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Home My Public Portal About9830 VAL ST_Plumbing__ 76AW7-CES1712159 TEMPLE CITY APPLICATION FOR PLUMBING PERMIT COUNTY ANO�F�SLOS ANGELES D� LAM COUNTY OF FETY UNTY EN6I N,IEERP DBFBB WILLIAM A JENSEN BUTT OF BUILDIND ! - LOCALITY FOR APPLICANT TO FILL IN cnoRs arae �- NUMBER FIXTURE OR ITEIA OWNER WATER CLOM MAll '1 HATE T" - DUBS � .G�! 880WEH cITY TEL NO CoNTBAcTOR LAVATORY SUCK ADDRESS DISHWAS= CTR TEL NO CONTRACTOR B STA LAUNDRY TOB BECIMTRATION NO COUNTY CLOTHES WARNER DISTRIC' 0 GROUP NR PCESSED BY WATER BEATER [[...[5. OO�SJJ OAS SYSTEM 1NDUSTHIXL WASTE APPROVAL INSPECTION RECORD O U N O ' G W • m Pffi rrEeE APPROVALS DATE INSPECTOR S SIGNATURE PERMIT f $ 00 UNDER SLAB WORK TOTAL FEE I ROUGH PLUMBING GAS PIPING I HEREBY STATE ACETONE AB THAT 1 CHAVEORRECT READ THIS APPLICATION GAS YENT AND STATE CTHATOUNTY THE ABOVE IS CANRECT AMD AGREE A LATUIS PLL ALL COURTT ORDINANCES AND STATE LAVE REQOLATIMG HOT WATER HEATER PLOY&RO I HERESY CERTIFY THAT 1 AN PROPERLY REGISTERED AMD/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS AMOELSS COUNTY AND STATE OF GAB.��. �P / CALIFOSJUA OR THAT 1 AY THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PPP&RrY UTILITY CO NOTIFIED / ! SIGNATURE22 OF PERMIrr, FINAL q ///,/V / ®r VALIDATION ROBERT A/WOOD is E G, G,UMI SUPERVISING MECHANICAL ENG R 4725 �— fs.,R31 5 D 3.00 �-ii I' 7EAW7 CE81712159 TEMPLE CI"T"Y oe APPLICATION FOR PLUMBING PERMIT CO ((�� O��FyQLOS ANpGELF3 D LA I CoOVNTrEN ION AIDS ss° d - ` . ST• WILLIAMA JENSEN SUPTOPSUILOIRO LOCALITY T , FOR APFLICANY TO FILL IN NEAREST ly CROSS 87. NUMBER FIXTURE OR ITEM OwNea .{/ UJ E/� WATER CLOSET RATA 70D DRESS F 5r - SHOWER CITY TEL NO LAVATORY CONTRACTOR O am ADDRESS Q DDRIWASHER ,��En. TEL NO� �d S I / CONTRACTOR / /+� STATE LAUNDRY TOB REGISTRATION NO. / 3d'V COUNTY CLOT8E8 WASE DISTRICTNO GROUP ZONE PROCESSED BY WATER fiPAffi DTDUSTRTAL WASTE APPROVAL NBSPacrloN RecoRD � O V 0 O • G a e �m ;I 00 APPROVE DATE INSPECTOR 391GNATURE PERMIT f E 00 UNDER B WORK TOTAL FEE �� ROUGH PLUMBING GAS PIPING 1 HERESY ACRIIOALEDOE THAT i HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE I9 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDItlABCEt AND STATE LAME REGOLA7IN0 HOT WATER HEATER PLUMBING 1 HEREBY CERTIFY TKAT 1 AN PROPERLY REGISTERED ARDOR PLUMBING FIXTURES LICENSED N IRED BY LOS ANGRLEE COUNTY AND BTAT[ DF GAB TEST CAUFOAMIA A7 I AM TH{ OI1L o run OF DEDC81B60 TIAL P UTILITY NOTIFIED SIGNET �/ OF14 C ,��T9'� FINAL ®P / YR Q. N ROBERT WOOD, III u ■ Q. cATM SUPERVISING MECHANICAL F.N6 R Ur 3793 ftR10 5 D 300 /tea 7SAR87-0ERM7 2-65 4 � APPLICATION FOR PLUMBING PE IT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION SUq,pD(G p�O JOHN A LAMBIE COUNTY ENGINEER ADDQN a 4C j1Aj COLEMAN W JENKINS SUPT OF BUILDING LOCALITY 7�_ IIC FOR APPLICANT TO FILL IN CROSS BY O� E NUMBER FIXTURE OR ITEM EACH FEE pWNLR _ TZ WATER CLOSET $125 RATH TOR 125 WDRESS 3444 SHOWER 135 °m 4 ° LAVATORY 175 CONTRACTOR RDQ 115 ADDRESS J �� DISHWASHER 115 CRY TEL HO LAUNDRY TOR 125 STATE LIC LICENSE NO CLASS CLOTHES WASHER 125 DIRTRIC[NOS/' 6 P B WATER HEATER l SR r o(['/ OAS SYSTEN _OU7LEI8 1 WASTE APPROVAL OUTLETS OVER S PES SYSTEM JIO L (J INSPECTION RECORD a O U W d