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Home My Public Portal About5780 TEMPLE CITY BLVD_Plumbing__ 67 7818- eI7 se APPLICATION FOR PLUMBING PERMIT 1 cE BUILDING AND SAFETY DMSION Deportment of County Engineer County Of LOS Angeles BUILDING d -` JOHN A.LAMBIE,COUNTY ENGINEER ADDRESS ft5fv CASSATT 0.GRIFFIN,SUPT OF BUILDIN43 or LOCALITY 90 FOR APPLICANT TO ML IN NEAREST CROSS ST. OWNS DISTRICT NO. GROUP I ZONE READY FOR INSPECTION MAIL a ADDRESS O , r INDUSTRIAL CITY �! TEL.NO. WASTE APPROVAL PLUMBER grW INSPECTION RECORD ADDRESS CITY LICENSE NO, NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 $ BATH TUB @ $1.00 SHOWER @ SI.00 LAVATORY (WASH BASIN) @ $1.00 KITCHEN SINK @ $1.00 DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 GAS SYSXAM @ $1.00 1 .+ APPROVALS ` DATE INSPECTOR'S SIGNATURE i UNDER SLAB WORK PERMIT $ I 1 00 .ROUGH PLUMBING GAS PIPING 'Q TOTAL FEE 3 S . v V GAS VENT 1 HEREBY ACKNOWLED THE AND STATE THAT ABOVE IS CORRECT AND AGREE TO COMPLYGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STAT OF CALIFORNIA OR THAT 1 AM THE LEGAL 0OF 7H OYE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL PROP SIGNATURE OF PERMITT FINAL ROBERT A.WOOD. JOHN A.LAMBIE.COUNTY ENGINEER ALIDATION SUPERVISING MECHANICAL ENG'R M.C. CASH tto 2 8 9 2%'n- 00T 2 3 2.0 0 • DB 17 7-38 25M DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES PLUMBING NATURE OF INSTALLATION D.ISTR1CT NO. -GROUP f No �fPEIRMITfNo..ROUGH � PLUMBING FIXTURES �ICTANNI I / NEATER -CESSPOOL fBREADY FOR RECEIVED BY DATE IS9USD - —_ FIRST INSPECTION L.�/ �...� GAS MISCELLANEOUS - 7 PLIPANT I LL IN HEAVILY OUTLI ED PORT ON ONLY j13 NAME l ADDRES ff 1, ADDRE $ 4 6ALJ% LOCALITYNEARET . �/ V .OSI CITY. /LTEL. NO. , CROSSS T. � '.(// �/' __ ..,�/� STATE COUNTY / �r a� LICENSE NO. REG. NO. � r. NAME p. LOCATION OF SEPTIC TANTE,OR C SPOOL z MAIL ADDRESS * NORTH �� j l�r!G CITY O TEL NO. CORRECTIONS SOUTH DESCR EMON OF WORK _BATH TUB gURNACE APPROVALS -SHOWER DISHWASHER DATE INSPECTOR'S NAME VATORY —REFRIGERATOR ROUGH PLUMBING KITCHEN SINK _WATER SOFTENER +y ) (7 GAS PIPING - ~ ) d A C1.i " Ry _41—FLOOR OINK SAND TRAP _ �,, r+'�, A u� �1-11 GAS VENT I SLCP 'SINK. ---FLOOR DRAIN ' CESSPOOL WASH TRAY URINAL SEPTIC TANK _WATER CLOSET DRINKING FOUNTAIN SEWER _WATER NEATER DENTAL LAVATORY ,' •+TER GAS CODA FOUNTAIN UTILITY CO. NOTIFIEDIL1� .L° QUTL FINAL �• T 1 AM THE LEGAL OWNER'OF TPIE ABOVOL08 ANGELES COUNTY REGISTRATJ A18 Rf f' TOTAL NUMBER OF FIXTURES:7-i ® J SEPTIC TANK _ PLUMBER 1 AM THE LEGAL OWNER OF THE PROPERTY ESCRIBED _—:.__CESSPOOL ABOVE. TOTAL FES I OWNER 76"67 08817 11-50 APPLICATION FOR PERMIT DEPARTMENT OFNG AND SAFETY PLUMBING COUNTY OFF LOS LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER DISTRI13T NO. GROUP ZONE —7mmi-F N0. FOR APPLICANT TO FILL IN PLUMBER o RE READY FOR DAT I=IJ /'��ty-'� FIRST INSPECTION ADDRESS ® /��, ? / BUILDING R CITY TEL No. e ® DDRESS 6 A 1 COUNTYJAL OOALITY p i LICENSE NO. EXPIRES a / NEAREST PERMIT FEES CROSS ST. NUMBER TYPE of FIXTURE OR ITEM FEE OWNER MAIL r� WATER CLOSET(TOILET) 0.50 G ADDRESS l�lA. BATH TUB a 0.50 CITYf6ig TEL No. SHOWER @ 0.50 1 HEREBY IcKNOWLEDmE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT I POSSE99 THE ABOVE VALID LOB LAUNDRY TUB OR TRAY O.50 ANGELES COUNTY LICENSE, OR 1 AM THE 4.EGAL OWNER OAS SYSTEMCUTLETS 0.50 OF THE REBIDENTI L P RTY DESCRIBED ABOVE. � WATER HEATER ! 