The URL can be used to link to this page

Home My Public Portal About9623 VAL ST_Plumbing__ 7GAB6710E-6171- 5/73 -2 J APPLICATION �MBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING - MAKE CHECKS PAYABLE TO ADDRESS qN HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPEI NEARESOSST T CIU CR NUMBER FIXTURE OR ITEM ® FEE WATER CLOSET 1 75 OWNER Pt MAIL KBATH TUB 1 7g ADDRESSSHOWER 1 75 CINTe _ CTEL LAVATORY 1 75 CONTRACTOR (ZrjqL SINK 1 73 ADDRESS 0 E cc DISHWASHER 1 75 S iCITY �//J 1t7 TEL CLOTHES WASHER 1 7g STATE /YENSENO OOCC SWIMMING POOL RECEPTOR 1 DISTRICT NO GROUP N F ESS By 11111111 LAWN SPRINKLER SYSTEM 1 .LO T I ` WATER HEATER 1 STE APAPROVAL 1' GAS SYSTEM OUTLETS 1754 INSPECTION RECORD G: OUTLETS OVER 5 PER SYSTEM CD S c�L -75 W d N Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEES 9 00 TOTAL FEE APPROVALS DATE INSPECTOR i SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel No GAS VENT HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUM SI Ne GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY LO[ ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED R[310EMTITY FINAL SIGNATURE OF PERMITTEE PERMIT VALIDATION C M 0 CASH PLAN CHECK VALIDATION CR M 0 CASH 6 1 4i"Gu1N 6 5 D O.0 , AM Ta..BT a "'BD ® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY I PLUMBING 1 COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRIC=rNO GROUP ZONE PERMITNO -1. PLUMBERGURVARD RECEIVED BY READY FOR DATE ISSUED L FIRST INSPECTION //_,,_�D ADDRESS PT- VALLEY L • BUILDING _J• / CITY TEL NO ADDRESS ! C COUNTY LOCALITY kICKNSE NO 93M EKPIREB NEAREST PERMIT FEES CROSS BT NUNN" TYR OI FIXTUM 0111T[Y FEE OWNER MAIL WATER CLOSET TOILET 080S ADDRESS / A BATH TUB O 60 0 CI TEL N Y' SNOWHR O 80 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ ,THIS LAVATORY WASH BASIN O 80 D APPLICATION AND STATE THAT THH ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY OROINANC® AMC KITCHEN BINK O SO STATE LAWS REGULATING PLUMBING 1 CERTIFY THAT G1 POSSESS THE ABOVE VALID LOS LAUNDRY T BOR TRAY 050 O OF ANGELES H COUNTY I L` E S ERTY DHB M THE BED LEGAAISOWNER OAS SYSTEM OUTLETS O SO _O 6F T ERMIB OF WATER NEATER @ O 805-6 SLOPSINK 0 O 50 INSPECTION RECORD FLOOR SINK 030 FLOOR DRAIN O 80 DISHWASHER O 80 DRINKING FOUNTAIN O80 URINAL O 80 J HOUSESEWER 050 < _Z MISCELLANEOUS (� K 0 APPROVALS DATE IN[P[CTOR[ MAN[ ROUGH PLUMBING GAS PIPING GAB VENT CESSPOOL 0 100 CESSPOOL SEPTIC TANK SEPTIC TANK DRAIN ( ) PIT I 1 1 00 SEWER PERMIT I DO GAB TEST S� UTILITY CO NOTIFIED TOTAL FEE � FINAL CGA°°' Tt B-BB ® APPLICATION FOR PERBUT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICTNO GROUP ZONE PERMITNO PLUMBER VALLEY BOULEVARD PLUMBING CO. R9CIqVED BYREADY INSPECTFORION 3 o �,—,,e (DATE ISSUED ' ADDRESS 8300 EAST VALLEY BLVD. PI RST CITY ROSEMEAD TEL NO AT. 2.2719 BUILDING / nG3 ADDRESS {f 1� COUNTY 93M 6.30•x/ LOCALITY LICENSE O Ia NEAREST PERMIT FEES CROSS ST NUMB" TYM OF RZTYII[OR RIY FEE OWNER MAIL ov WATER CLOSET TOILET O SO S ADDRESS BATH TUB O SO Ijazt,� EL NO SHOWER O SO i HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY WASH BASIN) O SO APPLICATION AND STATE THAT THE ABOVE I9 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK