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Home My Public Portal About5837-5839 TEMPLE CITY BLVD_Plumbing__ D.E.S:17 Z5X SETS 1S 40 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY - COUNTY OF LOS ANGELES �L��G ' WM.J.FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP I ZONE PERMIT NO/. ROUGH' FIXTURES COMPLETE 'r-, HEATER CESSPOOL SEPTIC TANK RECEIVED BY a READY FOR DATE(SSU -- FlRBT 1N8PECTION �� GAS MISCELLANEOUS (J� APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB 0.�i Pi ADDRESS 3p, LOCALITYADDRE86 NEAREST C TY Wim �F.X1/t�V A.rT! L.No. E^ . CROSS-BT. COUNTY CERT.No. EXPIRES NAME f&23f-'&2')e0 `J LOCATION OF SEPTIC TANH, OR CESSPOOL Z MAIL 3 NORTH ADDRESS +' 0 - CITY TEL.No. I ANI THE LEGAL, POSSESSOR OF THE ABOVE LOB J ANGELES COUNTY CERTIFICATE ; 0 QUALIFIVA710N. - �� ptdNOER 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. OWNER CORRECTIONS -SOUTH DESCRIPTION OF WORK ATH TUB FURNACE + ROWER DISHWASHER LAVATORY REFRIGERATOR -KITCHEN SINK WATER SOFTBNER FLOOR SINK AsND TRAP LOP SINK FLOOR DRAIN ASH TRAY URINAL -APPROVALS L ATER CLOSET DRINKING FOUNTAIN DATE IN9PEGTOR'8 NAMB ATER NEATER DENTAL LAVATORY ROUGH PLUMBING ETER GAS RODA FOUNTAIN OUTL GAB PIPINGGAS VENTCESSPOOLOTAL NUMBER OF FIXTURES "`—- - SEPTIC TANK ESSPOOI- nEP77C TANK SEWER R INEMENNE 3 UTILITY CO.NOTIFIED.+ { TOTAL FEE D.B.S.-17 2nH2:SETS 12-45 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF :LOS ANGELES L WM.J..FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP /ZONE PERMIT No,, ROUGH _- FIXTURES COMPLETE ' F I v- / C/ / Q la HEATER CESSPOOL I-I SEPTIC TANK BY READY FOR DATEISSUED 2EI1 r FIRINSPECTION r q� GAB MISCELLANEOUS I / APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY NAME ? JOB C �f i��"�!�a)_•�'f�°�'�'1�' ADDRESS m ,� .s,A_ LOCALITY �'!J � ADDRESS � �;/•i4/?.,/ _ �.!_'� 1•-4. v NEAREST d CITY If,_ Js>11 -;.0EL.No. _ CROSS ST.. - COUNTY / ` ` t37-7 CERT.No. EXPIRES CM NAME >'' s �%'r ") o+i 0��.- LOCATION OF SEPTIC TANK, OR CESSPOOL' z MAIL 3 ADDRESS NORTH O CITY TEL.No. IAM THE LEGAL POSSESSOR OF TWE ABOVE LOB ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMB[R ` 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. • I � OWNER y CORRECTIONS SOUTH DESCRIPTION OF WORK ATN TUB FURNACE r-I MOWER DISHWASHER O AVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP LOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I ETER GAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK I I _ -CESSPOOT SEPTIC TANKQ Q SEWER O S UTILITY CO.NOTIFIED, TOTAL FEE / 49 I 67 i ,` y RINAL WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I have a certificate.of consent to self in- 20-0026 DPW 4/87 76A667A sure-or a certificate of Workers'Compensation Insurance,or a CE 817(REV.8/8.6) certified copy!fhereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS � department. NUMBER FIXTURE.OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET(TOILET) �Q NEAREST ' CERTIFICATE OF EXEMPTION FROM'WORKERSt ' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL D � the permit Is for one hundred dollars($.100)or less.) LAVATORY ADDRESS E L PA ohe , as.to become subject to the Workers' sati aws. DISHWASHER. I' CONTRACTOR Ire Date Applicant CLOTHES WASHER ADDRESSG, NOTICE TO APPLICANT: If, after making this Cer i to of Ex- SWIMMING POOL RECEPTOR' e.mption,you should.become subject to the Wor Compen.