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HomeMy Public PortalAbout9861 VAL ST_Plumbing__ u WORKERS'COMPENSATION DECLARATION Aft PLOCATI®N FOR PLUMBING PERM0 ° 'r I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 oinsure, dr a certificate of Workers'Compensation Insurances 76A667A or a certified copy thereof(Sec. 3800, Lob. C.) � �.p COUNTY OF LOS ANGELES DEPT,OF PUBLIC WORKS Policy No / Compan08= Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING , Certified copy is filed with the county building inspec- ADDRESS CEO I tion department. NUMBER FIXTURE OR ITEM ® FEE P LOCALITY� / WATER CLOSET Dat Appli4ant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. Q COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by SHOWER the permit is for one hundred dollars. $100 or less. MAIL P ( J ) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner SINK CITY -r—' TEL.NO. 4 L so as to become subject to the Workers'Compensation Laws. DISHWASHERe CONTRACTO Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of R9900 X SWIMMING POOL RECEPTOR Exemption, you should 'become subject to the Workers' CITW" TEL. NO. Compensation provisions of the Labor Code, you must forth- • C. with comply with such provisions or this permit shall be LAWN SPRINKLER SYSTEM /. LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT N PROCESSED BY I hereby offirm•that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS 1, (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER U and Professions Code,and mV license is in full force and effect. 5 PER SYSTEM. FINAL VALIDATION C DATE 1-1-2-34Y License Number Lic. Class (� FINAL Contracto Date "GZ BY, O ❑ I am exempt under Sec. 1 W B.BP.C. for this reason rName ck fee Cn ♦{Gt. Date: PLUMBING PERMIT ISSUING FEE$ Signature _ TOTAL FEE applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License z•Law for the following reason (Section 7031.5, Business and i ."C.1Professions Code : ;3fa' cc) Tel. No. �?(�? .�.s,_�;,1 I, as owner of the property, will do the work and the i i f'1i`•= structure is not intended or offered for sale (Section 7044, Business and Professions Code). t.i 5 �= CONSTRUCTION LENDING AGENCY -)FJ l HL m 50 I hereby affirm that there is a construction lending agency for f NE K 35.5f] the performance of the work for which this permit is issued ! s (Sec. 3097,'Civ. C.). Lender's Name ` Lender's Address 0d11170-1;) 131 6/10/91 1 certify that I have read this application and state that the 7i17 a Vit!! �r ,• 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-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ignoture ermWee Date 76A667-CEi/817 4-64 APPLICATION FOR PLUMBING PERhi7 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY.ENGINEER BUILDING AND SAFETY DIVISION fDD=RESSUIING. JOHN A.LAMBIE. COUNTY ENGINEER WILLIAM A.JENSEN.SUPT OF BUILDING OCALITYlw C,FOR APPLICANT TO'FILL.IN EAREST ROSS ST. q w i. f✓1 NUMBER FIXTURE OR ITEM EACH FEE OWNER G Q y/ )�P O WATER CLOSET $1.25 BATH TUB 1.25 ADDRESS sla SHOWER 1.25 CITY -5;lTEL. NO. LAVATORY 1,25 CONTRACTOR SINS 1.25- ADDRESS DISHWASHER 1.25 CITY SdR y» %o TEL. NO. CONTRACTOR'S STATE ED TUB 1 REGISTRATION NO. COUNTY ❑ CLOTHES WASHER 1.25 DISTRIDC N� OUP rF P O J WATER HEATER 1.50 d /VI I GAS SYSTEM OUTLETS I'M INDUSTRIAL O OUTLETSOVER5 PER SYSTEM .00 IN/SpP'ECTION.