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Home My Public Portal About9610 VAL ST_Plumbing__ D,,, 17 APPLICATION FOR PLUMBING PERMIT 1 DRY IT loss DIVISION OF BUILDING AND SAFETY DBpartm*nt of County EnpinRN r County of TAB Angeles BUILDING JOHN A LAMBIE, COUNTY ENGINEER ADDRESS CASSATT O GRIFFIN,SUP TOP BUILDING I- TV FOR APPLICANT TO FILL IIIc NEAREST CRO40 ST OWNER 144ja - DISTRICT NO GROUP ZONE I EEAPT MR INrrflRloR MAIL ADDRESS Q INDUSTRIAL CITY TEL NO IVA707tOWASTE APPROVAL PLUMBER INSPECTION RECORD ADDRESS CITY NO LICENSE NO , NUMBER TYPE OF FIXTURE OR ITEM FER WATER CLOSET (TOILET) 100 E BATH TUB 81 00 �D SHOWER @ $t oo I LAVATORY (WASH SASIN) #100 KITCHEN SINK BI 00 DISHWASHER 81 00 LAUNDRY TUB OR TRAY @ 8100 cLATHIBWASHER sloo _ /1//.1..,. /1/ /�` –lx-r/ — WATER HEATER of 00 I Q�� /LRJB' / /l J GAS SYSTEM C@ 81 00 1A1T' ,W/L/ IST/LL BE (SaMC E Oi✓ APPROVALS DATE INSPECTOR S SIGNATURE UNDER SLAB WORK PERMIT ROUGH PLUMBING 1 00 C' B GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITYCO NOTIFIED DESCRIBED RESIDENTIAL P OPERTY SIGNATURE �. OF PERMITTEE '2!& FINAL _ im JOHN A LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR ■ • uRR LACO EI 8 9 4 ZR AUG 3 3 400 " xAseT IT E-so ® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TQ FILL IN DISTRICT O GROUP ZONE PERMIT NO. S9 0 3.2.. PLUMBERVALLEY R0111FVARn PHIMAINP CoRECEIVED BY READY FOR DATE I Um FIRST INSPECTION ADDRESS \ pJw\ (/ CITY ROSEMEA TEL NO BUILDIN O C U N[ H% RBS 0 93M ` LOCALITY S NEAREST qglo PERMIT FEES 4CROSS;ST KOYO[11 TYPE OI PIYTUIR OR RIM FEE nn OWNERMAIL ,�/ 041 WATER CLOSET TOILET O SO S0 ADDRESS / 7 YLY ✓ BATH TUB 0 O SO O C L NO C SHOWER 050 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ 7<16 LAVATORY WASH BASIN O SO APPLICATION AND STATE THAT THE ABOVE iS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK O SOSTATE LAWS REGULATING PLUMBING 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB / LAUNDRYTUSORTRAY O SO ANGELES COUNTY LIEN [ OR I AM THE LEGAL OWNER OF THE RMIDENTIA PARTY DESCRIBED ABOVE OAS 8YBT[M-i%3—OUTLETS O SO SIGNATURE OF WA R HEATER O SO PERMITT SLOPSINK O SO INSPECTION RECORD F LOOR FLOOR URINAL 0 ,0 MISCELLANEOUS QZ OI I .J K O APPROVALS DATE INSPECTOR• NAM[ ROUGH PLUMBING - GAS PIPING v GAS VENT CESSPOOL 1 00 CESSPOOL SEPTIC TANK SEPTIC TANK DRAIN 1 I PIT I I ® 1 00 SEWER PERMIT 1 00 GAH TEST _ TOTAL FEE UTILITY CO NOTIFIED [ FINAL '0A"'•1f '''O ® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICTNO GROUP I ZONE PERMITNO 001 13 PLUMBER VALLEY BOULEVARD PLUMBING CO. RECEIVED BY READY FOR DATE ISSUED \ FIRST I NSPECTION ,— 3o- .S� ADDRESS 8300 EAST VALLEY BLVD. UILDING CITY ROSEMEAD ADDRESS U TEL NO AT. 2.2719 // COUNTY93M EXPIRES .30. / LOCALITYLICENSE NO 5 NEAREST (O O PERMIT FEES CROSS ST NUMB" TVP[OF FIKTUN[oR ITEM FEE OW NHR MAIL11 Fell WATER CLOSET (TOILET) O SO S ADDRESS BATHTUB @ O SO CITY TEL NO �� SHOWER 030 I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS LAVATORY WASH BASIN 0 SO APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK ® O SO