0.511 G SIGNATURE Of PERM ITTE SLOP SINK 0.50 INSPECTION RECORD FLOOR SINK 0.50 FLOOR DRAIN 0.50 DISHWASHER 0.50 DRINKING FOUNTAIN 0.50 URINAL 0.50 J HOUSE SEWER 0.50 Z MISCELLANEOUS O APPROVALS DATE INSPECTOR-B NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL 1:00 CEBBPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( I PIT ( ) @ 1.00 SEWER PERMIT I 1.00 0 a TEST UTILITY 00.NOTIFIED TOTAL FEE S �� AP l FINAL s WORKERS'COMPENSATION DECLARATION 6AS67A I hereby affirm that I have if certificate of consent to self E W(2-e0) APPLICATION FOR PLUMBING PERMIT 'insure,or a certificate of Workers'Compensation Insurance,or "fl ,a certified copy thereof(Sec.900,Lab.C.) ,.. i BUILDING.AND SAFETY 136 60 rf COUNTY OF LOS ANGELES �� Policy No. ompany Certified copy is hereby furnished. FOR APPLICANT TO FILL IN,(PRINT OR TYPE) BUILDING /q ,,pp ADDRESS vV L e/� rOtn/a 9 Certified copy is filed with h my bui Ing Inspection NUMBER FIXTURE OR ITEM • FEE - U e LOCALITY 1 E l • Date_Jy� Applican (/�LGrx�i WATER CLOSET NEAREST, I BATHTUB Cb OSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' ' SHOWER" OWNER . COMPENSATION INSURANCE 4646_r,. (This section need not be completed if the work involved LAVATORY MAIL by the. permit is for one hundred dollars ($100) or less.)by } SINK CITY TEL..NO.236-1./Z.5' 0 I certify,that in the performance of the workfor which this DISHWASHER �// U permit is Issued,,I shall not employ any person in any manner CONTRACTOR A' m /�•v_ so. as to become subject to:the.Workers'Compensation Laws. CLOTHES WASHER ADDRESS Date . _.Applicant ' v '�� SWIMMING POOL RECEPTOR NOTICE TO APPLICANT: If, after making this Certificate of CITY IL1,4 TEL.'NO. Y 6!6!Z! LU d Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC ca Compensation provisions of the Labor Code,you must forth- LICENSE NO.393 '16"3 G ASS _4--3� Z with comply with such provisions or this permit shall be I WATER HEATER deemed revoked. GAS SYSTEM OUTLETS 3 DISTRICT NO. PROCFffiSED LICE14SED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I.am licensed under provis)ons of Chapter 5 PER SYSTEM 9' (commencing with Sedtion 7000)of Division 3 of the Busi-' FINALp VALIDATION ness and Professions Code, and my license.is in full force and DATE r v �� effect. /' FINAL License Number' Lic.Class 3(l. BY Contractord-1 AA-l7fA ALQ. Data ,. '0,� p/ ElI am ekempt from the licensing requirements as I am a Plan check fee d licensed architect or, a registered professional engineer acting .in my professional capacity (Section 7051, Bus- PLUMBING PERMIT ISSUING-FEE$ iness and Professions Code). TOTAL FEE 3 Lic.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); 13 I, as owner of the property, am exclusively contracting R 0 2 1.2 A with licensed contractors to construct the project i (Section 7044,Business and Professions Code), 1 $� 0 0 o'o o rj CONSTRUCTION LENDING AGENCY � � ` 2 1 300 I hereby affirm that there is a construction lending agency ' for the performance of the work for Which this permit is d I 0.0 0 1 ,3.0 0 issued(Sec.3097.,Civ.C.). 