�yRECORD j/ V Y ~ N Z 1 APPROVALS PATE INSPECTSR'S SIGN T RE UNDER SLAB WORK PERMIT $ 2 00 ROUGH PLUMBING r c TOTAL FEE ZEiGAS PIPING S P �Fl 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THILICATION GAS VENT ' AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES_ LICENSED AS REQUIRED. BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN.THE ABOVE BED RESIDENTIAL PR PERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMIT, FINAL /J !Z22,-4u,00-7- 1 VALIDATI ROBERT A.WOOD CK. M.O. CASH SUPERVISING MECHANICAL ENG'R LACG,.l 7 3 4 Q MAY 18 5 D 4.7 5- W DEPARITdENT OF BUILDING AND SAFETY 11 APPLICATION FOR REIT COUNTY .OF LOS ANGELES I PLUMBING WM. J. FOX, CHIEF ENGINEER _ NATURE OF INSTALLATION DISTRICT NO. GROUPZONE PERMIT NO. ROUGH FIXTURES COMPLETE � I e? ,3-574 RECEIVED BY READY FOR DATE ISSUED HEATER CESSPOOL SEPTIC TANK d FIRST INSPECTION �` _ �� GAS MISCELLANEOUS �1/f 1v h/ APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB B NAME_ �� /Cj�,f ADDRESS +� fil m � ADDRESS,? o �+ r¢i LOCALITY CITY TEL.NCRO88 ST.NEAREST COUNTY � CERT.No. EXPIRES/—,7LW' NAME LOCATION OF SEPTIC TANS, OR CESS P OL , MAIL ADDREsB NORTH O. CITY TEL:No ' a I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF WALIFICATION. PLUMBER 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED �Y1 ABOVE. OWNER CORRECTIONS SOUTH Q Z DESCRIPTION OF WORK ATH TUB �FURNACE0T 0 HO ER DISHWASHER -- __LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK QAND TRAP SLOP SINK FLOOR DRAIN —7 WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HSATER 'DENTAL LAVATORY ROUGH 'PLUMBING J// /,•' METER A9 SODA FOUNTAIN GAS PIPING OUTL GAS VENT / CESSPOOL 1 TOTAL NUMBER OF FIXTURES SEPTIC TANK ov i--m/.—CEBSPOOL SEPTIC TANK SEWER UTILITY CO. NOTIFIED I I' TOTAL FEE t$�," I /v -/ "iJ; '-r✓-- I D.B.S.tT asM BErs ta.aa � C APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING . „ COUNTY OF LOS ANGELES Wm.J. FOX.CHIEF ENGINEER M=589 NATURE OF INSTALLATION DISTRICT NO. GROUP ZO EE PERMIT NO. ROUGH FIXTURES COMPLETE �n 4 FIR © / 4 HEATER CESSPOOL 1-1 SEPTIC TANK READY FOR IV B ST INSPECTION DATE 188UED / GAS MISCELLANEOUS 4 Z_ , APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB K NAME Harry E. Deem ADDRESS 211.4 1 Val St. W y_ B ADDRESS 401 S o Hoyt LOCALITY Temple Cityp California g J NEAREST s, CITY El Monte TEL.No.RD-8C)821 CROSS ST. CCU CERT.•NO. 4360 MGF EXPIRES e � NAME HenryLether LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL 3 ADDRE88 l t NORTH ' O - CITY Temple City TEL.No. 1 AM THE LEGAL POSSES80 OF THE ABOVE LOB ANGELES COUNTY CERTIFICA QUA i I TION. PLUMBER I AM THE LEGAL OWNER OR Tot PROPERTY DESCRIBED ABOVE. to owlim CORRECTIONS SOUTH DESCRIPTION OF WORK BATH TUB FURNACE • O ROWER DISHWASHER „ LAVATORY x REFRIGERATOR ITCHEN SINK WATER SOFTENER --FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET I+RINKING FOUNTAIN DATE INSPSCTOR'B NAME WATER HEATER - DENTAL LAVATORY ROUGH PLUMBING I I ETER GAS SODAFOUNTAIN OUTL (SAS PIPING I I GAS