX 1 75 riffADDRESS 4265 North Baldwin Avenue / DISHWASHER 1 75 CITY El Monte TEL NO 443„0078 CLOTHES WASHER 1 75 STATE 231741 LIC C3 SWIMMING POOL RECEPTOR 1 75 LICENSE NO CLASS DISTRICT SO NO. - GRO P Z E FR C D BY LAWN SPRINKLER SYSTEM 1 75 NO , WATER HEATER N 1 75yj1D APPROVAL ASYGAS SYSTEM OUTLETS 1 75 INSPECTION RECORD OUTLETS OVER 30 �7 5 PER SYSTEM 6 ~W' d Plan OhBCk feB $e. Revvm PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DOTE IHG cion v IrNA TJRC Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING r Address GAS PIPING City Tel NO GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAW! REGULATING PLUMBING GAS TEST 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AMD/OR UTILITY CO NOTIFIED LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND ST TE OF CALIFORNIA OR THAT 1 AM C LEGAL OWNER OF, AND HD TO RESIDE IN THE ABOVE DCS (SED R NTIAL PROPER FINAL SIGNATURE OF PERMITTEE PERMIT VALIDATION CK M 0 CASH PLAN CHECK VALIDATION cK M O CASH LnW R 0 9 2;1' SEP 2$ 5 D 1 8.7 55" e 76A667 (CE-817)-8-71 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING 5532 — 5546 N.Te qNO ADDRESS LOCALITY City FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST TeMDle CROSS ST NUMBER FIXTURE OR ITEM ® FEE ^ OWNER Ron MCClos d. WATER CLOSET 1 76 BATH TUB 1 75 Q ADDflMAIL ESS 870 East Mariposa SHOWER 1 76 Q CITY Altadena TEL 16 LAVATORY 175 CONTRACTOR SINK 1 ]s ADDRESS 4265 North Baldwin DISHWASHER 1 75 d CITY El MDnte TEL CLOTHES WASHER 1 76 STATE LICA 10 LICENSE NO 2317 CLASS' C3 SWIMMING POOL RECEPTOR 1 75 N G O P Z E E BV LAWN SPRINKLER SYSTEM 1 76 �DISTRICTr WATER HEATER C0 � 176 INDTR AL d WASTEUS A�PROVAL O GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD V OUTLETS OVER 5 PER SYSTEM 30 Z O H 1 U W 4 N Z Plan check fee See reverse PLUMBING PERMIT ISSUING FEE 8 3 GO TOTAL FEE Q APPROVALS QATE, 119FECTONAB GXAruRE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel NO GAS VENT 1 HEREBY ACKNOWLEDGE THAT I HAVE READ,TXIa AvvuuTlOH HOT WATER HEATER AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS AS TEST I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY LOS—ANGELES COUNTY AND STATE OF CAL IIORNIA OR TXAT AM XC LE AL OW N[II F A INTEND TO RCBmE IN THE AeDVE D RI D DEHn L vnD Y FINAL SIGNATURE A IE J OF PERMITTE L�' PERMIT VALIDATION cK M o cAax PLAN CHECK VALIDATION cK M D CASH u1►,p8,0, 9 6� SEP 28 55 D�0— a ti,7eAe67 ICE-ern-un APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION euILDINc MAKE CHECKS PAYABLE TO ADDRESS 5514-50-56-58 N.Temple City Byld HARVEY T BRANDT, COUNTY ENGINEER LOCALITY TeMle Cit FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST NUMBER FIXTURE OR ITEM ® FEE WATER CLOSET 1 7S " OWNER Ron McCloslW _ - MAIL BATH TUB 1 75 ADDRESS SHOWER 1 75 CITY Alatadena TEL NO $..G LAVATORY 1 73 CONTRACTOROwen umbin SINK 1 75 ADDRESS 4265 North Baldwin Avenue DISHWASHER 1 75 CITY n Monte TEL NO 443-0078 CLOTHES WASHER 1 75 STATE NO 231741 LIC SWIMMING SWIMMING POOL RECEPTOR 1 75 DI-$:RIDCT G OUP Z E F F BY LAWN SPRINKLER SYSTEM 1 75 ✓U`ISTR y WATER HEATER � 1 75 D WASTE APPROVAL O.. GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD OUTLETS OVER 30 5 PER SYSTEM Q W Plan check fee See Re",,. PLUMBING PERMIT ISSUING FEE 8 3 00 TOTAL FEE APPROVALS DATE Iv Ptc Toe 1 BicNATIRE Plan Check applicant UNDER SLAB WORK Name ROUGH PLUMBING ,5 Add/BSS GAS PIPING City `" Tel No GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND !TATE THAT THE ABOVE ID CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STAT! LAWS REGULATING PLUMBING GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STAT[ OF CALIFORNIA OR THAT I AM TH LEGAL OWNER OF AND INTEND TO RESIDE IN TN[ ABOVE OESCR D R SIO N IAL PROP[ TY FINAL ' SIGNATURE OF PERMITTEE PERMIT VALIDATIONcK M 0 CASH PLAN CHECK VALIDATION CK M Q CASH utw809 !;3 sw28 5 0 73.00-A 7 CHIG1710..' s APPLICATION FOR PLUMBING PERMIT 1 DIVISION OF BUMDING AND SAFETY DspOntn"t of County Enginew County of LOS AngsisE BUILDING JOHN A LAMBIE COUNTY ENGINEER ADDRESS CASSATT D GRIFFIN,SUP T OF BUILDING FOR APPLICANT TO FILL Di NEARLOCALITYEST CROSS BY OWNER DISTRICT NO OUP ZONE I READY POS INSPECTION ADDR888 I �a F'•� INDVSTRIAL CITY EL NO WASTHAPPROVAL PLUMBER INSPECTION RECORD ADDR CITY N I .I LICENSE NO mumalml TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) St 00 $ BATH TUB $t 00 SHOWER $t 00 LAVATORY (WASH