STATE LAWS REGULATING PLUMBING I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRYTUBORTRAY O SO ANGELES COUNTY LICENSE OR I AM THE LEGAL OWNER OF THE RMSIDKNTIAI,7R PERTY DESCRIBED ABOVE GAS SYSTEM—OUTLETS O SO SIGNATURE OF WATER HEATER O SO PHRMIT'rE SLOPBINK O SO INSPECTION HEWED FLOOR SINK O SO FLOOR DRAIN O SO DISHWASHER O SO DRINKING FOUNTAIN O SO URINAL O SO J HOUSHSEWER O SO Q Z_ MISCELLANEOUS _UI C O APPROVALS DATE INSFUCTOR N MAMN ROUGH PLUMBING GAB PIPING tea.)0 OAS VENT CESSPOOL too (,/ CESSPOOL SEPTIC TANK SEPTIC TANK DRAIN ( ) PIT ( ) ® 1 OO SEWER PERMIT 1 00 GAB TEST UTILITY CO NOTIPIED TOTAL FEE B Q i FINAL 1 �� WORKERS' that COMPENSATION DECLARATIONI.I210M DPW UW APPLICATION FOR PLUMBING PERMIT sure,or affirm that I havee ce Compensation at consent to self m- 76A667A z--, sure,or a certificate of Workers Compenwhon Imurance,ora [lull certified copy thereof (Sdc 3800, Lab C ) Policy No Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy is hereby furnished ❑ CeFOR APPLICAW TO ALL IN(PRINT OR TYPE) BUILDING Ir Certified copy a filed with the county building impaction ADDRESS deportment NUMBER FIXTURE OR ITEM {$ LOCALITY Date Applicant WATER CLOSET(TOILET) NEAREST �- � i CERTIFICATE OF EXEMPTION FROM WORKERS BATHTUB CROSS ST COMPENSATION INSURANCE SHOWER ER (This section need not be completed Hit work inveh Sid by MAIL the permit is for one hundred dollen(111100)or less) LAVATORY ADDRESS i I certify that in the performance of the work for which this per- mit is issued I shall not employ any person in any manner so SINK CITY I TEL m to becom subject to the Workers'Co nwtion Lo s DISHWASHER CONI Date Applicant CLOTHES WASHER ADDRESS Pei Q NOTICE O A (CANT If, Diet making t Is Certificate of Ex- SWIMMING FOOL RECEPTOR emption,you should become subject to the Workers'Compen- Cm' 7 16fr scion provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS lyy with such provisions or this permit shall be deemed revok- STALE / LIC ed WATER HEATER LICENSE NO 6 CLASS LICENSED CONTRACTORS DECLARATION DISTRICT PROCESSED BY I hereby offmm that I am licensed under provisions of Chapter GAS SYSTEM � Q O 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER �/- 1 and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION feet ROSE BIB DATE L¢ense Number Lic Class 6 Contractor T�7Xa-Date_�/ /J BYE V I am exempt u &2Z2 cc nOder Sec cc B 8P C for this reason Plan check fee ► �/�lin�� PLUMBING PERMIT ISSUING FEE f 7 Sienoture cL � !// TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that i am exempt from the Contractor s License Norse Law for the following reason (Section 7031 5, Business and Professions Code) Address E] 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) poolCONSTRUCTION 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 cenify that I have 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 hereby authorize representatives of this County to enter upon the above- d property f r inspection purposes G 3 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature c PermLgs to