N Z APPROVALS DATE INSPECTOR 3 SIGNATURE PERMIT S 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING I N[ROY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE TXAT "a AEDVE IE CORRECT AND AGUE[ TO COMPLY WITH ALL COUNTY ORDINANCE[ AND STATE LAWS REGULATING HOT WATER HEATER PLUMRINO 1 HERERY C RTIPY THAT I AM PROPERLY REGISTERED AMWOR PLUMBING FIXTURES LICENSED AE REQUIRED BY LOG ANGELES COUNTY AND STATE OF GAS TEST GLIIdfNIA OR THAT I AM THE "GAL OWNER OF AND INTEND TO REFIRE IN THE"ME DEECRI D REDID AL PROPERTY UTILITY CO NOTIFIED SIGNATURE OF PERMITTEE FINAL `� 0 C JACK R. ALLEN M cK M o uEN SUPERVISING MECHANICAL ENG'R LAt;o4 9 9 6e SEP 28 5 D 3.50- s RMERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT {� n6 that,) have a certificate of consent to self S �J myr a ceraflC catiS of Workers Compensation Insurance, CE 10/BI) -or a certified copy thereof (Sec 3800 LabLC ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy NQ, f ompony i� ' D - CarleNied c m eby furnished Pol FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING `�L 7--C! Certified copy is filed with the county building mspec- NUMBER FIXTURE OR ITEM LOCALITY hon department r , 1 ® FEE ..t,),II'',, kI''/ YJD (AJI 'A P- WATER CLOSET Date s.W_gpplicant nEatEST - CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS STjgeZT COMPENSATION INSURANCE SHOWER OWNER (This saclbn nand not be completed If the work Involved by / ADDRESS MAIL the parmlf b for one hundred dollars (6100)or leu) LAVATORY 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 GTY TEL NO so os to become subject to the Workers Compensation Laws DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER A�R£55 NOTICE TO APPLICANT If after making this Certificate of SWIMMING POOL RECEPTOR you should become subject to the Workers Compensation provisions of the Labor Code you must forth- LAWN SPRINKLER SYSTEM CITY C C TEL Flo with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION GAS SYSTEM OUTLETS —DISTRICT NO SSED 9Y 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER � and Professions Code,and my license is in full face and effect 5 PER SYSTEM FINAL VALIDATION mss' DATE License Number �N '07 Lm Class FIN U Connacton fr/YF✓/I��LAF Date BY ❑ - d' I am exempt under Sec O B 8P C for this reason Pilo Plan check fee a Date to PLUMBING PERMIT ISSUING FEES Sigrsoture TOTAL FEE Pian check applicant SINGLE FAMILY HOME OWNER BUILDER DECLARATION Name - I hereby affirm that I am exempt from the Contractors License Address Law for the following reason (Section 7031 5, Business and Professions Code) City Tel No ❑ 1 as owner of the property will do the work and the structure is not intended or offered for sale (Section pop.7044 Business and Professions Code) ;25 6 6 7 A CONSTRUCTION LENDING AGENCY _ _ _ JJ 5 1 hereby nfhrm that there is a construction lending agency for I • - 34.50 the performance of the work for which this permit is issued (Sec 30,97, Cis, C ) • • • 3&5 0 Lender s Name 1 0-16-86 Lenders 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 and State lows regulating Plumbing and hereby authorize reprelentahves of this County to enter upon the above mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE -- - -- - - - ign ure of PeFm—IWG Date - --