The URL can be used to link to this page

Home My Public Portal About5936-5936 1/2 TEMPLE CITY BLVD_Plumbing__ WORKERS'COMPENSATION DECLARATION 76AS67A I hereby affirm that I have C'cettffic*te of consent to self CE 817 Ir.-a°) APPLICATION FOR! PLUMBING PERMIT insure,or a certificate of Workers'Compensation Insurance,or a certified co thereof(Sec.3800,Lab.C.) 2310790079 Ca. Casualty Indemnity COUNTY OF LOS ANGELES BUILDING AND SAFETY 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 NUMBER FIXTURE OR ITEM • FEE ADDRESS 5936y' Temple City Blvd. WATER CLOSET LOCALITY Temple City Dated P t 1 , Applicant E. L_ PAYNE COMPANY NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. Woodruff COMPENSATION INSURANCE SHOWER JOWNER John Barr Contractor (This section need not be completed if the work involved MAI L P LAVATORY ADDRESS 10258 E. La Rosa Drive IL by the permit is for one hundred dollars ($.100) or less.). SINK CITY Temple City TEL.NO-443-6533 U I certify that in the performance of the work for which this DISHWASHER !r permit is issued, I shall not employ any person in any manner CONTRACTOR E. L. PAYNE COMPANY p so as to become subject to the Workers'Compensation Laws. CLOTHES WASHER H Date_ 8-81 Applicant E. L; PAYNE COMPANY ADDRESS 166 W. Live Oak Avenue W i SWIMMING POOL RECEPTOR d NOTICE TO APPLICANT: If, after making this Certificate of CITY Arcadia. TEL.N0.446-61 18 y Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM Compensation provisions of the Labor Code,you must forth- STATE WATER HEATER LICENSE NO.1 20228 CLASS C-20 _ with comply with such provisions or this permit shall(be deemed revoked. — DISTRICT NO. PR �ESSEDY 1 GAS SYSTEM 1 OUTLETS 3 QQ LICENSED CONTRACTORS DECLARATION OUTLETS OVER �O I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL �� VALIDATION ness and Professions Code, and my license is in full force and DATE �2� effect. License Number 102228 Lic.Class C-20 BY AL r Contractor E. L. PAYNE Date 6—8—81 ' ri I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ 7 Q acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE 110 QQ Lie.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): 2 0 1 9.7 A I, as owner of the property, am exclusively contracting with licensed contractors to construct the project # 0 0 0 0 ° 5 (Section 7044,Business and Professions Code). 2 ° ° 1000 CONSTRUCTION LENDING AGENCY 0 0 0 1 Q Q L1 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is 6 1 5 issued(Sec.3097,Civ.C.). 5-81 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 SEE REVERSE FOR EXPLANATORY LANGUAGE I ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above- ntioned propert or ins ection purposes. 6-8,41 ignature of Pex*ittee Date WORKERS'COMPENSATION DECLARATION 78A867 ) APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a• certificate of consent to self ee er7(a-eo insure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) C 081 }tFPT TT , T T(l�•111TTTY COUNTY OF LOS ANGLES BUILDING AND SAFETY Policy NoP 935 Company-- e Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDIN�S7;+ NUMBER FIXTURE OR ITEM • FEE ADDRES93g2 TIITPLE CITY BLVD, LVD T.C. �Certified copy is filed with the county building inspection LOCALITY T'M1.n)J , CITr WATER CLOSET Date NEAREST BATH TUB CROSS ST.L1 CERTIFICCOMPENSAT ON INSURANCE ATE OF EXEMPTION FROM ORKERS' SHOWER OWNER IM-23 L. TEGGATE TORY MAIL > (This section need not be completed if the work involved LAVAADORES�939z TEtZ'LE CITY BLVD• a. by the permit is for one hundred dollars ($100) or less.) SINKCITY TEL.NO DISHWASHER 0 0 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner CONTRACTORmnw W so as ecome subject to the Workers'Compensation Laws. CLOTHES WASHER V ADDRESS Date t 28/81 Applicant J & D Plumbing w SWIMMING POOL RECEPTOR tL NOTICE TO APPLICANT: If, after making this Certificate of CIT= MpJEL TEQ.36 to Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIZ Compensation provisions of the Labor Code, you must forth- LICENSE N0.307 66 CLwith comply with such provisions or this permit shall be WATER HEATERdeemed revoked. GAS SYSTEM OUTLETS DIST�NOj. LICENSED CONTRACTORS DECLARATION OUTLETS OVER CJ! !/ I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL / ness and Professions Code, and my license is in full force and �- ►� DATE 1j� VALIDATION effect. License Number 307766 Lie.Class C-36 FINAL t ContractorJ & D PlW bingpate 5/28/81 F1 I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ /A acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE (/ Lie.