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Home My Public Portal About6402 TRELAWNEY AVE_Plumbing__ iBAGfiT-CEBITIB-W ll// ��— APPLICATION FOR PLU BING PERMIT DEPT{}}+TT��{M+1T�E��.LTy� {��TS��T 68 RE", NON eBJVf11VIALAMtlIC OUNTY SEER ADDRESS 02 Tre18 Kn� Ave.# WILLIAM A JENSEN SUPT OF BUILDING LOCALrrr Temple ity FOR APPIdCANT TO FILL IIF �gr NUMBER FIXTURE OR ITEM OWNER Claude R• Link WATER cLOREr mm6402 Trelawney Ave., BArR res DBS SHOWER c1rT Tem le Cit Ter. No LAVATorr coNmcroRAntho Pools Ina. am ADDRESS 5871 Firestone Blvd. Di�WASHER cm South Gate T= No SP- 23 0 CONTRA a 90179 SCS LADIIDRT rDR BEG 1aTEAnOR 3 comay CLOTHES WAH® DISTRICT NO ROUP ZONE PR ED BY WATER NEATER d" GAS SYBr9! DMUSTBDIL WASTE APPROVAL DISPE4711015 BBCORD o� U Frehh water pi i All swim Fftppoolsv / • OR00ra Ram : / APPROVALS DATE INSPECTOR ElIGNATURL PERMIT S = 00 UNDER SLAB WORK TOTAL FEEj Q ROUGH PLUMBING GAS PIPING 1 X®LGT AC[NO HE AB THAT 1 RREC READ THIS ATO CO CION GAS VENT AND FALL THAT THE ABOVE E CAHAVENB[CT AND AGREE TO COMING PITO ALL COUNTY ORDINANCES AND STATE W! REGULATING PLUMBINGHOT WATER HEATER 1 HEREBY CERTIFY THAT I AN PROPERLY REGI AND/OR PLUMBING FIXTURES LICENSKO AN REQUIRED BY JOS ANGELES COUNTY STAT! OF GAS TEST CALIFORNIA OR T 1 THE LEGAL ME 0 T YL DESCRIBED REST AL FESTT UTILITY CO NOTIFIED SIGNATURE < OF FERMIFINAL mF ALIDA17ON ROBERT A WOOD, r.0. SA0 SUPERVISING M&CMMICAL ENG R Lro7474 —� tf:Y '23 5D 300 &dam 7¢ASOT-CES817 10.¢2 TV OF APPLICATION FOR PLUMBING P RMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DrMlON I°SD°D°BnBEes JOHN A LAM IE COUNTY ENGINEER WILLIAM A JENSEN Sup T OF Bu1LDING LOCALITY FOR APPLICANT TO FILL IN OBA S ST Qc NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 1125 x NAM Z BATH TOB 125 ADDRESS SHOWER 125 Cm , TEL NO LAVATORY ISS CONTRACTORe SIN[ 115 ADDRESS DMHWASMM 115 Cm TEL NO 7- Y LAUNDRY ITIS 1 YS CONTRACTOR NO o 'COUNTTYY CLOTHES WASHER 115 DISTRICT NO GROUP ZONE PROCESSED B WATER HEATER 150 ,S O /.., R 1 GAS SYSTEM OUTLETS 150 INDUSTRIAL 17 r, WASTE APPROVAL O OUTLETS OVER 5 PER SYSTEM 50 INSPECTION RECORD U '/%IF 4 h�A i APPROVALS DATE \INSPECTOR 0[IDI nTu PERMIT f 2 OO UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING ---�-'-�' •� I HERESY ACFNOW"DG¢ THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ASOVE IS CORRECT AND AOREE TO COMPLY WITH ALL COUNTY OROINANC[S AND STATE LAWS R[OULATINO PLUMBING HOT WATER HEATER I H[REOY CERTIFY THAT I AM FROP¢RLY REGISTEAED ANDIOR PLUMBING FIXTURES LICENSED AS REQUIRE, eY LOE ¢LEE 'UNTY AND STATE OF GAS TEST U CALIFORNIA OR THAT 1 AM THE AL OWN¢A OF AND .—NO TO NI,[ IN THE A"" IDEHrut PROPERTY UTILITY CO NOTIFIED SIGNATURE OF PERMITTE FINAL a VXMATION ROBERT A WOOD Crc M O CASH SUPERVISING MECHANICAL ENG R LiLo 4 3 5 2 ZZ SEP 2 9 5 D �-7 C_- N, WOCOMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirmrm that I have a certificate of consent to self yygM7A insure or a certificate of Workers'Compensation Insurance, CE 817(REV 10/81) or a cart Ted copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy o Company Certified copy is her nbhed Certified co i filed u RKEIRS' ldng inspec- FOR APPLICANT TO FILL IN(PRINT OR ttff) BUIIRrss -77zzZ G/NE ADDRESS 2 non NUMBER FIXTURE OR ITEM ® FEE Locnu � L9/ Date A n WATER CLOSET NEAREST CERTIF TE OF EXEMPTI RO BATH TUB CROSS Si c-G I•I COMPENSATION INSURANCE OWNER (This section need not be completed R the work Imrotsred by SHOWER MAIL the perntft Is for one hundred dollars ($100)or Mss ) LAVATORY ADDRESS I certify that in the performance of the work for which this ---.• - ` permit is issued I shall not employ any person in any manner SINK CITY TEL NO so ca to become subject to the Workers'Compensation Lows ``^ , ,/ DISHWASHER CONTRACT - ��/�[.N' n Date Applicant CLOTHES WASHER ADDRESS Sys NOTICE TO APPLICANT If offer making this Certificate of63 //r./ Exemption, you should become subject to the Workers SWIMMING POOL RECEPTOR .