BASIN) Q 1100 KITCHEN SINK Q •1 00 DISHWASHER Q $I DO LAUNDRYTUB OR TRAY 0 SI Oo CLOTHES WASHER @ IlI 00 WATER HEATER 0 $t00 GAS SYSTEM Q •1 00 ' APPROVALS DATE INSPECTOR S SIGNATURE UNDER SLAB WORK PERMIT s t 00 ROUGH PLUMBING f� GAS PIPING / 4 TOTAL FEE GAS VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ TH19 APPLICA7 AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES PLUMBING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST Q LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED DESCRIBED RESIDENTIAL PROPERTY SIGNATURE OF PERM ITTEB 4&ae Ij FINAL JOHN A LAMBIE COUNTY ONGINEER VALIDATIO ROBERT A WOOD CHIEF PLBG INSPECTOR �p4 69 V; JAN29 3 2.0 0 in IT ISM SETS 0-4e, 1 'APPLICATIONiFOR PERffiT N__7ARTMENT OF BUILDING AND SAFSTY,rr � e ^ COUNTY OF LOS ANGELES - P�{IF����V ' ♦ WY J FOX.CHIEF ENINmI INSTALLATION— FADDR=8 FIxrURES COMPLETE 5 / K / � 7ly CESSPOOL SEPTIC TANK READY PORR N®BY FIRST INSPECTION DAT[INYm1 UPPLICANT FELL INH VILY OUTLINED PORTION ONLY JOB ADDRESS C44 zr LOCALNEARESTTR No CROSSR EIPIRES b' NAM[ / LOCATION OF SEPTIC TANS, OR CESSPOOL 3 ADI �i NORTH O CITY TEL No 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION ` RUY�OI 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED � ABOVC OWN= CORRECTIONS -O a yt E' SOUTH J DESCRIPTION OF WORK [TOTAL TUB FURNACE El rc ER V DISHWASHER O TORY� REFRIGERATOR NEI SINK WATitR SOFTEiN R SINK SAND TRAP SINK OOR DRAIN TRAY URINAL APPROVALS R CL088T V DRINKING FOUNTAIN DAT[ IIN<RC10R•""a R NEATER ^ENTAL LAVATORY ROUGH PLUMBINGAS SODA FOUNTAIN OAS PIPING 21 'I G �rltOUTL GAS VENT E�.•1 �L�•/CESSPOOLL NUYBEt OF PIETU RES 3 SEPTIC TANK POOI SEPTIC TANK ( SEWER SUTILITY CO NoTmim FINAL Dom �-IDEP�RMENT OF BUILDING AND SAFSTY ' APPLICATION FOR PERMIT COUNTY OF LOS ANGELES ��V����� WK J FOX.eHls ENGINEER NATUREOF INSTALLATION MIT NO. ROUGH IIKRIRES COMPLETE NEATER CESSPOOL SIPTIC TAMK RECEIVED BY READY FOR DATE ISSUED j� FIRST INSPECTION / /-/ / x n APPLICANT FILL INHEAVILY OUTLINED PORTION ONLY y. NAME L V ADDRESS L S O, LJ N f C G ADDRESS O. S V AIJC C f LOCALITY LLQ CITY e L L 2. TO-Ne CROSS irr L o COUNTY ERTEXPIRES NAME O �Al LOCATION OF SEPTIC TANK, OR CESSPOOL ADDRMAIL ESS NORTHnn CRY /� 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. Pwrmt 1 AM THE LEGAL OWNER THE DESCRi ED ABOVE - 0�M0 CORRECTIONS e SOUTH J DESCRIPTION OF WORK a z ATN TUB ✓ FURNACE ii C HOWER L. DISHWASHER cl VATORY L- - REFRIGERATOR KITCHEN BINK L/ WATER SOFTENER R SINK - SAND TRAP P SINK F DDR DRAIN WASH TRAY URINAL APPROVALS ATER CLOSE ✓ DRINKING FOUNTAIN DATE'l INYEGTOR a MiU1E WATER NEATER DENTAL LAVATORY ROUGH PLUMBING u a EER�G/1S ✓ SDDAFOUNTAIN GAB PIPING OLITL OAS VENT CESSPOOL 7 TOTAL NUMBER OF FIXTURES •J `{� SEPTIC TANK CESSPOOI SEPTIC TANK SEWER S TOTAL FEE UTILITY CO NOTIFIED FINAL 2 O - 3�fi DEPARTRffidT OF COUNTY ENOngEER. - PLUMBING 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES Bu1LDINo WILLIAM L FOX, CGUNTY ENGINEER ADDRESS G G I FOR APPLICANT FILL IN LOCALITY BUILDING CROSS 8TNEARESdA Xe ADDRESS d DISTRICT NO GROUP 20ME PERMIT NO LOCALITY \ 1�� �'T I �-/1 / NEAREST L ( V C EI CROSS ST � — 1 RECEIVED BY Rudyfor lwFEatlaa DATE ISSUED OWNER MAIL - rpt INDUSTRIAL ADDRESS 7 J C) /I( (. WASTE APPROVAL CITY j e TEL NO INSPECTION RECORD PLUMBER /) } ADDRESS f) 7 O CITY L TEL NO I �4; STA LICENSE NO L� -f �Y [7 COUNTETY J PERMIT FEES = 4UMO[R TYrE OI rl T R[ OR MM IE[ 0 WATER CLOSET(TOILET) 0 080 8 rc O BATH TUB 0 080 SHOWER 0 0.80 LAVATORY(WASH BASIN) 0 080 KITCHEN SINK ® 080 LAUNDRY TUB OR TRAY 0 080 1 SLOPSINK 0 080 FLOOR BINK 0 080 FLOOR DRAIN 0 080 DISHWASHER 0 000 DRINKING FOUNTAIN 0 080 URINAL 0 080 OAS SYSTEM _OUTLETS 0 1-00 WATER HEATER 0 100 MISCELLANEOUS _ APPROVALS _ DATE INSPECTOWS SIGNATURE UNDER SLAB WORK PERMIT ; 1 00 ROUGH PLUMBING TOTAL FEE 3 0 GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- GAS VENT CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AMD/OR LICENSED AS REQUIRED BY LO ANGELES COUNTY SABTEST AND STATE OF CALIFOR IA OR THAT I� THE LEGAL OWN- ER OF THE ABOVE DE IBED RESyTp/pN AL PROPERTY UTILITY CO NOTIFIED SIGNATURE OF PERMITTE _ FINAL 11 TOAOBT DBSIT O�* 2aA/STB „-+A �' APPLICATION FOR PZRffiT' =--_ DEPARTMENT OFNG AND SAFSTY PLUN4BING COUNTY OX.F LOS LOB ANGELES WY J PDX,CHIEF ENGINEER (///p fLOCA FIXTURES COM ✓ / CESSPOOL /@TIC TANK READY PORISO BY FIRST INSPECTION / m oc