HomeMy Public PortalAbout5940, 5942, 5944 TEMPLE CITY BLVD_Plumbing__ 76A667-CE#817 2-62 TEMPLE CRTY
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS +
WILLIAM A.JENSEN, SUP'T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN CRONEAREST
S TT. Y v
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25
MAIL
BATH TUB 1,25 ADDRESS
SHOWER1.251 CITY TEL. N
LAVATORY 1.25 CONTOR
SINK 1,25 ADDRESSow
y
DISHWASHER 1.25 CITY TEL.
LAUNDRY TUB 1 :CO OR'S STATE
REGIST TION NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRIC 7 GRO ZONE P O E BY
WATER HEATER 1.50 i• ( 3
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .90 INSPECTION RECORD
O.
1 u
F=
tu
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 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
PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I A TH GAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DE RI D RESIDE L P RERTY. UTILITY CO.NOTIFIED
1 'r
SIGNATURE /
OF PERMITTE
VALIDATIONROBERT A.WOOD
CK. M.O. CASH SUPERVISING MECHANICAL ENG'R
Ld:0
N5 0 5 6 JM 3 0 5 D 3,5 Q N
" D.B.S.:17 26n€SETS 6-48 •• APPLICATION FOR PERMIT .
DEPARTMENT OF 'DUILDING AND--.,SAFETY
COUNTY OFLOS ANGELES P`�����G
WK.J.FOX.CHIEF ENGINEER
-1ATURE OF STALLATION DI `1. N GROU ZONE PERMIT
ROUGH FIXTURES COMPLETE J' �_ /
HEATER CESSPOOL I SEPTIC TANK RECEIVED Y READY FOR DATE ISSUED
Iry CFIRST INSPECTION
AS MISCELLANEOUS
APPLICANT' FILL IN HEAVILY OUTLINED .PORTION ONLY
� JOB y
C - NAME p - A
ADDRESS- 6 , 3L4,
W
M ADDRESS UrtAA. LOCALITY
H
JL CI —& _ TEL.NO a ndt" N
. CROEASRSBST ST.
CCU
CERT.TY
NO. EXPIRES/ -3045- j .NAME I _
LOCATION OF SEPTIC TANS, OR CESSPOOLLC 'MAIL
$ ADDRESS
NORTH_ O
CITY TEL.NO.
I .AM THE LEGAL POSSESSOR OF THE ABOVE LOS
/ ANGELES COUNTY CERTIFICATZ41K qU64FI O
C pj!umozit
I AM THE LEGAL OWNER OF THE PROPERTY�04CRIBED
ABOVE.
3 OWNER
CORRECTIONS
- SOUTH
- J
DESCRIPTION OF WORK _a
Z
BATH TUB FURNACE '
ROWER DISHWASHER 1
B LAVATORY REFRIGERATOR
ITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
LOP SINK FLOOR'DRAIN
® WASH TRAY URINAL APPROVALS
—(pL—WATER CLOSET DRINKING FOUNTAIN, DATE INSP R'S NAME
-WATER HEATER *+ENTAL LAVATORY - ROUGH PLUMBING I I
ETERy.�-- uTL SODA FOUNTAIN GAS PIPING
GAS.VENT
i CESSPOOL I
TOTAL NUMBER OF FIXTURES SEPTIC TANK
�'ESSPOOI SEPTIC TANK SEWER I
$ UTILITY CO.NOTIFIED
TOTAL FEE - pC`I'C7
FINAL
76A667 17 2SM BETS 7-4B' APE%ICATION FOR
DEPARTBIENT OF WILDING-AND SAFETY 'i PLUMBING� ���
COIJNTX OF LOS ANGELES
CHIEF ENGINEER
NATURE OF .INSTALLA77ON DISTRICT O: ORO UP ('O E PERMIT O.
ROUGH FIXTURES. COMPLETE :
HEATER __ CESSPOOL -I SEPTIC TANK R���CCCEIVED Y READY FOR DATE ISSUED
Q � FIRST INSPBCTION
A MI8CELLAN OU8
APPLICANT FIj L If HEAVILY OUTLINED PORTION ONLY
-JOB.
E NAME' ADDRES8 -0) /162
Ill —a
ADDRESSME
.� Pe' x!/161/. ' t . i• LOCALITY
J NEAREST
K CITY ! .Rn TEL:No. CROSS ST.
COUNTY l
LICENSE NO. EXPIRES C NAMELOCATION.-OF SEPTIC'TANK, OR CESSPOOL MAIL
* .3 ADDRESS
NORTH O
CITY TEL.No.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY. CERTIFICATE OR QUALIFICATION.
PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
OWNER
• t
CORRECTIONS
SOUTH J
DESCRIPTION OF WORK z _
ATH TUB FURNACE'
HOWER DISHWASHER '; G
-LAVATORY REFRIGERATOR
ITCHEN SINK WATER SOFTENER
L^OR SINK SAND TRAP
GLOP SINK FLOOR DRAIN
WASH TRAY - URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAINS
DATE INBPeeroR's Nwwa
WATER HEATER - DENTAL LAVATORY ROUGH PLUMBING I
ETER awe SODA FOUNTAIN GAS PIPING I
OUTL
GAS VENT:
CESSPOOL I
TOTAL NUMBER OF FIXTURES SEPTIC TANK i
CEBSPOOl SEPTIC TANK i SEWER I ...
G �� _UTILITY CO.NOTIFIED lI !
TOTAL FEE 1 `�� L�.r2rd
FINAL.
7BAS67 (CE-817)-4/72
APPLICATION F PLUM NG PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO.• . . BUILDING 0 r ey
ADDRESS 7 T
HARVEY T. BRA•NDT, COUNTY ENGINEER LOCALITY
0
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
..
NUMBER FIXTURE OR ITEM @ FEE CROSS ST.
WATER CLOSET 1.75 OWNER
el
MAIL 6111-4
BATH TUB 1.75 ADDRE S 17<4 vv
SHOWER 1,75 CI TEL. NO..
LAVATORY 1.75 CONTRAC OR +
SINK 1.75 ADDRESS 2
DISHWASHER 1.75 CITY' ` TEL. NO.
CLOTHES WASHER 1.75 STATELIC ®
LICENSE N.O.2j d-y._i CLASS V
SWIMMING POOL RECEPTOR 1.75
DISTRICT NO. G OUP ZONE OCESSED BY
LAWN SPRINKLER SYSTEM 1.75 O� ^L IC-
-' \
WATER HEATER 1.75 INDUSTRIAL y
WASTE APPROVAL II:
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD v
OUTLETS OVER C
5 PER SYSTEM .30 CD
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INS P_ECTOR'9 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING v
City Tel. No. GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND. STATE THAT THEABOVE 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
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I r'q THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE lCjt IBED RESIDENTIAL PROPERTY. p�
{/.//�/// r FINAL .�+• O�C /'!r �i�...G
SIGNATU RE
OF PER-MITTEE
PERMIT VALIDA. �ON0c.. ' M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
7 5 8�.APR -3O 5 D A96
. 4.7 5
7SA6e7 17 25M SETS 7-4e..• APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING .AND SAFETY
COUNTY OF LOS ANGELES PLUMBING 1
'WILLIAM J. FOX, CHIEF ENGINEER '
DISTRICT GR P P .
FOR APPLICANT TO FILL IN
PLUMBER y * READY FOR
ECE1'ED B DATE ISSUED
� /�� -•/�/ �� /,RFIRST INSPECTION
ADDRESS
CITYp_ A_ /.(,TEL..No.
ADDRESS
COUNTYp
LICENSE NO. EXPIRES
LOCALITY , �'.t7-�L,Y�/i:t. G_t�.�..4 •
1 CERTIFY THAT I .POSSESS THE ABOVE VALID LOS NEAREST
ANGELES COUNTY LICENSE. CROBS.ST.
OWNER
MAIL
PUIMSER ADDRESS
PERMIT FEE IS $1.00 FOR THE FIRST FIXTURE OR CITY. TEL. No.
ITEM LISTED BELOW, PLUS SOc FOR EACH ADDITIONAL I AM THE LEGAL OWNER OF THE RESIDENTIAL PROP-
ITEM. FOR EACH SEPTIC TANK AND PIT OR DRAINFIELD ERTY DESCRIBED ABOVE.
$1.00: MINIMUM FEE FOR ANY PERMIT $1.00. EACH
GAS SYSTEM IS A SEPARATE ITEM.