7 0 6—$ 1 Lender's Name z 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 SEE'REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives .of this County to enter upon the abov - ntio a property for inspection purposes. Signature of Permittee- Date �, �IORKERS'COMPENSATION DECLARATION 20-0026 DPW 4/90 APPLICATION FOR PLUMBING PERMIT 1•e-4j,, affirm4hat I have a'tertificate of consent to self in- 76A667A sure;or a'dertificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) i Policy Na.Va1u2, 1y Company SIi�D COUNTY OF.LOS ANGELES I' DEPT. OF PUBLIC WORKS , I to Certified copy is hereby furnished. BUILDING a-Wo FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS J WV g Certified copy is filed with the county building inspection ub- department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Ddte S�� Applicant N WATER CLOSET(TOILET) NEAREST BATH TUB ;CROSS ST. CERTIFICATE OFEXEMPTION FROMWORKA, I COMPENSATION INSURANCE SHOWER OWNERFNfAjV, l@MWl 1&qt& fs� (This section need not be completed if the work Involved by "MAIL 1r' [ the permit Is for one hundred dollars($100)or less.) LAVATORY, ADDRESS I certify that in the performance of the work for which this per- ' mit is issued, I shall not employ any person in any manner so l SINK CITY �d�`{`� TEL.NO. �D as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR � ��'��LO� •Iv w(�F Date. Applicant CLOTHES WASHER NOTICE TO APPLICANT: if, after making this Certificate of Ex- i ADDRESS PD. �� 3 SWIMMING POOL RECEPTOR - emption,you should become subject to the Workers'Compen- CITYrj TEL.NO. CJI, 6\ provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS ' N �� (C`�u1 ly with such provisions or this permit shall be deemed revok- STATE `��p� LIC. ed. WATER HEATER' LICENSE NO. t;J l60 CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSEI)BY I hereby affirm that I am.licensed under provisions of Chapter GAS SYSTEM OUTLETS J� -O 9(commencing with Section 7000)of Division 3 of the-Business .I OUTLETS OVER U and Professions Code, and m license is in full force and ef- 5 PER SYSTEM FINAL fect. y VALIDATION GZ�� HOSE BIB DATE ��6—�� ;0-- License License Number ?-L1�� Lic. Class d r I ,;FINAL 5 r) Contractor A A�� Date �`2J�� BY B, aU 42 � I am exempt under Sec. t � •° V B.&P.C. for this reason + Plan check fee a I ! ITEMS v, Date: PLUMBING PERMIT ISSUING FEE$ Signature (UM � �� TOTAL. -`-1"2_'�'0 TOTAL FEE ,cp C t 60 SING FAMILY � Ur1ELl� HOME OWNER-13 DECLARATION Plan check applicant CHANGE •.00 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 I��lCi3-(�QCI$ 5/25!95 I, as owner of the property, will do the work and the City Tel. No. 0608 Ai = structure is not intended or offered foe sale(Section 7044, Business and Professions Code). 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 i (Sec. 3097, Civ.-C.). Lender's Name , I Lenders Address I certify that I have read this application and state that the , above information is correct.I agree to comply with all County l ordinances and State laws regulating Plumbing, and hereby I authorize representatives of this County to enter upon the above-mentio d property for inspection purposes. � SEE REVERSE FOR EXPLANATORY LANGUAGE •I• Signa ure of Pe ittee Date