The URL can be used to link to this page

Home My Public Portal About9755 VAL ST_Plumbing__ TS A ss;=GE 817 e/e8 A Y• l G APPLICATION FOR PLUMBIN PERMIT COUNTY,OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER11111111 BUILDING AND SAFETY DrMON BUILDING SJOHN A LAMBIE COUNTY ENGINIER 9755 Val COLEMAN W JENKINS SUPT OF BUILDING LOCALITY Temple City FOR APPLICANT TO FILL IN PR NT OR TYPE CROSS NEAREST V��J NUMBER FIXTURE OR ITEM EACX FEE Milton Bade OWIfER WATER CLOSET l 50 �Q HATH TOB iso 3� ADDRESS KAIL 20 BLZ'chOToft SHOWER 150 '� CITY TEL NO 6-76 LAVATORY 150 "6 CONTRACTOR Owen Bros. Plumbing,Inc / SINK 150 s0 ADDRESS 26 No. Baldwin Ave. DISHWASHER 150 p cnT El Monte TQ, NO 443-0 / CLOTHES WASHER 1 50 — ATE LIC U LICENSE NO 2 1 CLASS C 36 SWIMMING POOL RECEPTOR ISO SESSION DI�ICT N GROU ! ► SY y LAWN SPRINKLER SYSTEM 200 1!9 , O 1 WATER HFATER 1 50 5-0 INDUSTRIAL 8 / WASTE APPROVAL 2 GAS SYSTEM OUTLETS 150 PECTIO RCC F� OUTLETS OVER w+ 5 PER SYSTEM 30 / (� N 2 Plan check Bel 25- oI above See reversjlWtNO PI UMBINC PERMIT ISSUING M LF 00 fOTAL EFF APPROVALS TE INir TOR iiI 11E PIM cheek gppllrant UNDER SLAB WORM: Name ROUGH PLUMBING 017 Address GAS PIPING GAS VENT NS CIt) 'Bel NoHOT WATER NEATER I MESSY ACKNOWLEDGE THAT 1 HAVE READ ICATIOM AND STATE THwI THE ABOVE a CORRECT AND COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LATING GAS TEST l� ✓ ff/ PLUMBING 1 MR" METIPT THAT 1 AM PROPERLY REAND/OR UTILITY CO NOTIFIED 7—/Q--74' LICENEEO Ai REQUIRED BY LOS ANGELES COUNATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OiNO TOBESIDE IN TME ABO DE ISSO RESIDENT, PRFINAL OIGNATU Rfi JACK R ALLEN, 9UPERV S MIING MECHANICAL ENG R OF PERMITTEE PERT VALIDATION CK M D CASH PLAN CHECK VALIDAT70N CK _ M O CASH lA�a4 6 0;2R tR22 5 D 2 0.00r Ir WORKER I have COMPENSATION Df consent OI'W e,® APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of wneent to Bell Insure or a certificate of Worker a Compensation Insurance or a certified . .. copy thereof(Sec 1890 Lab C) l / Policy r � � COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS DEPT OF PUBLIC WORKS DIV No OL42L❑ Certified copy Ia hereby furnished FOR APPLICANT TO FILL N(PRINT OR TYPE) BES ^� F1 Certified copy a 1Ded with the county building Inspection ADD ESS97SS La department NUMBER FUTURE OR REM 9 FEE LOCALT' r^ C Dete�_Applkant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERSCROSS sT C COMPENSATION INSURANCEBATHTUB ASSESSOR (This section need not be cwInvolved the work Invosd by the KNOWER MAP BOOK PAGE PARCEL permit Is for ons hundred dollars($100)or len I LAVATORY OWNER I certify that In the performance of the work for which this permit IS issued I Shall not employ any person In any manner so as toSINgX MALL 7S"' / become subIM to the Workers Compensation Laws ADDRESS DISWASHER CITY _• TEL NO r Data APPlicam CLOTHES WASHER CONTRACTOR f t NOTICE TO APPLICANT If after making this Certificate of y /�I Exemption you should become sub)ect to the Workers Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code you must forthwith comply with such provisions or this permit shall be deemed revoked LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CRY TEL NO } I hereby affirm that I am licensed under provisions of Chapter 9 WATER NEATER d LIC (commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OURETS LA E NO CLASS G:](� — Professions Cade and my license is In full force and affect OUTLETS OVER DISTRICT NO PROCESSED BY � 6 PER SYSTEM �jOR License Number �1-0 SY ,-I /`-/ tic Cless.�.�� DC U Donuanor(6d.6Lp�yhDete t��-� � ^•-/2-9Z VALIDATION Wa ❑ I am exempt under Sac gym B aP C for this reason Data Plan check fee Signature PLUMBING PERMIT ISSUING FEE$ -21 5 ❑ TOTAL FEE < 5 Plan check applicant 6AC.CT.i HOME OWNERR SINGLE FAMILY BUILDER DECLARATION Noma I hereby&Hurn that I am exempt from the Contractor's License Law 3-707 39.30 for the following reason (Section 7031 6 Business and Professions Address Code) City - 1 ITEMS El as owner of the property will do the work and the structure Tel No T01 A" 39 - 30 is not intended or offered for sole(Section 7044 Business and Professions Code) , 39,30 CONSTRUCTION LENDING AGENCY CHANGE .00 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) 0000-moi 3i11/92 Lender a,Name 4952 1 AM 10:54 Lender a Address .3 I certify that I have read this application and state that the above , Information a correct I agree to compy,with SII County ordinances and State Iowa regulating Plumbing and hereby authorize representatives of 1pia Cou to enter upon the above mentioned property I f o ya� �/'� SFE REVERSE FOR EXPLANATORY LANGUAGE vSl Bre of P rm@te Date