OWNER
NUMOER TYPE OF FIXTURE OR ITEM
WATER CLOSET (TOILET) CORRECTIONS
BATH TUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
LAUNDRY TUB OR TRAY
GAS SYSTEM OUTLETS
WATER HEATER
SLOP SINK J
Q
FLOOR SINK Z
FLOOR DRAIN L7
R'
DISHWASHER O
DRINKING FOUNTAIN
URINAL
MISCELLANEOUS
APPROVAL ••
DATE IN$pEaW NAME
ROUGH PLUMBING �_� Z•
GAS PIPING
GAS VENT
CESSPOOL
SEPTIC TANK - DRAIN'( ) PIT ( ) $ SEPTIC TANK
CESSPOOL $ SEWER
HOUSE SEWER $ GAS TEST )
f cT-(D UTILITY CO.NOTIFIED
TOTAL FEE
.—FINAL
76A667 17 25M 5ET9 7-48 APPLICATION ION T.OR PEis11 T
DEPARTMENT OF BUILDING AND SAFETY 1i� 8d9i/ A!1 1V Y` YOAY6Li 1
COUNTY OF LOS ANGELESI I
Wm.J. FOX.CHIEF ENGINEER
NATURE OF-INSTAJUATION DIRI o. OU Zo E PERMIT o.
ROUGH' FIXTURES COMPLETE i 4O
READY FOi
NEATER CESSPOOL SEPTIC TANK RECEIVEDrHY DATE UED
;+� /f`+/� 'FIRST INSPECTION
MISCE6LANEOU8_
AJOB
APPLIlgANT LLL IN HEAVILY OUTLINED PORTION ONLY
a NAME �3 ,a' t /�`�//��/Vn/f/�yJ ADDREBS titD `e/- ey I ' /1,G:�7-pl o
B ADDRESS / �•/,{ /�R+�/an�e ,/j LOCALITY �/�CJi'7y- y,. J
CITY �.�Yy'^.! /� CROSS
C/
/! �G� TEL.No. CROSS 8T.
COUNTY'
LICENSE NO. EXPIRES NAME ,
LOCATION OF SEPTIC TANS, OR CESSPOOL' K MAIL t
NORTH O ADDRESS_
CITY TEL.No.
I AM THE LEGAL POBB OCR OF THE ABOVE LOS
ANGELES COUNTY.CERTIFI TE OR.7 UAL i AT N.
PLUNeml
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
t owNen
CORRECTIONS
SOUTH J
DESCRIPTION OF WORK _z
HATH TUB FURNACE
!C
ROWER DISHWASHER Q
—LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR BINK SAND TRAP
VWA
'FLOOR DRAIN
URINAL. APPROVALS
SET DRINKING FOUNTAIN DATE INSPECTOR-8 HAMS
TER DENTAL LAVATORY ROUGH PLUMBING
rsAs QODA FOUNTAIN I I {
OUTL GAS'PIPING r . .
GAS VENT
CESSPOOL
ER OFFIXTURES SEPTIC'TANK AEPTICTANK SEWER
S
/ UTILITY CO.NOTIFIED I f f
TOTAL FEE
FINAL
U.S.N.& Z5M SETS 7-47 - APPLICATION FOR PERMIT ! .
DEPARTMENT OF BUILDING AND SAFETY �
COUNTY OF LOS ANGELES
Wm.J. FOX.CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT GROUP zo PERMIT NO.
ROUGH FIXTURES COMPLETE '—
HEATER CESSPOOL N —I SEPTIC TANK. RECEIVED•. Y READY FOR DATE ISSUED
J FIRST INSPECTION
GAB- MISCELLANEOammmm / G r` I
ICA)XT FILL IN HEAVILY OUTLINEIDA oP��ORTgqION ONLY
E NAME 1 ADDRESS sLe ®I�
ofJ�j
g
ADDRESS „ LOCALITY
j OY
NEAREST
p, CITY - TEL.No. CROSS ST.
COUNTY m NAME �a
CERT.No. EXPIRES
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'CERTIRTPO UAL
PLUMEER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
OWNER
CORRECTIONS
SOUTH W,
DESCRIPTION OF WORK
Ej
BATH TUB ' =URNACE J
D.
°ROWER DISHWASHER a
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
LAP SINK =LOOR'DRAIN
k-- C7ESSPOOt-
ASH TRAY URINAL APPROVALS
ATER CLOSET ■+RINKING FOUNTAIN
DATE INSPECTOR'S NAME
ATER HEATER DENTAL LAVATORY ROUGH PLUMBING I
6TE� CV SODA FOUNTAIN GAS PIPING I I
GAS VENT
CESSPOOL
AL NUMBER OF FIXTURES "c I I ,
SEPTIC TANK
QEPTICTANK SEWER I I
S
TOTAL FEE UTILITY CO.NOTIFIED I
�'p"'-
FINAL
v.earri MOM e&.In nwe APPLICATION FOR �11Wi1
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WM.J.FOX.CHIEF ENGINEER PLUMBING
°NATURE OF INSTALLATION 13111rRl NO. GROUP —PERMIT NO.