APPLIC�]AN,T FILL IN HEAVILY OUTLINED PO RTION ONLY "AMC /-(ab G"'1" ADODR//B /`�� I L J LOCALITY NRARSST _/� TEL NO CROPST Y EXPIR® ' NAYQ OF SEPTIC TANS, OR CESSPOOL ADDRESS NORTH O C TEL NO I AM THE LEGAL POSSESSOR OP THE ABOVE LOS ANGELES COUNTY CKIMFIC�IM{F OF ZALC O TIO^ �J' \79/11 XG PLwSIDII ti""-"y 1 AM THE LEGAL OWN01 OP THE PROPERTY DteCRNlm s ABOVE / OMMO CORRECTIONS SOUTH J DESCRIPTION OF WORK ATN TUB FURNACE O C HOWER DIBHWASHRR O- VATORY RF"IGKRATOR ITCHEN SINK WATERSOFTENER -----FLOOR BINK FAND TRAP LOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOBET DRINKING FOUNTAIN - DATE IIOr•G1011 a NAY[ t WATER NEATER DENTAL LAVATORY E000X PLUMBING QT AB ------SODA FOUNTAIN GAS PIPING OUTL OAS VENT CESSPOOL V 4 ry S TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOL ARPTICTANK / {/ (/ SOWER S UTILITY CO NOTTFIm TOTAL FEE GDEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES ������� WM.J. FOX.CHIEF ENGINEER OF INSTALLATION MOUNT NO. PL�MATION PIXTUR® COMPLETE M CESSPOOL SEPTIC TANK �BY READY POR DATE ISSU062 R11}t' FIRST INSPECTION PPLICANT FILL IN HEAVILY OUTLINED PORTIONNLYJoe NEARESTOK) GROY EXPIRES ` NAME EPTIC TANK, OR L MAIL NORTH O C No I AM THE AL POSS®SOR THE ABOVE LOS ANGELES COUNTY CKRTIPI Tt OP J7ICATION 0. PLIIM>� I AM THE LEGAL OWNER 01 THE PROPERTY D .SCRIBED ABOVE. OWN= CORRECTIONS SOUTH J DESCRIPTION OF WORK ATH TUB FURNACE HOVJM DISHWASHER VATORY �WRIOEIIATOR TTCHEM SINK WATERSOPTENER R SINK BAND TRAP LOP SINK FLOOR DRAIN WASH THAT URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INtPE6TO m"&NE WATER MEATIER - DENTAL LAVATORY ROUGH PLUMBING R 'KRG" SODA FOUNTAIN GAB PIPING DIM DAB VENT CESSPOOL s-3 -91 fP+s TO�T/AL/NUMBER OP FIXTURES SEPTIC TANK QSSPOOL_.SKPrIC TANK SEWER B TOTAL FEE UTILITY CO NOTIFIED PLUMBING 1 PL DEFAItTMENNT'oF ooV1vTY ENanvEEe , DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDI No WILLIAM J. FOX. CDLINTY ENGINEER ADDRESS / FOR APP ANT TO FILL IN LOCALITY 7,1 C BUILDING // "ROSS ADDRESS (D CRO88 I DISTRICT NO GROUP OME PERMIT NO LOCALITY ! -1 l NEAREST V i� Cfl088 8T RECEIVED `BV— J ROAQY 70r I0E0MI�0 DATE ISSUED OWNER 1/�—,/' �/ v MAI INDUSTRIAL ADD 88 WASTE APPROVAL CITY / TEL Ko INSPECTION RECORD PLUMBER ADDRESS r CITY TEL NO ❑STATE LICENSE NO (1 COUNTY J PERMIT FEES < z I...ER TYM OF IIFTYR[ OR MN rE[ Q WATER CLOSET(TOILET) a 080 $ BATHTUB a 080 O SHOWER 8.80 LAVATORY(WASH BASIN) a 080 KITCHEN SINK 0 0 80 LAUNDRY TUB OR TRAY a 0 80 SLOPSINK a 080 FLOOR BINK a 080 I FLOOR GRAIN a 000 - DISHWASHER a 080 DRINKING FOUNTAIN 080 URINAL a 080 GAS SYSTEM _ _OUTLETS a Im WATER HEATER a 100 MISCELLANEOUS F APPROVALS DATE INSPECTOR'S SIGNATURE UNDER BLAB WORK PERMIT s 1 00 ROUGH PLUMBING TOTAL FEE I fQ GAB PIPI NO 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI• OASVENT CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE HOT WATER NEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY OAS TEST AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN- ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED SIGNATURE OF PERMITTEE -- - -- FINAL 78A807 DBS17 rd6 19.53 o e 6 172w arra TYT APPLICATION FOR PERffiT DEPARTMENT OF BUILDING AND SAFETY APPLICATION COUNTY OF LOS ANGELES S n WM d PDX.CHIEF ENGINEER NXWW tMff p I ROUGH PDRURO COMPLETE J ^~_ HEATER CESSPOOL SEPTIC TANK RECKWW BY READY FOR 1 1 y PIRUT INSPECTION II - 1k APPLICANTFILL IN HEAVILY OUTLINED PORTION ONLYNAME `A �(/(/`�/T7// /� ,o ADRKBKADDRESS 4-I %S 0, ` d�l" LOCALm /CRY l=/tI L[� TO. No. � NRROSB�QT. L ve O�/<zvCERT No CVIR[S NAME LOCATION OF SEPTIC TANK, OR CESSPOOL �nnEe. L!f .LS o, lNORTH T6.No 1 AM THE LEGAL POSStlGOR OF THE ABOVE LOG ANGELES COUNTY CERTIFICATE OF WALIPICATION PSAPPINtit I AM THE LEGAL*"§Wcw THE PlIbEiRTY DEBCRIBKD ABOVE. owra CORRECTIONS �� 4-f/ S �//O /.J RII O SOUTH J DESCRIPTION OF WORK a z3� _ ATN TUB FURNACE _ O_ R HOWER H DISHWASHER Q �LAVATORV REFRIGERATOR RCHEN SINK WATKR SOPTKNER FLOOR SINK AANDTRAP SINK DDR DRAIN WASH TRAY t� URINAL APPROVALS / WATER CLOSET L-' DRINKING POUNTAIN DAT[ ���ppp IRV[CTOII•XwY[ �LWATER HEATER f DENTAL LAVATORY ROUGH PLUMBING S' Y= h 6 ET AS FDDAFOUNTAIN OAS PIPING / OUTL OAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES; � (� SEPTIC TANK CES[FDrL FEPTIC TANK SEWER S /t UTILITY CO NOTIFIED TOTAL P66 �G_. V o r O-IV aeN ll T I1� I — r , APPLICATION FOR PS$ffiT DEPARTMENT OF IIAND BAFETY ����� COUNTY