VENT CESSPOOL I TOTAL NUMBER OF FIXTURES Q ® -SEPTIC TANK I ESSPOOI SEPTICTANK SEWER I 8 fTOTAL FEE / UTILITY CO.NOTIFIED C ate- 1 Z 00 RINAl- / -on, I ` CE 817(REV=14/78) APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE( BUILDING ADDRESS / NUMBER FIXTURE OR ITEM ® FEE WATER CLOSET LOCALITYNEAREST BATH TUB CROSS ST. ©4ade! / SHOWER OWNER AllUDfi LAVATORY MAIL ADDRESS /�� /(�v SINK CITY —rel j L� TEL.NO. y(r'/(JJ, DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITY TEL.NO. LAWN SPRINKLER SYSTEM STATE LIC. WATER HEATER LICENSE NO. CLASS ' GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING pZ', GAS PIPING GAS VENT HOT WATER HEATER 10 PLUMBING FIXTURES f e3s GAS TESTr` Plan check fee UTILITY CO.NOTIFIED �� I` V PLUMBING PERMIT ISSUING FEE$ 7. 00 TOTAL FEE O 0 FINAL Plan check applicant PLAN CHECK VALIDATION F Name 8 1 9.9 A Address �/ • ' ,S� City -reA&e Gtr Tel.NO. I/1/1,1�l�3 # 0 0 o a o 5 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE 2 -, , 1 0,00 THAT THE ABOVE IS CORRECTAND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION 0 0,0 0 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE ,12 12-79 LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. /t& `' /�/J� SIGNATURE 4 �LO!/J 6 OF PERMITTEE//��LL/r/li �W�, DISTRICT NO. P OCESS�,FD BY INDUSTRIAL WASTE APPROVAL Tenser-c'Eliel5 a-ea APPLICATION FOR PLUMBI G PERMIT COUNTY OF LOS ANGELES DEPARTMENT.OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING JOHN A. LAMBIE.COUNTY ENGINEER ADDRESS WILLIAM A.JENSEN.SUPT OF BUILDING LOCALITY �000111 11111=0101 FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER �J WATER CLOSET ;1.25 p BATH TUR 1.25 IL ( 6 SHOWER 1.25 CITY TEL.NO. LAVATORY 1,2,5 CONTRACTOR SINS 1.25 ADDRESS / DISHWASHER 1.25 CITY '—TEL. NO. p ATE LAUNDRY TUB 1,25 CONTRACTOR'S COUNTY ❑ REGISTRATION NO. CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE I P9OCgSSED BY WATER HEATER 1.50 '�6 — I J GAS SYSTEM OUTLETS 1.50 INDUSTRIAL O WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD V 99 OR U W O. to Z APP ALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER VM WORK �%Z -- ROUGH PLUMBING TOTAL FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY WITH ALL .COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES �J�✓ �w„� �tf?l ;,.` LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST � CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN.THE ABOVE'DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE A �n OF PERMITT INALVVXM � TI.ON ROBERT A."WOOD V CK. M.O. CASH SUPERVISING MECHANICAL ENG'R UALO0111'%'M' MR30 5 D 5.75NCK asAe�-cael�-u-s� . APPLICATION FOR PLUMBING PIERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING _JOIN A.LAMIE, County Engs'nees ADDRESS ASSATr D. GRUTIN.Sup t of litildiag LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM WATER CLOSET OWNER }� BATH TUB ADDRESS SHOWER CITY Al X= NO. LAVATORY CONTRACTO SINK ADDRESS �(y DISHWASHER CITYLolTEL.NO./% f• SSS LAUNDRY TUB CONTRACTOR'S STATE [I REGISTRATION NO. COUNTY CI CLOTHES WASHER D1STR1 GtZ®F3P■ WE / READY FOR INSPECTION' WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD APPROVALS 10 $1.00 PER ITEM /� DATE INSPECTOR'S.SIGNATURE OR FIXTURE $ I ( UNDER SLAB WORK PERMIT $ 00 ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE'LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST Yftp ffI LICENSED AS REQUIRED BY LOS ANGELES COUNTY.AND STATE OF :. CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL PROPER Y. SIGNATURE OFPERMITTEFINAL4�2. -wo� BERT A.WOOD. ®' V DATION PERVISING MECHANICAL ENG'R CK. M.0. CASK` Lnuo2 1+n• JM 27 5 A 3.00 M• COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer �] DIVISION OF BUILDING & SAFETY O L I WILLIAM J. FOX, County Englneer GROUP . FO DR PLICANT TO FILL IN 57 T I & I �G�1 ti PLUMBER - READY FOR ECEIVED BY DATE ISSUED FIRBT INSPECTION ADDRESS�®7W an^ BUILDf CITU TEL N L dJ�J ADDRESS / COUNTY t^ LOCALITY LICENSE f EXPIRE NEAREST . siL•. 1PEBJ= FEES CROSS 8T. NUMBER TYPE OC morns OR ITEMFEE OWNER MAIL WATER CLOSET(TOILET) C605o III ADDRESS BATH TUB Q 13VO CITY • TEL D Nn d[�� SHOWER DAD 1 HERJgY ACKNO OE THAT I HAVE READ THIS LAVATORY (WASH BASIN) .50 APPLICATION AND E THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK 0 13NO AND STATE LAWS REGULATING PLUMBING. 1. CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB LAGNORY TUB OR TRAY 0 0.40 ANGELES COUNTY ICENSE, OR I AM THE LEGAL OWNER GA9 SYSTEM OUTLETS Q also ATURE OF THE RESIDENT/LPROPE DEBCR ABOVE. WATER HEATER Q m SIGN ERMITTE ( y� GLOP BINK a 0.10 INSPECTION RECORD FLOOR BINK a DAD 1 FLOOR DRAIN @ .SO DISHWASHER @ 060 DRINKING FOUNTAIN .O. Q _ URINAL ,50 J HOUSE SEWER 5O Z MISCELLANEOUS O O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING BAB VENT CESSPOOL ® 1.00 CE88POOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) 1.00 SEWER PERMIT 1.00 GAS TEST TOTAL FEE UTILITY CO.NOTIFIED to v 1 FINAL �+ Y 7GA667 DBS#17 10/58 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1202130001 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 12368 LT: 11 9861 VAL ST IFEE DESCRIPTION: QUANTITY: QOM: AMOUNT: TEMP CA 917801442 ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: GOLDEN WEST 15383-025-011 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: Al LOCALITY: TEMPLE CITY, Cl I . 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.30 (TENANT: TOTAL FEES 44.10 (ISS D ON: PROCESSED BY: PLAN BY: 102/.3/12 SR OWNER: TEL. NO: IF7NAL DATE FINAL BY: CODE: IFLAMMANG ANDRE F;REBECCA A (626) 446-1857- I 19861 VAL ST I �J�Z TEMP 917801442 IDESCRIPTION OF WORK INEW GAS SERVICE FROM VAULT METER BOX AT CURB TO HOUSE (APPLICANT: TEL. NO: I I IPEDROTTI PLUMBING (626) 285-4429- ISPECIAL CONDITIONS: I I (CONTRACTOR: TEL. NO: I IAPFROVALS DATE INSPECTOR SIGNATURE IPEDROTTI PLUMBING (626) 285-4429- I 1-1 I IPO BOX 661195 LIC. NO JUNDER SLAB WORK I I I IARCADIA, CA 91066 878606C36 + I I_ I I I IWAT�R SERVICE I I I IPLP.STIC Y/N METAL Y/N I I I ARCHITECT OR ENGINEER: TEL. NO: _ I - I IROUGH PLUMBING LIC. NO: I I I I IGASIPIPING /i IGAS VENT Aid IA I !HOT WATER HEATER I I I I I !PLUt4BTNG FIXTURES I I I LAWN SPRINKLERS I I I I IGAS TEST I I I UTILITY COMPANY NOTIFIED( I I I I IcWV I I I !GRAY WATER SYSTEM I I I I I I I I I *' ADDITIONAL DATA ON FILE I I I I I IREPORT ID: DPR263 ROUTE TO: BS0508 I I I I