- t: CITY TEL. N8.. sation provisions of the Labor Code,you must forthwith comp- :LAWN SPRINKLER SYSTEM Q ' ly with such provisions or this permit shall be deemed revok- STATE LIC. ed: WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARAI ION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions�of Chapter GAS SYSTEM OUTLETS �' 9(commencing with Section 7000)of Division 9 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5'PER SYSTEM FINALVALI TION >_ fect. DATE O License Number Lic. Class V FINAL Contractor Date BY p 1-am exempt under Sec.. W B.BP.C. for this reason RAF Ib Plan check fee y Dater pop- ;!'82a-0A . PLUMBING PERMIT ISSUING FEE$ . , Signature TOTAL FEE #.o. 0 0 0.0 5 SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION PP• _ I •O ° 2$,5 I.hereby.affirm that I am exempt from the Cori tractor's License Name Law for the following reason (Section 7031.5, Business and 0 0 - 2a505 Professions Code): Address J. �, Q 4 8 7 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). ' 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 Lender's Address I certify that I have read this application and..state.that!he ; .above information is correct.I agree to comply with all County : ordinances and State laws regulating Plumbing, and hereby author• a eprese atives of this County to enter upon the ciboduln ne rope /or inspection urpo e! +, �(J( SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of IDIOMittee Date ��,W RKERS'COMP,�NSATIOIN DECLARATION APPLICATION FOR' PLUMBING PERMIT I he a 'y affirm that I'have a certificate of consent to self 76A667A i r or a certificate of Workers'Com ensation Insuran ; CE 817(REV. m/81) or;a certifi pcopy thereof(Sec. 3130. b. C.) ��/�� COUNTY OF LOS ANGELES / f� BUILDING AND SAFETY Policy No'O -If Company r /Ili! ,j❑ Certified copy is hereby furnised. I _ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING �) Certified copy is filed.with the county building inspec- FEE ADDRESS` cJ /�•/ n epartment. ��/ NUMBER FIXTURE OR ITEM LOCALI / Dat�,�A• Appliga � 2% WATER NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE 1 OWNER (This section need not be completed if the work involved by SHOWER MAIL the permii is for one hundred dollars(;100)or less.) LAVATORY ADDRE !/ .tel" I certify that in the work of the ork for which this AIF �j� permit is issued; I shall not employ any person in any manner SINK CITY TEL. so.as to become'subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR01. Date. ' Applicant CLOTHES WASHER ADDRESS �� Q� NOTICE TO APPL'ICANT: .If, after making this Certificate of Exemption, you should become subject• to the Workers' SWIMMING.POOL RECEPTOR Compensation.provisions of the Labor Code, you must forth- CITY TEL,401W—, j g LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall- be STATE 9 LIC. deemed revoked.. WATER HEATER z d LICENSE NO: / �� CLASS LICENSED CONTRACTORS DECLARATION DI CT NOESSED BY. I hereby offirm•th6t I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (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 }. i' D ✓. a � A7E...7/ VALI, . TION. License Number Lic..:.Class - �/�/ _ om FIN C) Contrbcto ,�� '��' Date BY ❑ 1 am exempt under Sec. O - B.BP.C. for this reason W Plan check fee n. Date: oil, in PLUMBING PERMIT ISSUING FEE$ D Zr Signature TOTAL FEE SINGLE FAMILY Plan check applicant. HOME OWNER-BUILDER DECLARATION Name '1.1, 225 o Q 1 hereby affirm that'I'am exempt from the Contractor's License o 0 -22tJ U v Low.for the following reason (Section 7031.5, .Business,prid Address Professions Code): City Tel. No. c a 7 l t 8 6 ❑ I, as owner of the property, Will do the work ancll the structure is not intended .or offered for sale (Section 7044, Business and Professions Code). I CONSTRUCTIONLENDING AGENCY 1 hereby affirm that there•is a construction.lending agency for th.e performance of the Work,for which this permit is-issued (Sec. 30.97, Civ. C..). Lender's Name L.en..der's Address - • I certify that I shave.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 heieby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR. EXPLANATORY LANGUAGE • ignature of Pe-rmifte-e Date C. B. iT 7-40. IBM - - APPLICATION FOR PERMIT DEPARTMENT. OF BUILDING AND SAFETY - F�. - ,; COUNTY OF LOS ANGELES L�J : I WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUPZONE PERMIT No. " PROUGH LUMBING FIXTURES ]-COMPLETE _ y I Z /��9iv�8T_ RECEIVED BY READY FOR DATE.ISSUED HFJ►TERCESSPOOL SEPTIC TANK C� FIRST INSPECTION GAB MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION :ONLY •- K NAME < < b /la-'G� if � � ADDRESS m 1� m ADDRESS � /'[ ( 1. p_ fc/ LOCALITY' .I P!-,/�Tfti. • MOSS STNEAREST_ / 1� _ CITY 9,141— TEL No. . /� / qi COUNTY: CERT. NO. EXPIRES II NAME Z MAIL LOCATION OF SEPTIC TANK, OR CESSPOOL 3 ADDRESS '-�,�' ... NORTH CITY' I AM THE.. LEGAL POSSESSOR OF THE. AB;VE LOS ANGELES' COON CERTIfC7ly F QUALIFICATION. ►- y PI:IIMBER I AM THE LEGAL OWNERVOF THE PROPERTY DESCRIBED ABOVE. 3 •. - .. - OWNBR . CORRECTIONS SOUTH ' DESCRIPTION OF.WORK a Z PATH.Tue FURNACE SHOWER DISHWASHER O VATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER LOOR BINK SAND TRAP LOP-SINK FLOOR DRAIN WASH TRAY URINAL -•'APPRO r•ALS WATER CLOSET DRINKING.FOUNTAIN, DATE. BPECTOR•S NAME WATER HEATER DENTAL LAVATORY -ROUGH PLUMBING ETES GAS SODA FOUNTAIN GAB PIPING OUTL GAS VENT ( 7-7. CESSPOOL r j J TOTAL NUMBER OF FIXTURES. SEPTIC TANK SEPTIC TANK - pv CESSPOOL SEWER - _ $ -�-�� UTILITYCO. NOTIFIED TOTAL FEE FINAL , 17. B. 17 7-40 26M APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING WM: J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PER IT No ROUGH no? PLUMBING FIXTURES COMPLETE RECEIVEDBY READY FOR DATE ISSUED HEATER CESSPOOL SEPTIC TANK y FIRST INSPECTION GAS MISCELLANEOUS /7 /� ►////a G I APPLICANT FIPL,IST HEAVILY OUTLINED PORTION ONLY Joe I. K NAME r«y+� ADDRESS N vim` i M ADDR U. 0 �' LOCALITY p of rN1. D �ty�,r �. DEAREST d n � CITY 1. r�t� EL No _ DROSS ST. � to COUNTY -IRA CERT. NO. / 9 P ld NAME OCATION OF SEPTIC T MAIL ANS, OR CESSPOOL ADDRESS NORTH C CITY Tr' TEL N I AM THE LEG . POSSESSOR OF THE ABOM LOS ANGELES COUNTY CERTIFICATE OF QUALIRIC N. 1. s -.tllv P MBER � 1 AM THE LEG k OWNER OF THE PRO EIRTY