^ Compensation provmons of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM Clry p�O/4 TEL N114/-7 with comply with such provisions or this permit shall be STALE UC deemed revoked WATER HEATER LICENSE NO CLASS, LICENSED CONTRACTORS DECLARATION DISTRICT NO NOCFSED BY I hereby affirm that I am licensed under provisions of Chapter 9 OAS SYSTEM OUTLETS ,S / (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER a and Professions Code,and my license n in full force and effect 5 PER SYSTEM FINAL 11 n-1 VALIDATION 6 DATE V License Number LIc Class 0 FIN � Contractor Date BV O ❑ I am exempt under Sec G B 8P C for this reason w Plan check fee = Dote PLUMBING PERMIT ISSUING FEES so 2.3 1 a 7 A Signature TOTAL FEE V46 L50 # e e e e e 5 Plan check applicant SINGLE FAMILY lee 1650 HOME OWNER BUILDER DECLARATION Name�- �ke 1 hereby affirm that I am exempt from the Connector s License ^ Law for the following reason (Section 7031 5, Business and Address Z V H1 vAFR/ • e e 1 655 0 2i Professions Code) City Tel No I a 16 8 5 ❑ 1 as owner of the property will do the work and the 011,structure is not intended or offered for sole (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 a issued (Sec 3097, Civ C ) Lender s Nome Lender a Address I certify that I have read this application and state that the ► .bdig mfornauon is correct I agree to comply with all Count' wdI d State laws regulohng Plumbing and hereby rnooves of thn County to enter upo the ov m roparty for mspecbon pure a 6 / SEE REVERSE FOR EXPLANATORY LANGUAGE rat of Pe Dat v�roRl�nBcoMPENSAnoeocuRAn0,0026 oN 76AWDPWare9 APPLICATION FOR PLUMBING PERMIT ] I � y eltirm that I have a certificate offconsent to self Insure or c8rt10care of Worker a Compensation Insurance or a certified Copy thereof(Sec 3800 Lab C) 0 No COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS DEPT OF PUBLIC WORKS DIV Certified copy le hereby t nnhed ❑ f-0R APPLICANT TO FILL IN(PRINT OR TYPE) BULDINO ( � 1 W N� n Cstlfbd copy re filed with the county building inspection AODRE3S �9 G [. depenrtlent NUMBER FD7URE OR ITEM O FEE LOCALITY Tpl4e CA Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERSCROSS ST w� N COMPENSATION INSURANCE ' BATH TUB ASSESSOR (This section need not be completed N the work involved by the SHOWER MAP BOOK Z PAGE dZZ PARCEL 02 permit Is for one hundred dollars(111100)w law) LAVATORY OWNER C4 I P, 1 certity 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 SINK AADDDLRESS na1A-..(_ a bo V-1-� become subject to the Workers'Compensation Laws Z I DISWASHER 7 CITY TEL NO Deb Applicant CLOTHES WASHER CONTRACTORNOTICE TO APPLICANT If after making this Certificate of Exemption you should become subject to the Workers Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code you must forthwith comply with such ADDRESS provisions or this permit shell be deemed revoked LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL NO d WHEATER AR I hereby affirm that I am licensed under provisions of Chapter 9 STATE UC (commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS LICENSE NO CLASS 8 Professions Code and my license is In full force and effect OUTLES OVER DISTRICT NO PROCESSED BY cc 3PER&YSTEM �Der Q Llcense Number Lic ClensFINAL U DATE III � VALIDATION CL DATE Contractor Data ^ Z F1I am exempt under Sec BBY B 8P C for this reason Date Plan check fee SignaturePLUMBING PERMIT ISSUING FEES , ALF � El TOTAL FEE 4n SINGLE FAMILY Plan check applicant HOME OWNER BUILDER DECLARATION Name TOTAL I AL 6u : ¢o I hereby aNlrm that 1 am exempt from the Contractor's License Law for the following reason(Section 7031 8 Business and Professions Address CHECK f3.,E Code) 0' I as owner of the property will do the work and the atructuro city Tei NO CNfndSE is not intended or offered for sale(Section 7044 Business and Professions Code) ► CONSTRUCTION LENDING AGENCY [I 19 i—[I[IllL 7/ I hereby affirm that there is a construction lending agency for the QJ S 1 At j ILI p CIO Performance of the work W which this permit Is Issued(Sec 3087 CN C) LerMer•Name Lends a Address I certify that I have read this application and state that the above poll.Information b correct I agree to comply with all County ordinances and State Iowa regulating Plumbing and hereby authorize representatives of this County to enter upon the above mentioned pro ty f Inspection purp0aes ` SEE REVERSE FOR EI(PLANATORY LANGUAGE X Signature of�i� Date