Loading...
HomeMy Public PortalAbout5825 TEMPLE CITY BLVD_Plumbing__ 76A667 17 2SM SETS 7-48 •'APPLICATION FOR PERMIT DEPARTMENT OF EUILDING AND SAFETY COUNTY OF LOS ANGELES WM.J.FOX.CHIEF ENGINEER PLUMBING-- - NATURE O INSTALLATION ISTRICT NO.- GROUPI-ZONF. PERMIT No. ROUGH FIXTURESCOMPLETE HEATER CESSPOOL H SEPTIC TANK RECEIVED BYY READY FOR- DATE ISSUED �J�4 /�.. . FIRST INSPECTION ,A —.2 _ L! AS-. MI CELLANEOU / APPLICANT FILL IN HEAVILY OUTLINED PORTION O Y Af ME �� JOB ADDRESS DRESS / LOCALITY�.�qNEAREST TY • I EL.No. CROSBST. UNTYCENSE NO. EXPIRES Y NAME /?a LOCATION OF SEPTIC.T OR CESSPOOL 3 ADDRESS NORTH O C17Y TEL.No. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICAF gUALIFIC TON. M _ t FLuma R 1 AMTHE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. 3' OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK i ATH TUB FURNACE F, SHOWER DISHWASHER 13 LAVATORY REFRIGERATOR .-KITCHEN SINK WATER SOFTENER FLOOR SINK pAND TRAP LOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME 'WATER HEATER DENTAL LAVATORY ROUGH.PLUMBING I ETES GAS SODA FOUNTAIN GAS PIPING I I OUTL GAO VENT CESSPOOL TOTAL NUMBER OR FIXTURSB SEPTIC TANK I I —CESSPOO, ¢EPTICTANK 'J SEWERZan I S UTILITY CO:NOTIFIED I TOTAL FEE sd' 7SA667-CEBSI7 4-64 APPLICATION FOR PLUMBING PERMI COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING•AND SAFETY DIVISION ADDRESS r, JOHN A. LAMBIE, COUNTY ENGINEER WILLIAM A:JENSEN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN' NEAREST CROSS.ST. Adaad NUMBER FIXTURE OR ITEM EACH FEE OWNER s WATER CLOSET 81.25 MAIL BATH TUR 1.25 ADDRESS n. SHOWER 1.25 CITY TE . NO." Ir LAVATORY 1.25 CONTAACTO SINS 1,25 ADDRESS DISHWASHER 1.25 CITY TEL. NO. RESTC STATE LAUNDRYTUB 1.25 REGISTRATION COU TY CLOTHES WASHER 1.25 DISTRICT NO. I GROUP I ZONE PROC SED B.Y WATER HEATER 1.50 X61 Q r I zj GAS SYSTEM[ OUTLETS 0. 1.50 WASTE�APROVAL O OUTLETS OVER 5 PER SYSTEM .80 INSPECTION-RECO)ID V V W d H Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT S 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS 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 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DEBCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEE FINAL LIDATION ROBERT A. WOOD ( CK. M.0. CASH SUPERVISING MECHANICAL ENG'R _ _ . LA[;o 6'5 6 OZO DEC 310 .. 5 0 3.5 0— 1 D.B.S.-17 25M SETS 12-46' APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES `� ' ' WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUPf ZONE PERMIT NO.- ROUGH FIXTURES_ MPLETE REG IVSD BY READY•FOR DA E ISSUED HEATER CESSPOOL 1:�:lC:T:A::N:K:j_ � � FIRST INBPECTdON AS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY NAME {�A`j� /e a ADDRESS X ADDRESS � �''� `f LOCALITY ! if ��y9 T CITY PAA22,42,./i TEL.NO.f4a JJ �I CROS S . Y . 5!e4,L �9 COUNTY' ��y ;� �� CERT.No. /`� EXPIRES d I NAME N' .- LOCATION OF SEPTIC TANH, OR CESSPOOL Z MAIL - 3 ADDRESS NORTH O CITY TEL.No. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICA OF QUALIFICAT ON. 