OX.FLMOS "ANGELS$ V • WM J FOX,CHIEF ENGINEERENGINEER �Le 8 OF nqNWGUMOV DISTRICT NO. GROUPI ZONE PERMIT (7 116D ROUGH FIXTURES'EATRECa BY RKADY FOR DATEFIRST INBFaCTIONAPPLICANT FILL IN HEAVILY PORTION ONLY NAM[ 191 DDRESS r in wDDRESS Z lal, LOCALITYAA PjNREST GRY TEL No. CROSS ST COUNTYCERT NO EXPIR® - ' NAM[ A DLOCATION OF SEPTIC TANK, OR CESSPOOL MAIL ADDRESSNORTH OCT' Td No 1AM TX[ LEGAL POESOSOR OF TN�6CABOVE Los 11ANG�HD COUNTYCOITIFICA�O'qyA�j�Qt ,�'r'FWNDA1 AM THE LEGAL OWNER OF THE PROPERTY DESCR ABOVE. OWNA CORRECTIONS SOUTH J DESCRH'TION OF WORK [TOTALLFEE rx TUB R'IRNACa ° rc OWER DISHWASHER ° VATORY R��IGaRATOR TCHEN SINK WATKRSOFrKNER OOS SINK RAND TRAP OP SINK - FLOOR DRAIN ASH TRAY URINAL APPROVALS ATER CLOSET DRINKING FOUNTAIN GATE INo[croR•MANS ATER HEATER DENTAL LAVATORY ROUGH PLUMBING TaR�OM ^ODAFOUNTAIN OAS PIPING OUTL GAB VENT (�7� C[HSPOOL ' TAL NUMBER OF FIXTURES .,J '� BEPTIC TANK r - ESPOOI RKPTIC TANK SEWER - S UTILITY CO NOTIFIED _ WORKERS'COMPENSATION DECLARATION I7Ui497A I hereby affirm that 1 have a certificate of.ronsaqjoself 'cz$17 (1-11J ,_ APPLICATION FOR PLUMBING PERMIT insure, or a certificate of Workers'Compensation Insurance,or , a certified copy thereof(Sec 3800,La ) COUNTY OF LOS ANGELES rBUILDING AND SAFETY Policy No Company C) 1 1 or Certi py u hereby furm ed FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Cer ed opy n filed with t b 1 { c on NUMBER FIXTURE OR ITEM • FEE ADDRESS 19 WATER CLOSET LOCALITV�' Det Applicant NEAREST BATH TUB CROSS ST CERTI 1CATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCL SHOWER OWNER MAIL (Thea section need not be completed if the work involved LAVATORY ADDRESS 2 by the permit is for one hundred dollars ($100) or Ives) BINK CITY TEL NO 2 CL 1 certify that in the performance of the work for which this DISHWASHERU Permit is issued. I shall not employ any person in any manner CONTRACTO so as to become subject to the Workers' Compensation Laws CLOTHES WASHER ADDRESS . Date_Applicant SWIMMING POOL RECEPTOR NOTICE TO APPLICANT If, after making this Certificate of CITY "r TEL NO 2 O a Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE f LIC Compensation provisions of the Labor Code, you must forth LICENSE NO d / CLASS with comply with such provmons or this permit shall be WATER HEATER deemed revoked GAS SYSTEM OUTLETS DIS(T�jGT NO C SSED LICENSED CONTRACTORS DECLARATION OUTLETS OVER v AI 1 hereby affirm that I am licensed under provisions of Chapter S PER SYSTEM 9 (commencing with Section 7000)of DivistonN3 of the Bust FATAL DA I ness and Professions Code, and my license is in full force and effect License NumberLic Class B Contractor_ Data 1(�► ` I am exempt from the licensing requirements a, 1 em a Plan Check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus Iv`U iness and Professions Code) TOTAL FEE pco Lic or Reg No Date LAddr� pplicant HOME OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for thefollowing reason (Section 7031 5, Bust Tel No ness and Professons Code) i ElI, as owner of the property, em exclusively contracting 15 3 a 9 A with licensed contractors to construct the project p (Section 7044, Business and Professions Code) # • • • • • 5 CONSTRUCTION LENDING AGENCY 2 • • 1,Q O O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is • • 1 p 0 0 3 • issued(Sec 3097 Civ C) Lender's Name 0 526-81 Lender's Address I cgzee a read this a ce nand state that the abos co ct I ee c mply with i o my SEE REVERSE FOR EXPLANATORY LANGUAGE ordte r isle umb[ng, en he she autat a of hes u y to enter Po the aboo y it it purposes Signature of Permittee Date - WORKERS COMPENSATION DECLARATION 10,0029 DPW 9/89 f I har%by eff' ihatI have a certificate of consent to self Insure 7a'"a7A APPLICATION FOR PLUMBING PERMIT - or a certiflcate of Worker a Compensation Insurance, or a certified' copy thereof(Sac 3900 Lab C) Policy No&C 20 pony CLow COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS DEPT OF PUBLIC WORKS DIV ❑ Certified copy rs hereby famished _rn FOR APPLICANT TO FILL IN"M OR TYPE) t��NB O I hT[�J Certified cam'b filed with Uro county building Inspection FOR D Qyv� 1 d a/�lmQm/� NUMBER FIXTURE OR ITEM tD FEE Date i l" 7 f m App9cant G 6 L�REm I.'ERV/ WATER CLOSENEAREST FICATE OF EXEMPTION FROM WORKIERS BATH TUB SM STS COMPENSATION INSURANCE _mN ASSESSOR �S OR P PARCEL (This section need not be oopiated the work Involved by the SHOWER permit Is for one hundred dollars(111100)or less) OWNER I certify that In the performance of the work for which this permit LAVATORY Is Issued I shall not employ any person In any manner so as toSINX ADDRESS E93 become subject to the Workers Compensation Laws SINK DISWASHER CITY ^ TEL NO3,07--4Z73 Date Applicant CLOTHES WASHER CONTRACTOR !