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- Ci Tel.No. ness and Professions Code): 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044,Business and Professions Code). 1 0 0 0 0 0 CONSTRUCTION LENDING AGENCY 7 0 0 1 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is 0 , issued(Sec.3097,Civ.C.). Lender's Name l) C 3—'� I 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 above-me tion d op y fo ins n purposes. r _ Signa f PermitWe Date WORKERS'COMPENSATION DECLARATION 76A667A I hereby affirm that I have a'-certificate of consent to self CE 617(z-ae) APPLICATION FOR PLUMBING PERMIT insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) COUNTY OF LOS ANGELES T e.. BUI WING AND SAFETY Policy N mpanY—REPUS +IC INDZ=ITY Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING 1 ® _ ADDRESS — Certified copy is filed with the county building inspection NUMBERI FIXTURE OR ITEM • FEE LOCALITY d art ent. WATER CLOSET TF. PIE (iTTV Da _ Applicant. ,Tr]] La.'MRING NEAREST BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER COMPENSATION INSURANCE SHOWER G RY MAIL T VAO } (This section need not be completed if the work involved LA .ADDRESS � —1PLR OTTY nu. o. by the permit is for one hundred dollars ($100) or less.) SINK CITY TEL.NO 0 I certify that in the performance of the work for which this DISHWASHER permit is issued, I shall not employ any person in any manner CONTRACTOR -PT,*MRTNG0 so as to become subject to the Workers'Compensation Laws. CLOTHES WASHER ADORES (~j Date Applicant .14 80, RIK (,ARRTTPT1 SWIMMING POOL RECEPTOR d NOTICE TO APPLICANT: If, after making this Certificate of CITY AN GABRIEL TEL.NO!287783CO) Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. Z Compensation provisions of the Labor Code, you must forth- WATER HEATEF� LICENSE NO. CLASSC �6 with comply with such provisions or this permit shall be deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. I PRO SSED$Y LICENSED CONTRACTORS DECLARATION OUTLETS OVER I 1' I hereby affirm that I am licensed under provisions of Chapter 5 PER 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 o2 -2�- effect. FINr ]— BY AL �- License NumbeF� Lic.Class V—'-"--'`-+ ContractQL11M PT1JM_Pa4GDate 6/12A81 F1 I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Q 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): d 7� I, as owner of the property, am exclusively contracting with licensed contractors to construct the project =61- (Section 7044,Business and Professions Code). 77 CONSTRUCTION LENDING AGENCY a 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.). 6 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives of this Caar4y to enter on the above- tprop r�inpectiojfpurpose 457r Signetof Permi ee Date 76A667 (CE-817)- 5/73 APPLICATION OR ,PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER -BUILDING AND SAFETY DIVISION _ MAKE CHECKS PAYABLE TO: AUDIDRESS GMA1 HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST + NUMBER FIXTURE OR ITEM (9� FEE CROSS ST. WATER CLOSET 1.75 OWNER . 7A,, C,� MAIL, BATH TUB t.I S ADDRESS SHOWER 1.1 5 CITY TEL. NO.(a 7 L s LAVATORY 1; 5 4ADDRE SINK N 10 S ® � DISHWASHER 1175 TEL. NO. � `(� CLOTHES WASHER 1 75 CLASSLSWIMMING POOL RECEPTOR 1 5NO. GROUP ZONROCESS D BY LAWN SPRINKLER SYSTEM 1. 5 q- ti , z._ WATER HEATER 1. 5 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1. 5INSPECTION RECORD v OUTLETS OVER 5 PER SYSTEM •30 O F- L W d. G7 Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMB Address GAS PIPING City Tel. No. GAS VENT HOT WATER'HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST adr �. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED ASREQUIRED BY LOS ANGELES COUNTY AND STATE OF �y CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO ,,j. �;• ' RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPE FINAL SIGNATURE OF PERMITTEE Lx, PERMIT VALIDATIONcK M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH V _ -8 N1AY 14 5 0 4.7 5 a�a r 76A667;(C E-817)-8-71 '3APPLICATION FOR PLUMBIG PER�I'IT - COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING.ADDRESS (p C.. remnkt LOCALITY FBATHTUB PPLICANT TO FILL IN (PRINT OR TYPE) CROSS S S FIXTURE OR ITEM ® FEE n OWNER' 1. G ER CLOSET 1.75 MAIL 1.75 ADDRES (Ip V WER 1.75. -CITY TEL. NO. LAVATORY 1.75 CONTRACTOR SINK 1.75 d ADDRESS s` DISHWASHER 1.75 CITY TEL. O. ,jF CLOTHES WASHER 1.75 STATELICQ SWIMMING POOL RECEPTOR 1.75 LICENSE NOl? 74� . CLASS 6 DISPICT N ROUP ONE PR SS BY LAWN SPRINKLER SYSTEM 1.75 7 r O � WATER HEATER 1.75 INDUSTRIAL WASTE APPROVAL. GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD OUTLETS OVER 90 0 5 PER SYSTEM 0 ' W A. - H • e Plan