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. a OWNER CORRECTIONS O SOUTH DESCRIPTION OF WORK ATH TUB FURNACE ROWER DISHWASHER 0 ® —LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP LOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS• WATER CLOSET DRINKING FOUNTAIN DATE IIISPBCTOR;'S NAME WATE77-GAS ER DENTAL LAVATORY ROUGH PLUMBING b I n I AP'l METE SODA FOUNTAIN GAS PIPING• Vvv./ UTL - V ' GAS VENT ' CESSPOOL TOTAL NUMBERLOFFIXTURES d Q SEPTIC TANKESSPOOT TIC TANK SEWER BEMS I TOTAL FEE 1 UTILITY CO.NOTIFIED I FINAL WORKERS'COMPENSATION DECLARATION 76A667A ' I hereby affirm that I have ir certificate of consent to self Ise 817(2-66) APPLICATION FOR PLUMBING PERMIT insure, or a certificate of Workers'Compensation Insurance,or 1 a certified copy thereof(Sec.3800,Lab.AA .) i COUNTY OF LOS ANGELES BUIL I.NG AND SAFETY ,Policy No. Company_ ii. Certified copy isbereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDIN �s^ J.. mjgCertified copy is filed with t my u'din ADDRESS pf g inspection NUMBER FIXTURE OR ITEM • FEE i �{•— de ar Ra��' WATER CLOSET LOCALITY �Qq InQO Date-� p�Applicant _ NEAREST BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE. SHOWER OWNER LAVATORY MAIL (This section need not be completed if the work involved ADDRESS OO d d J by the .permit is for one hundred dollars ($100) or less.) SINK n tL CITY TEL.NO. & e(� 0 I certify that in the performance of the work for which this DISHWASHER U permit is issued, I shall not employ any person in any manner CONTRACTOR - cc so as to b6cojne subject to the liars' en tion Laws. CLOTHESWASHER _ O 'ADDRESS Inzo CIWG Ur Date Appliiant SWIMMING POOL RECEPTOR TEL.NO. YY NOTICE TO.APPLICANT: If, after ung this Certificate of jCITY tl Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE 1 i C q LIC. / /�Q Compensation provisions of the Labor Code,you must forth- �, LICENSE NO ' l. J.O 78- CLASS Ifs oC 12 with comply with such provisions or this WATER HEATER permit shall be _. 3 deemed revoked. GAS SYSTEM OUTLETS DIICT NO. PROCESSED BY LICENSED CONTRACTORS•DE.CLAR.AT.ION' OUTLETS OVER I hereby affirm that 19 m licbnsed under provisions of Chapter IS PE R.SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi= FINAL VALIDATION ness and Professions Code, and my license is in full force and DATE ^� -- � effect. Q p CS6 FINAL License Num u�v Lic.Class BY Contra Date I am, Xe pt from-the licensing requirements as I am a Plan check fee . licensed architect or a• registered professional engineer acting in my'professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE 0 Lic.or Reg.No. Date LAddress pplicant z 2 �,5.A 'I HOME OWNER-BUILDER DECLARATION # 0 0 0 0 o 5 I. hereby affirm that I. -am exempt from the Contractor's. �; 2 0 0' 1 (10 0 License Law for the following reason (Section.1031.8, Busi- Tel.No. ness and Professions Code): 0'0 0 1.0.0 0 I, as owner of the property, am exclusively contracting with licensed contractors to -construct the project f i 1'3'0—8 1. (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY I I hereby affirm that thereis a constructionlending agency i. for the performance of the: work for which this permit is , issued(Sec.3097,Civ.C.). �� F+ ' Lender's Name uR FINAL WrnEpqp�a%ULender's '�1C�Address I certify that I have read this-application and state that the above information is correct.I.agree to comply with all County1 ordinances and State laws regulating Plumbing, and hereby SEE REVERSE FOR EXPLANATORY LANGUAGE authorize epresentatives of this County to enter upon the above- en ned r arty for'inspectiJon pur 0 Signature ermittee Date I I } t ',