_ NOTICE TO APPLICANT If after making this Certificate of LL6_' Exemption,you should become subject to the Workers Compensation SWIMMING POOL RECEPTOR Provisions of the Labor Code you must forthwith comply with such ADDRESS Q provisions or this permit shall be deemed revoked LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATIONCff1' TEL NO — y S I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER (commencing with Section 7000) of Division 3 of the Business and GAS SYSTEM OUTLETS LICENSE NO STA E «B3 e-3 cg Professions Code and my license Is In full force end effect R OUTLETS OVER DISTRICT NO PROCESSED By O License Number ' 3 CI Llc Clap C 3(fl b PER SYSTEM .O D' C O U Contractor `�/'-"C--yn Date FINAL ; VALIDATION ❑ I ern exempt antler Sec FINAL ?By _ B dP C fortiers reason 1 Plan check fee S A^ 5 sreoer sw PLUMBING PERMIT ISSUING FEE E '/ iR ACCT'i ❑ KKK����1TOTAL FEE 3 L , \ 7 3�•` Plan check applicant HOME ITE11S SINGLE FAMILY _ — TOTAL 39.30 HOME OWNER BUILDER DECLARATION Name ���tr 1 hereby affirm that I am exempt from the Contractorry a License Lew 4 `-HECK 39.2.0 for the following reason(Section 7031 5 Business and Professions Adtlmae Code) .00) ❑ city Tel No 1 as owner of the property will do the work and the etruaureIs not intended or l and Professions Code)offered for eels (Section 70M Business _ _ , 0000-0001 12J10/92 7 W CONSTRUCTION LENDING AGENCY 6 1 A y 111%L7 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) Lander,a Name ' Lender a Address I certify that 1 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 t - representatives of this County to enter upon the above mentioned property for Inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE , r - WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT _ I hereby, affimnWORK that have a certificCOMPENSATION of co TIO to self m- 20-OM DPW U9 _ sure,ora certificate of Workers'Compena.c Inwrancs a 76A667A cern c p there (S �La6 Pol pony COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ILJI , Certified copy is hereby furnished - �,�p/ Certified copy is filed with the county building inspection FOR APWCANT TO FILL IN(PRINT OR TYPE) BUILDING y-'�de tm nt WATER CLOSET(TOILET)NUMBER FIXTURE OR ITEM a F{E LOCALITY Dat Applicant - NEAREST CdZTIFICAT"E OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER .I _ �, s OWNER i (Thls section need not be complsrted If the work intro"by MAIL the pennff Is for one hundred dollars($100)or less ) LAVATORY I certify that in theperformance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so C TEL NO as to become subject to the Workers'Compensonon Lows DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER NOTICE TO APPLICANT If, after making this Certificate of Es- ADDRESS emption you should become subject to the Workers Compen- sation provisions of the Labor Code you must forthwith comp- CTry �� NO ly with such provisions or this permit shall be deemed revoLAWN SPRINKLER SYSTEMS STATE ed WATER HEATER LICENSE LICENSED CONTRACTORS DECLARATION DISTRICT NO D BY I herebyoff that I am licensed under p GAS SYSTEM I OUTLETS _ provisions of t o Chapter 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER �J and Professions Code and my license is in full force and ef- 5 PER SYSTEM FINAL W6DATION fect /�/� HOSE BIB DATE ✓Z License Numbe Lic Cla 11 ZA —1—M 6 Contractor6fol Date 15,44 BAY AL TOTAL 4 1 � tic V I am exempt under Seca �W03HEUx 41. I- 8 8P C for this reson r' ��UJ W Plan check fee ► IL Date PLUMBING PERMIT ISSUING FEE$ G 2 Signature OWD � - 1 5/3 l/4� _ SINGLE FAMILY TOTAL FEE 5436 1 AM 10:4 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 Professions Code) Address I as owner of the property, will do the work and the City Tel No structure is not intended or offered for sale(Section 70", Business and Professions Code) CONSTRUCTION LENDING AGENCY ► ' hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued - (Sec 3047, Civ C ) , Lender s Name , Lender s Address T _ I certify that I have read