ROUGH FIXTURES COMPLETE �P
HEATER CESSPOOL �I SEPTIC TANK REC61V READY WT DATE ISSY
FIRST INSPECTION s � ��
S. M18CELLANEOUB (�
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
K NAME ' ADDRESS
X ADDRE8B r LOCALITY Cwt
R
j NEAREST
d. CITY TEL.NeQ CROSS ST.
COUNTY p� 0-a
CBRT.NO. EXPIRES Y NAME
LOCATION OF SEPTIC TANH, OR CESSPOOL Z MAIL
NORTH ADDRESS
CITY TEL.No.
1. AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFIQR QUALIFICATION.
/T f7 PLIIDMMBB*
I AM THE LEGAL OWNER OF THE PROPERTY DICRIBED
ABOVE.
3 OWNER
CORRECTIONS
SOUTH
_ J
DESCRIPTION OF WORD Q
Z .
BATH TUB FURNACE 5
F b
HOWER DISHWASHER Q
r
VATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR BINK SAND TRAP
SLOP SINK ._FLOOR DRAIN
iviS
WASH TRAY
_ APPROVALS
WATER CLOSET _DRINKING FOUNTAIN
DATE INSPECTOR'S NAME
` ., . WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I
METE SODA FOUNTAIN GAS PiPINm I ,
GAS VENT I
CESSPOOL I
TOTAL NUMBER OF FIXTURES b SEPTIC TANK
CES8P00LSEPTIC TANK � SEWER I ',
TOTAL FEE S v UTILITYCO.NOTIFIED fAi E/rZ
FINAL /
ION
WORKER'S I have
a certificate
of consent to 20-0026 DPW PW9189 APPLICATION I°OWPLUMBING PERMIT
I heresy affirm that I have a certificate of consent to self insure,
or a certificate of Worker's Compensation Insurance, or a certified
copy thereof(Sec.3800 Lab.C.)
Policy No. Company COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV.
❑ Certified copy is hereby furnished. BUILDING
F1 Certified
APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS
Certified copy is filed with the county building inspection
department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY 4
Date Applicant WATER CLOSET NEAREST C'
CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST.
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed If the work Involved by the SHOWER MAP BOOK PAGE PARCEL
permit is for one hundred dollars($100)or less.) LAVATORY OWNERZI; �, z ��J
I certify that in the performance of the work for which this permit "
is issued, I shall not employ any person in any manner so as to MAIL /
become subject to the Workers'Compensation Laws. LG ` ADDRESS zel __e
DISWASHER CITY ` / TEL.NO.
Date Applicant CLOTHES WASHER u
CONTRACTOR
NOTICE TO APPLICANT: If, after making this Certificate of � ��� �
Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS
provisions of the Labor Code,you must forthwith comply with such
provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM
LICENSED CONTRACTORS DECLARATION CITY TEL.NO. }
I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER CLQ
(commencing with Section 7000)of Division 3 of the Business and STATE LIC.GAS SYSTEM OUTLETS LICENSE NO. CLASS V
Professions Code,and my license is in full force and effect.
OUTLETS OVER DISTRICT NO PROCESSED BY Q
5 PER SYSTEM ,{ �� C
License Number Lic.ClassFINAL
v t
DATE �/_ ) VALIDATION Liua
Contractor Date T (lt 41 04
❑ I am exempt under Sec. FI AL 3307 70.65 �
B.&P.C.for this reason 1 ITEMS
Date: Plan check fee 5 ® TOTAL 70_65
Signature PLUMBING PERMIT ISSUING FEE$ 70.65
TOTAL FEE CHECK
❑
SINGLE FAMILY Plan check applicant CHANGE .00
HOME OWNER-BUILDER DECLARATION Name t-,t�� f,
I hereby affirm that I am exempt from the Contractor's License Law �{11Lfu_��V1 a/ 4/93
for the following reason (Section 7031.5, Business and Professions Address
Cod❑e) (,(i 9GG cc City Tel.No. 804825 1 AM11027
I,as-ewrrer of the property,will do the work and the structure
is not intended or offered for sale(Section 7044, Business
and Professions Code). 010.
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 the above
information is correct. I agree to comply with all County ordinances 010,
and State laws regulating Plumbing, and hereby authorize
representatives of this County to enter up the above-mentioned
pro y for inspection p rposes. _ SEE REVERSE FOR EXPLANATORY LANGUAGE
G �
S anaturA of Permlttee Date