a O so STATE LAWS REGULATING PLUMBING 1 CERTIFY THAT 1 P08869p THE ABOVE VALID LOS LAUNDRY TUB OR TRAY O 60 ANGELES COUNTY ICE OR 1 AM THE LEGAL OWNER OF THE RESIDENTI P OPERTY DESCRIBED ABOVE WATER HIEN OUTLETS O SO SIGNATURE OF WATER NEATER O BO PERMITT SLOP BINK o Bo INSPECTION RECORD FLOOR BINK O BO FLOOR DRAIN O SO DISHWASHER O 50 DRINKING FOUNTAIN O SO URINAL (pD O SO ,J HOUSESEWER O So Q _Z MISCELLANEOUS 0 Ix 0 APPROVALS DATE INBP[CTOR B NAM[ ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL 40 1 00 c CESSPOOL SEPTIC TANK SEPTIC TANK DRAIN ( ) PIT ( ) -@1 00 SEWER PERMIT I 1 00 GAS TEST TOTAL FEE UTILITY CO NOTIFIED �_0 FINAL � VOORK1t COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby eflirm t I hove a certificate of consent to self 76M607A insure, or a certificate of Workers Compensation Insurance CE 817(REV 10/81) or a certified copy ereo;'(Sec 3800, L C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No F" �oZm.•pony Certified copy n hereby furmahad FOR APPLICANT TO FBL IN(PRIM OR TYPE) ADDRESS q Certifieddepartment copy a fled with the co bw mg c• ADDRESS "L her�on depan(m�ent� NUMBER FIXTURE OR ITEM ® FEE WATER LOCALITY Dote s'..�-[t-��-�PPhSont CLOSET CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSSST COMPENSATION INSURANCE SHOWER OWNER (This section noel net be completed M this work Involved by MAIL the permit is for ono hundred dollars(11100)or loss) LAVATORY ADDRESS A I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner SINK CITPr� TEl NO /3 so as to become subject to the Workers'Compensation Laws DISHWASHER -1 CONTRACTOR Dote Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT 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- LAWN SPRINKLER SYSTEM CITY TEL NO with comply with such provisions or this permit shall be STATE, LIC deemed revoked WATER HEATER LICENSE NO LICENSED CONTRACTORS DECLARATION GAS SYSTEM OUTLETS DISTRICT NOSSED BY I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER c }� and Professions Code, and my license is in full forcee and effect 5 PER SYSTEM FINAL V LIDATION V ATE License Numberugq Class!`. FI3 f� FIN4FkO. Contractor ❑ I am exempt under B 8P C for this reason Plan check fee Date PLUMBING PERMIT ISSUING FEE S Signa sire TOTAL FEE ,� 1 2 7 6 3 A SINGLE FAMILY Plan check a%li # s e s e s 5 HOME OWNER-BUILDER DECLARATION Noe—'% I e * 4650 I hereby affirm that j exempt from the Contractor's License Address Law for the followingg r reason (Section 7031 5, Business and • • • 46,505 Professions Code) City Tel No ❑ 1, as owner of the property, will do the work and the p 8 2 1 =85 structure is not intended or offered for sole (Section ► 7041 Busmen and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there is o construction lending agency for the performance of the work for which this permit is issued (Sec 3097, Civ C ) Larder s Name Lender's Address I certi have read this application and state that the ► ab forma n is correct I agree to comply with oil County ar and tate laws regulating Plumbing and hereby a h repro to of this County to enter upon the a v do pr for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE rwture o Perminee Dote