this application and state that the lop, information is correct I agree to comply with all County , ordinances and State jaws regulating Plumbing, and hereby - authorize representatives of this County to enter upon the above conedprtv or ins a er,P7 P I s/ 9V SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Pe4hittee pate/ ' WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I herebyy offrtm that I have a certificate of consent to self 7Mee7A insure, or a cernficatd of Workers' Compensation Insurance, CE 817(REV IO/BI) caSrnJf ed copy Thereof(Sec 3800, L C ) UNTY OF LOS ANGELES BUILDING AND SAFETY i P❑o�cyTJO/7 y�3Company LSC GSC- 44y CuC- . Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS' D ❑/Cerhhed copy a filed with the court building inspec- ADDRESS Ss�a 7` pt V ! hon department R FIXTURE OR ITEM ® F{£ Date Y %L&P/AppliSnnt WATER CLOSET LOCALITY T CERTIFICATE OF EXEMP M WO KERS' BATH TUB CROSS S7 / P- 4 COMPENSATION INSURANCE SHOWEROWNER ��,� Ifecy A, (This section need not be completed H the work Involved by the permit Is for one hundred dollars($100)or less ) MAIL LAVATORY ADDRESS I certify That in the performance of the work for which this Tq r permit is issued I shall not employ any person in any manner SINK CITY / l TEL NO.2k7 4 Vf, so as to become subject to the Workers Compensation Laws DISHWASHER CONTRACTORf j JY Date. Applicant CLOTHES WASHER i NOTICE TO APPLICANT If, after making this Certificate of ADDRESS O Exemption you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code you must forth- LAWN SPRINKLER SYSTEM TEL NO S/5l7� with comply with such provisions or this permit shall ba STATE LIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO SS®BY I here offrtm that I am licensed under GAS SYSTEM OUTLETS by provisions of Chapter 9 , (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 d 9� / DAL �� O V IDATION u License Nu�mfber L¢ Class C— 3 C Contractor��// !f /L�r pate 9�1"' �✓I, BY V ❑ I am exempt under Sec B&P C for this reason !J 4 = Plan check fee Dote PLUMBING PERMIT ISSUING FEE f Signature 9 d 2 9 Q 5 A TOTAL FEE jb Plan check applicant # e 0 e e s 5 SINGLE FAMILY HOME OWNER BUILDER DECLARATION Name 1 e e 1 6 5 0 1 hereby affirm that I am exempt from the Contractor s License Address • ' • 1 Q 5 0 Low for the following reason (Section 7031 5 Business and Professions Code) City Tel No 0912-85 ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sole (Section , 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby offrtm that there is o construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ C ) Lenders Name Lender s Address 1 certify that I have read this application and state that the poll.above information n correct I agree to comply with all County ordinances and State laws regulating Plumbing and hereby authorize representatives this Co my to enter upon the abd zee r.Re honed pro or imp ion purposes SEE REVERSE FOR EXPLANATORY LANGUAGE I torture f Pe roes Dote KERS I hereby aWff rRm that I have aaSAIONate of consenttoself in- 70-0V26 DRV 4/90 _ APPLICATION FOR PLUMBING PERMIT sure,qr a certificate of Worker'Compensation ihsurance'w a 76A667Aity certified N copy thereof (Sec 3Lab C ) COUNTY OF LOS ANG LE ES DEPT. OF PUBLIC WORKS y'LIII Policy No -Company ny ❑ Certified copy is hereby furnished ❑ FOR APPLICANT TO FILL IN(PRIM OR TYPE) BUILDING Certified copy a filed with the county budding inspection V i department NUMBER FIXTURE OR 0EA1 ® FEE �� C' LOCALITY Date Applicant WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CJ+O55 ST S/7cr�l c✓ COMPENSATION INSURANCE SHOWER OWNER (This section need net be completed IF the work Involved by the permit Is for one hundred dollen({100)or leu) LAVATORY MAJL55 I certify that in the performance of the work for which this per ADDRE SINK y mit is issued, I shall not employ any person in any manner so - CITY TEL NO '3r as to becom sub act to the Workers'C2ipipesation Laws DISHWASHER �` CONTRACTORy G� Dote 'Applicant hCLOTHES WASHER ADDRESS �O NOTICE TO APPLICANT If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers Compen- ClttL L� sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS �rJ ��� TEL ly with such provisions or this permit shall be deemed revok- STATE / �j/� LIC WATER HEA LICLNSE NOCO�J« CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby offum that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 