DESC ED ABOVE. m a 3 -e1 OWNER CORRECTIONS SOUTH DESCRIPTION OF WORK a z BATH TuB FURNACE SHOWER DISHWASHER 0 LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER RLOOR SINK SAND.TRAP LOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER— GAS SODA FOUNTAIN GAS PIPING At OUTL GAS VENT 1 n CESSPOOL TOTAL NUMBER OF FIXTURES l .SEPTIC TANK CESSPOOL SEPTIC TANK SEWER $ UTILITYCO. NOTIFIED TOTAL FEE I I� ® FINAL O. S. 17 7.140 =M - APPLICATION FOR' PERMIT DEPARTMENT OF BUILDING AND SAFETY -PLUMBING COUNTY OF LOS ANGELES WM. .1. FOX CHIEF ENGINEER :. NATURE OF INSTALLATION o1sTRicr rlo. GROUP� ZONE PERMIT NO. � � � � v ROUGH PLUMBING k FIXTURES COMPLETE RECEfYED BY READY FOR DATE ISSUED HEATER CESSPOOL SEPTIC TANK FIRST INSPECTION ®��• MISCELLANEOUS APPLICANT FILL IN EEAVILY OUTLINED PORTION ONLY JOB � - ADDRESS k �, E NAME J LOCA-Ty y � , ADDR REST 'Rdss sr.CITY _ hE t d COUNTY x CERT NO EXPIRES 4�R:. 1NAME N -S"r' Z MAIL ` OCATION OF SEPTIC TANK, OR CESSPOOL a ADDRESS �j, p NORTH CITY .#tam ��yTEL No. ! AM THE L POSSEE*SOi2f OF THE A VE LOS ANGELES COUNTY CERTIFyIC. OF QUALIFICy LION. 44 ef ga.UMSl: 1 AM THE LEG.L OWNER OF THE PROPERTY DESdfrBSED ABOVE. N ' ' OWNER CORRECTIONS SOUTH ..1 Q DESCRIPTION OF WORK a BATH TUB FURNACE a ROWER DISHWASHER 0 LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER [�t FLOOR SINK SAND TRAP LOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET —DRINKING FOUNTAIN DATE INSPECTORS NAME WATER H TER DENTAL LAVATORY' ROUGH PLUMBING �{/' y� .X MET GAS SODA FOUNTAIN GAB PIPING a' lT.or�:rr"•,moi"""" QUTL GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK SEWER n CESSPOOL SEPTIC TANK -17 UTILITY CO. NOTIFIED / E TOTAL FEE ®� FINAL o.B.s.n zsN sETs 18-44 'APPLICATION FOR PERMIT - DEPARTMENT OF. BUILDING AND SAFETY COUNTY OF, LOS ANGELES PLUMB�� WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP _7O -PERMIT NO. ROUGH_ _FIXTURES COMPLETE HEATER CESSPOOL8161TIC TANK RECEIVED BY- READY FOR DATE'I8RUED rift"INSPECTION' '} GAS MISCELLANEOUS'. _ APPLICANT FILL IN HEAVILY'OUTLINED PORTION. ONLY C NAME Y�iY.t[:�l`t 'r��l}LiLCI.:`fC! 'C•Z'°!rl G.5 ADDRESS_ • W' - //;;11 �• 1 rI h L / � '.ADDRESS f� '/i' % �'lL+�l Gf.9� y�.S 3E.i"'�""' LOCALITY r, y d CITY ,til TEL.NoiJ l`a ! !/ r �r/CROSS ST. 17 COUNTY 6/ / 7 J Y /f: er - -CERT.No. EXPIRES r., r `� � hl NAME- 'LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL NORTH G , :ADDRESS. r 1 Y CITY TEL.No.- 1 AM THE LEGAL PO88ES9iOR'OF THE ABOVE LOS / ANCiELs ES CO1_UNTY CERpFICATZ'OF QUALIFICATION: i_. - PLtlMBtR - 1'AM THE LEGAL OWNER OF THE PROPERTY DKBC�RIS® ABOVE: i - -• >�. - OWNER CORR/EC�TIONSS _A - Ji-•� /y� ' 1 .• � ' -7.r1 /AlA 1�RrG.:J!4.r1._J`f��f��%��I!i'�.��h' SOUTH DESCRIPTION OF WORK ATH TUB' FURNACE r ` SHOWER nIGHWAIIHER O _JAVATORY REFRIGERATOR ITCHEN SINK . - WATER SOFTENER, FLOOR SINK SAND TRAP LOP SINK+ FLOOR DRAIN " L ASH TRAY URINAL APPROVALS ATER CLOSET ^RINKINO FOUNTAIN , , _ � ATB VNBPECTORiNAM ATER'HEATER ^ENTAL-LAVATORYROUGH PLUMSINA'ETER_LGAS SADA FOUNTAINOUR: GAS PIPINGGAS-VENT lE ACESSPOOLOTAL NUMBER.OF FIXTURES' ,. SEPTIC-TANK EBSPOOI, •SEPTIC TANK , SEWER ' s _ .TOTAL•FEE . � � � � UTILITY CO NOTIFIED d r $ Q6 1 - - - - FINAL-- -