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HomeMy Public PortalAbout9644 WEDGEWOOD ST_Plumbing__ FHA8H7, ti. T >65.I710.58 APPLICATION FOR PLUMBING PER�'110II1 DIVISION OF BUILDING AND SAFETY Deportment of.County Engineer , County of LOS Angeles BUILDING JOHN A.LAMBIE, COUNTY ENGINEER ADDRESS (� CASSATT D,GRIFFIN.SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST /� �/ CROSS ST. OWNER p(J 6�`s 6 8 (��' DIRI NO. GROUP WOrjE READY FOR INSPECTION MAIL ADDRESS WASTE APPROVAL PLUMBER CF*Lir A Qi>116t 311 J/- INSPECTION RECORD j ADDRESS ® © W CITY TEL.NO. LICENSE NO: ' Ll 2-9110 NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 5 Od BATH TUB @ $1.00 09 SHOWER @ $1.00 V LAVATORY (WASH BASIN) @ $1.00 D KITCHEN SINK @ $1.00 t� DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ .$1.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 LI GAS SYSTEM @ $1.00 APPROVALS . DATE INSPECTOR'S'SIGNATURE UNDER SLAB WORK pp PERMIT g 7 00 ROUGH PLUMBING s 1/ ,.---- IV GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGES THAT t 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 t HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST 2 LICENSED AS REQUIRED BY L NGELESCOUNTY ND STATE OF CALIFORNIA OR THAT AM LEGAL OWNE F THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTI P TY. SIGNATURE' OF PERMITTEE FINAL IJ OHN A.LAMBIE, OUNTY ENGINEER ALIDATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR. CE. N.6. CASH LAG 5b44'LAR MAY 2 3 11 .00 to 76A667-CE#817 2-66 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOSANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ! � JOHN A. LAMBIE,•COUNTY ENGINEER ADDRESS i "7 n COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY77 G a FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 51.25 NAM BATH TUB 1,25 ADDRESS SHOWER 1.25' CITY TEL. NO. LAVATORY 1.25 CONTRACTOR 1 SINS 1.25 ADDRESS VPZ.2 DISHWASHER 125 CITY TE —� LAUNDRY TUB 1,25 STATE' LICS _3 c7 LICENSE NO. �J CLAS CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE P SSED BY WATER HEAlW 1.50 GAS SYSTEM OUTLETS 1'50 INDUS APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD v CD _ W '.y Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT 5 2 00 UNDER SLAB WORK .ROUGH PLUMBING TOTAL FEE GAS PIPING. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR. PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF G CALIFORNIA OR THAT I AM THE LEGAL OWN F,AND S TEST NO TO A RESIDE IN,THE ABOVE DESCRIBRESIDENT L OPE UTILITY CO.NOTIFIED SIGNATURE OF PERMITTE FINAL X/4-1 - ALIDATION LACK R. ALLEN CK. M.0. CASH SUPERVISING MECHANICAL ENG'R. LAf .,01191- OCTl6 5 D 3.5 0^' im WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 insure, or a certificate of Workers' Compensation Insurance, 76A667A or as cc�e((rt''i�)fied copy thereof (Sec. 38, Lab. ) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Po (Z 1z el 7`&-)Company DCertified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM @ FEE ADDRESS LOCALITY Date Applicant w WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER C� (This section need not be completed if the work Involved by the permit is for one hundred dollars $100 or less. MAIL P � ) ) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. � so as to become subject to the Workers Compensation Laws. DISHWASHER CONTRACTOR - Date Applicant CLOTHES WASHER ADDRESS �/ C NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM C TY r� t� TEL. O. with comply with such provisions or this permit shall be STATE CLIC. .> v deemed revoked. WATER HEATER LICENSE N0. CLASS LICENSED CONTRACTORS DECLARATION / DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS O (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER Q %d t �c_c�tL✓ and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL cls ?4 C 3 DATE -/ VALIDATION a0 License Number, �� Lic. Class O FINAL Contracto x'02 Date — ` BY ^ Q DI am exempt under Sec. U W B.BP.C. for this reason �- Plan check fee Z Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE 10 Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. DI, as owner of the property, will do the work and the structure is not intended or offered for sale (Section ► _ 7044, Business and Professions Code). CONSTRUCTION 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 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 laws regulating Plumbing, and hereby aur ize represent fives of this County to enter upon the ave mentioned prperry r inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 3�3�Z (�Oure of Permit Date v COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0312030010 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: GAL D: FEES AID BUILDING ADDRESS: TR: 21833 LT: 13 BL: .001 9644 WEDGEWOOD ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802533 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BALDWIN 8588-009-004 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY 47 WATER HEATER(S) 1.00 WTH 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSEDB __PLAN BY: EXPIRES ON: 12/03/03 JK 05/31/04 OWNER: TEL. NO: FI L DATE FIN BY: CODE: WILSON ELEANOR A ( j 9644 WEDGEWOOD ST TEMP 917802533 ESCR PTION OF WORK REPLACE 40GAL GAS WATER HEATER APPLICANT' EL. NO: ( SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE WATER HEATERS ONLY INC. (800) 835-8345- 970 E. MAIN ST LIC. NO UNDER SLAB WORK GRASS VALLEY CA 95945 374573 HIC WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. NO: ROUGH PLUMBING LIC. NO: GAS PIPING GAS VENT OT WATER HEATER / PLUM NG F XTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED C V GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: SS0508