1 5 PER SYSTEM feet FINAL VALIDATION ,�QQ�'1ff HOSE BtB DATE License Number �/� Lrc CI5 d FINAL ACC T.t V Contractor Date �� BY Q I am exempt under Sec A J O B BP C for this reason P yVj Plan check fee yrs Date PLUMBING PERMIT ISSUING FEE$ ✓ 2 Signature TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER BUILDER DECLARATION PP 1 hereby affirm that I am exempt from the Contractor s License Name 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 structure is not intended or offered for sale(Section 7044, Business and Professions Code) Poo. LENDING AGENCY 15,04.095, SECTION 203 PLUMBING 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 ) CODE, AMENDED. SUBSECTION (d) OF Lender s Name SECTION 203 OF THE COUNTY PLUMBING Lender s Address CODE IS AMENDED TO READ. v S I certify that I have read this application and state that the above information is correct I agree to comply with all County "(d) COPPER TUBE FOR WATER PIPING 011. ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the SHALL HAVE A WEIGHT NOT LESS THAN above- troed proper ry for inspection p TYPSELIEVERSE FOR EXPLANATORY LANGUAGE Sig re of Permit ee Date i COUNTY OF LOS ANGELES TEMPLE CITY 0 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0110120012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS. TR 30403 UN. 33 5562 TEMPLE CITY BL 33 " FEE DESCRIPTION QUANTITY- LON: AMOUNT TEMP CA 917802529 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BROADWAY 8588-008-054 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID A3 LOCALITY: TEMPLE CITY 47 WATER HEATER(S) 1.00 WTH 16.20 TENANT TOTAL FEES 43 95 T9M ON: PROCESSED BY PLAN BY EXPIRES ON 10/12/01 JK 04/10/02 OWNER- TEL. NO FINAL DATE FTNAL BY OWE: 51562 TEMPL� CITY BLPETER (626) 309-9448- _ / TEMP 917802529 ffF9ffUPTMW-6F WORK 3--=- WATER HEATER C/O APPLICANT TEL. No ACTION CONTRACTORS (310) 515-1311- 17111 S. BROADWAY SPECIAL CONDITIONS: GARDENA 90248 CONTRACTORPt4GELES CO APPROVALS DATE I NSPnT6W-§rQ9r9ffF-- ACTION CONTRACTORS (310) 515.1311- x,05 - ONTy 17111 S. BROADWAY LIC NO UWR SLAB WORK GARDENA CA 90248 B/L 4201 WATER SERVICE PLASTIC Y/N METAL Y/N LIC MO// (►r■L 1111111 GAS PIPING GAS MENT PUBLIC WORKS LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIT M CwV G ®y servlceTha��o GRAY WATER SYSTEM i 1 • ADDITIONAL DATA ON FILE REPORT ID: DPR263 ROUTE TO- BS0508 COUNTY OF LOS ANGELES TEMPLE CITY R 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 IAS TUNAS PL 0508 1104040027 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT (LEGAL ID FEES PAID BUILDING ADDRESS TR 30403 UN 12 1 5588 TEMPLE CITY BL 12 (ASSESSOR INFORMATION NUMBER (FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802529 NEAREST CROSS STREET 18588-008-033 101 PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE 597 GRID A3 LOCALITY TEMPLE CITY Cl I 107 BATHTUBS/SHOWERS 1 00 FIX 16 30 (TENANT 45 WATER CLOSET/URINAL 1 00 FIX 16 30 (ISSUED ON PROCESSED BY PLAN BY TOTAL FEES 60 40 104/04/11 SR IOWHERI I TEL NO F DATE FINAL n BY CODE 1 15588 N JUDITH A _ / • V 15588 9TEMPLE17802 CITY BL 10 (TEMP 917802529 1DESCRIPTION OF WORK I (PLUMBING FOR BATHROOM REMODEL APPLICANT TEL NO 1 1 BROTMAN, IFAT (818) 987-7277- SPECIAL CONDITIONS I I I 1 ICONTRACTOR TEL NO I 1APPROVALS DATE INSPECTOR SIGNATURE 1 1 0 LIFETIME BUILDERS (818) 652-2446- 1 1 4545 WILLIS AVE LIC NO 1 UNDER SLAB WORK 1 SHERMAN OAKS CA 91403 920525 B tWATER SERVICE I (PLASTIC Y/N METAL Y/N 1ARCHITECT OR ENGINEER TEL NO - 1R000H PLUMBING LIC NO I IGAS PIPING I IGAS VENT I (HOT WATER HEATER (PLUMBING FIXTURES LAWN SPRINKLERS IGAS TEST I I I I I I 1UTILITY COMPANY NOTIFIED I IGRAY WATER SYSTEM I I I tj I I I I I I IREPORT ID DPR263 ROUTE TO BS0508 I i I I I I COUNTY OF LOS ANGELES TEMPLE CITY A' 0508 PLUMBING PERMIT .EPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 9907190003 P1rILDINP AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS TR 30403 UN 35 5572 TEMPLE CITY BL ASSESSOR INFORMATION NLKBER FEE DESCRIPTION QUANTITY 0011 AMOUNT TEMP CA 917802529 _ NEAREST CROSS STREET: BROADWAY 8588-008-056 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID A3 LOCALITY- TEMPLE CITY 47 WATER HEATER(S) 1 00 WTH 16 35 TENANT TOTAL FEES 44 10 ISSUED ON PROCESSED BY PLAN BY ExPiRES ON- 07/19/99 UT 01/15/00 OWNER TELTrRAr-MYE FINAL BY E TAMIIDA YUKIKO K TR TANADA TRUST (818) 286-4934- 5572 TEMPLE CITY BL TEMP 917802529 NOW M4 ze CHANGEIOUT OF WATER HEATER APPLICANT- TEL. NO SAME AS OWNERCONTRACTOR TEL - SPECIAL CONDITIONS 5 PNGELES COV ALS DATE INSPECTOR SIGNATURE SAME AS OWNER , LIC NO UNDER SLAB WORK WATER SERVICE PLASTIC Y/N METAL Y/N - ARCHITECT DR ENGINEER LIC. N0 lllllll I LIMBING GAS VFlff- _ GAS PIPING PUBLIC WORKSHOT WATER HEATER 7a 1LAWN SPRINKLERS GAS TEST o � !