check fee See reverse: PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS ATE IN CTOR'9 SIGNATURE Plan check applicant UNDER-SLAB WORK Name ROUGH PLUMBING_ Address GAS PIPING City Tel. No. GAS VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO .COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST e 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICEN§ED AS REQUIRED BY LOS ANGELES COUNTY AN STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF; A INTEND TO RES IDE 1'N THE ABOVE D BED RESIDENTIA PR RTY. FINAL SIGNATURE OF PERMITTEE PERMIT VALIDATION PLAN CHECK VALIDATION CK.. M.O. CASH I G�Eo 5 9 2 " -5 D 17.0 0- a 76A867 (CE-817)- 8/73 '21 APPLICATIO FOR PLZMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING C � ADDRESS HARVEY T. BRANDT, COUNTY ENGINEER- LOCALITY a � FOR APPLICANT TO FILL IN (PRINT Op TYPE) NEAREST NUMBER FIXTURE OR ITEM FEE CROSS ST. OWNER WATER CLOSET 1,75 -MAIL BATH TUB 1. 5 ADDRESS I CITY TEL. NO. ' 47 SHOWER 1,75 d LAVATORY 1, 5 CONTRACTOR J I/ .� .!� SINK 1, 5 ADDRESS ;� DISHWASHER 1. 5 CITY �- / P TEL. NO d IN 7 CLOTHES WASHER 1, 5 STATE LIC / LICENSE NO. L k,� $� CLASS c .3 SWIMMING POOL RECEPTOR 1, 5 DISTRICT NO. GROUP ZONE ---PROCESSED BY LAWN SPRINKLER SYSTEM 1, 5 WATER HEATER 1, Is INDUSTRIAL ` -424 WASTE APPROVAL •r GAS SYSTEM OUTLETS 1. '5CD INSPECTION RECORD v OUTLETS OVER 30 tr 5 PER SYSTEM CD F•- U ' W CL N Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBINGr 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 IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES ., WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICEN SEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM. THE LEGAL OWNER OF., AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDEN=7I��ev ,,t ¢ 0_'�`�~'` r. FINALSIGNATURE OF PERMITTEE PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH r WiAY 14 5 0 4.7 5 0!jd D.B.S.-17 25M SETS 12-40 ' APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY r_ COUNTY OF LOS ANGELES �L� WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP /ZIO�INE PER/MIT NO. ROUGH FIXTURES COMPLETE __577 FOR HEATER CESSPOOL. 1-1 SEPTIC TANK ar7j VP�� BREADI(`ECTDATEiSBUBD GAS MISCELLANEOUS I FIRST INN CTION 5- -, / :3 a LIC LL IN HEAVILY OUTLINED PORTION ONLY 1-`` JOB Q ' fi i, 6, NAME IrSsl,nne 1< < ADDRESS ..r - AA n — V I C LOCALITY 6C♦6 ADDRESS C d(-✓tv � CMDR q� p� ^� .. NEAREST L CITY , ci COUNTY ��,YAIOL,�+ Iq�.,, CROSS ST. �'� — CERT.No.* EXPIRES W NAME LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL. NORTH O ADDRESS CITY TEL.No. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICAF Q ALIF1I. ATION. I Qi ( /✓1/1�tf �� PLUMBER U 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. OWNER i CORRECTIONS SOUTH a DESCRIPTION OF WORK ATH TUB FURNACE (� ROWER DISHWASHER _LAVATORY REFRIGERATOR -KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP LOP SINK FLOOR GRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPZ=R'S.NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I I ETES GAB SODA FOUNTAIN GAS PIPING OUTL GGEEGI GAS VENT I CESSPOOL I TOTAL,NUMSER OF FIXTURES SEPTIC TANK k ESSPOOI SEPTIC TANK SEWER S UTILITY CO.NOTIFIED I I TOTAL FEE d�3�g �. FINAL k�a D.S. 17 asM sErs Ia-aa APPLICATION FOR PERMIT DEPARTMENT OF BUILDING. AND SAFETY • • • PLUMBING COUNTY OF LOS ANGELES WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP I ZONE. PERMIT No. ROUGH FIXTURES COMPLETE HEATER __ CESSPOOL SEPTICTANK RECEIVED BY READY FOR DATE ISSUED M18CELLANEOUS FIRST INSPECTION AS . / APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY -� tC NAME V2:4:;tP f}a!/�ll�:1f�✓2+:� l?��l4sE}/ � �.� ADDRESS A20 eti �4c.°dt1� ADDRESS ALOCALITY 4/7;x' 1,•%C�P� 4 $ �+1 NEAREST LL CITY H /� ' ! TEL.NO Q CROSS ST. COUNTY JJ p�{ f CERT.NO.l/II /!!i EXPIRES ( T4 -74Id NAMB /.tom'/' LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL �o // NORTH O ADDRESS 1S Ca �1/L� -/ / CITY �//�l�i%�c�� TEL.No 4 I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERT FI TE OF QUALIFIC ION. PLUMBBR 1 AM THE LEGAL OWNER OF THE ROPERTY DESCRIBED ABOVE. OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK z_ MATH TUB FURNACE 19 ix ROWER DISHWASHER LAVATORY REFRIGERATOR KITCHEN RINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY - URINAL APPROVAL WW WATER CLOSET DRINKING FOUNTAIN DATE INnSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METES = GAS SODA FOUNTAIN I r F I 1 V OUTL GAS PIPING GAS VENTSENSE CESSPOOL I' TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOL SEPTIC TANK SEWER S I) (� UTILITY CO.NOTIFIED I TOTAL FEE 0 FINAL "l lee