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Home My Public Portal About5318 WELLAND AVE_Plumbing__ 78A667-CE817-8-58- APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES ' DEPARTNINT OF COUNTY ENGINEER BUILMNG AND SAFETY DIVISION ElIMLIDINGJrOHN A. LAME. County games .�/d" l Ltr/±G GCASSATT D.GEPM.Supt of Su 1mgALITY FOR APPLICANT TO FILL IN NUMBER' FIXTURE OR ITEM y WATER CLOSET OWNER O &VrG. OPV RATE.TUB ADDRESS /! ERmc sflow� . CrrY G p Y Al TEL NO. ' LAVATORY CONTRACTOR ---VagleY Plumbing Co. s>rIs ADDRESS 442 69. Fleetwood PY. El DRMWASRER CITY Glendora. TEL.No. Ed 5_�. CONTRACTOR'S STATE ❑ LAUNDRY TUB REGETRATiON NO. COUNTY / CLOTHES WASHER DISTRICT NO. GROF ONE/ P OCESSED Y WATER HEATER f! GAS SYSTEM INDUSTEIAL WASTE APPROVAL - INSPECTION RECORD l .. - �' ^/Z-••..5� �•/JCc/•�f� !ne f - Ct�.G c�'1•e a! �G4Y- �� CDR �i ---- ri f `'' gg APPROVALS OR.OFIBTURE $ I . m rr', DATE INSPECTOR'S SIGNATURE UNDER ORK S`-/'2'rl (:;l-ii ko --•.- PERMIT S P.1 00 ROUGH PLUMBING ;Y ��ry �, JJ 'y 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 LICENSED .AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED. / DESCRIBED RESIDENTIAL PROP RTY. SIGNATURE 000, AL / OF'PERM LTTE ' ROBERT A.WOOD. OF VALIDATION SUPERVISING MECHANICAL ENG' H.0. CASH LAC0 6.0 5 4 A' wily 8 5 A 1 1.0 0 76A667-C.E#817 10-67 - •. :APPLICATION FOR PLUM ING PER IT &&TV& LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING ADDRESS JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY e.VA-Pu� CA NEAFOR APPLICANT TO.FILL IN PR NT OR TYPE). CROSS ST. NUMBER I FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 1.50 MAIL BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY TEL.NOG-79-%4. LAVATORY 1.50 CONTRACTOR SINK 1.50 ADD`" S`�g5 lTT tax— DISHWASHER 1.50 CITY . (C� (p L. NO.& ' �E29LLe CLOTHES WASHER -1.50 STATELIC LICENSE NO.2----d&4:='2L(2- CLASS GSsp�t SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. G ZONE I P ESMI)B LAWN SPRINKLER SYSTEM 2.00 eRt O fJLi-(� CJ WATER HEATER 1.50 INDUSTR AL WASTE APPROVAL O GAS SYSTEM OUTLETS 1..50 INSPECTION 11 D I.- OUTLETS OVER W 5 PER-SYSTEM .30 � ��./ + H Z Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE .. APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING -- Ci-ty" Tel. No. GAS VENT HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION - AND STATE THAT THE ABOVE :IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL, COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED- AND/OR UTILITY CO.NOTIFIED LICENSED AS REQUIRED BY LOS ANGEL198 COUNTY AND STATE OF CALIFORNIA. OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL SIGNATURE JACK R. ALLEN, SUPERVISINE HANK 'G'R. OF PERM.I E PERMIT VALIDATION fCK. M.O. CASH PLAN•CHECK VALIDATION CK. M.O. CASH WORKERS'COMPENSATION DECLARATION 76A667A APPLICATION FOR PLUMBING PERMIT Ia'' hereby affirm that I have certificate of consent to self C19617 (2-80) insure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) I COUNTY OF LOS ANGELES �� BUILDING AND SAFETY Policy No. Company- 0 ompany s ; Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING • 1 ��'1✓C �� Certified copy is filed with the county building inspection ! NUMBER FIXTURE OR ITEM ® A FEE DDRESS `LOCALITYw department. y WATER CLOSET NEAREST / C'i• ` Date Applicant BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' �A L COMPENSATION INSURANCE SHOWER d OWNER LAVATORY MAIL S /J vi(q f ('Phis section need not'be completed if the work involved ADDRES. • } by the permit is for one hundred dollars ($100) or less.) i SINK CITY-' TEL.Nne , a I certify that in the performance of the work for which this DISHWASHERyQ U permit is issued, I shall not employ any person in any manner I CONTRACTOR -so as to become subject to the Workers'Compensation Laws. CLOTHES WASHER 0 �� ADDRESS � O Date Applicant SWIMMING POOL RECEPTOR ftCITY NO. W NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' •i' LAWN SPRINKLER SYSTEM ' STATE LIC. N Compensation provisions of the Labor Code, you must forth- LICENSE NO. CLASS Z with comply with such provisions or this permit shall be WATER HEATER deemed revoked. II' ! DISTRICT N RO SED BY GAS SYSTEM OUTLETS } LICENSED CONTRACTORS DECLARATION OUTLETS OVER `-'' •v I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with.Section 7000)of Division 3 of the Busi- FINAL VALIDATI .N ness and Professions Code,and my license is in full force and DATE effect. FINAL License Number Lic.Class BY Contractor Date 'Plan check fee ` I am exempt from the licensing requirements as I am g -licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in 'my., professional capacity,(Section 7051, Bus- I o' o iness'and'Pr'ofessions Code). , i TOTAL FEE Lic.or Reg.No. Date Plan-check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section,7031.5, Busi- City Tel.No. ;P 3 2 R 7 A ness and Professions Code): ❑ o 0 0 0 o 5I, as owner of the property, am exclusively contracting• � with .licensed contractors to construct the project 2 - 1650 (Section 7044,Business and Professions Code). f CONSTRUCTION LENDING AGENCY o 0 0 .1 ( 5 v I hereby affirm that there is a construction lending agency I 3 1 V-8 2 for the performance of the work for which this permit is issued(Sec.30.97,Civ.C.). 1. Lender's Name L'ender'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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter uppa4he va mentioned property for inspection purpos S' nature of Permittee Date I