©y `b/�Q Service Tra��ot� CwV GRAY WATER SYSTE14 REPORT ID DPR263 ROUTE TO BS0508 1 o ' • COUNTY OF.LOS ANGELES TEMPLE CITY # 0508 PLUMING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0103260011 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID --7m PlID BUILDING ADDRESSI TR 30403 U1 11 5580 TEMPLE CITY BL FEE DESCRIPTION QUANTITY LION AMOUNT TEMP CA 917802529 ASSESSOR INFORMATION NLMBER NEAREST CROSS STREET- 8588-008-032 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID A3 LOCALITY TEMPLE CITY 47 WATER HEATER(S) 1 00 HFH 16 20 TENANT TOTAL FEES 43 95 ISSUED ON PROCESSED BY PLAN BY EXRTErVF_ 03/26/01 UT 09/22/01 LACHER, CHERIE (626) 451-0869- XPIR 5580 TEMPLE CITY - 1 TEMPLE CITY CA91780 mV� WATER HEATER CHANGE-OUT APPLICANT: -=No A L A P ASSOCIATION (818) 407-1247- 1 7229 VAR" ST SPECIAL CONDITIONS N HOLLYWOODS 91605 CONTRACTOR TEL NOS ;,%GEES CO A L A P ASSOCIATES (818) 407-1247- 0 TAPPROVALS DATE INSPECTOR SIGNATUREy 7229 VARNA ST LIC NO UNDER SLAB WORK NORTH HOLLYWOOD, CA 91605 771905 HIC WATER SERVICE ARCHITECT OR ENGINEER ILL NU / PLASTIC Y/N METAL Y/N LIC NGAS PIPING O ,,,lll'VVV/---I��l 1111711 F U Lmcu-? L C VV 0 Fro_l�K 6) 1 PEUETNG FIXTURES a $ f Qra lh O 0 ^ IGAS TEST oI(j c5 UTILITY COMPANY NOTIFrO GG/'c Ser CwV Vic0 e That�o` 1 • ADDITIONAL DATA ON FILE REPORT ID DPR263 ROUTE TO. BS0508 i COUNTY OF LOS ANGELES TEMPLE CITY d D508 I PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TIBIAS PL 0508 0206120009 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY G 91780 PHONE. (626) 285-0468 EXT TR 30403 UM 10 5578 TEMPLE CITY•BL'10 FEE DESCRIPTION QUANTITY UOM- AMOUNT TRIP G 917802529 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET BROADWAY, 8588-008-031 01 PERMIT ISSUANCE FEE 27 75 THOMAS�PAGE 597 GRID A3 LOCALITY \TEMPLE CITY 13 DISRWASHER(S) 1 GO FIX 16 20 TtMANT: TOTAL FEES 43.95 ISSUED ON PROCESSED BY PLAN BY 7xv IRtbUN 06/12/02 JK 12/09/02 OWNER. —Tm No FIKAI DATE FINAL BY: CDDE- KUDLIK SOPHIE TR KUDLIK TRUST (626) 285-6395- \` „ - _ 5578 TEMPLE CITY BL \ �, _ TEKP 917802529 C/O DISHWASHER APPLICANT TEL NO APPLIANCE INSTALLERS INC (562) 986.5511- I 3823 INDUSTRY AVE SPECIAL CONDITIONS- LAKEWOOD 90712 , CONTRACTOR TEL 90 Pr1GELES co APPR I UVALS DATE INSPECTOR SIZWMGWF-- APPLIANCE INSTALLERS INC (562) 986-5511- 95 r 3823 INDUSTRY AVE LIC NO \' �� 1 j' UNUET LAKEWOOD G 90712 594252C36 ' f WATER MUM- ARCHITECT OR ENGINEER: TEL NO PLASTIC Y/N METAL Y/N LIC NO / I GAS f PIPING GAS 9ENT I G UORDUC WrI0HOW HOT WATER HEATER �C Q b � jWXLNKLtKb C] (_�" GAS TEST -- o� CWV GRAYJWATER I I I I REPORT ID. DPR263 ROUTE TO BS0508 I ' I COUNTY OF LOS ANGELES TEMPLE CITY q 0508 I PLUMBING PERMIT DEPARTMENT OF PUBLIC FORKS 9901 IAS TUNAS' PL 0508 1009140019 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID ,. FEES PAIDBUILDING ADDRESS ITR 30403 UN 18 1 5540 TEMPLE CITY BL 1 I FEE DESCRIPTION QUANTITY LOM AMOUNT I TEMP CA 917802529 (ASSESSOR INFORMATION NUMBER i . I NEAREST CROSS STREET 18588-008-039 01 PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE 597 GRID A3 LOCALITY TEMPLE CITY C I 47 WATER HEATER(S) 1 00 ITCH 16 30 TENANT _ _ _ _ _ - TOTAL FEES 44 10 ISSUED ON PROCESSED BY PLAN BY 09/14/10 SR I I OWNER TEL NO FINAL DATE FINAL BY CODE TOPRANI RAY - 1 6013 HART AVE - TEMP 917802529 DESCRIPTION OF WORK REMO'E/REPLACE WATER HEATER 1 (APPLICANT TEL NO FAST WATER HEATER COMPANY (425) 636-7084- 12601 132ND AVE NE _ SPECIAL CONDITIONS KIRKIAND NA 98034 I I I CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE 1 (FAST WATER HEATER CO (425) 636-7054- _ _( I12601 132ND AVE NE LIC NO (UNDER SLAB WORK KIRKLAND WA 98034 931237 C36 •I I- i I WATER SERVICE (ARCHITECT OR ENGINEER TEL NO •� ` (PLASTIC Y/N METAL Y/N ' IROUG' PLUMBING LIC NO I11 I 1 1 (GAS -IPING I I (GAS VENC 1 IHOT WATER HEATER I I JPLUK3ING FIXTURES i I I (LAWN SPRINKLERS 1 I Imo ' EST I I I UTILITY COMPANY NOTIFIED( 1 EXPIRED, ,-, , CwV GRAY,WATER SYSTEM I I • ADDITIONAL DATA ON FILE 1 I I I I I 1 REPORT ID DPR263 ROUTE TO 880508 I 1