The URL can be used to link to this page

Home My Public Portal About8715 WENDON ST_Plumbing__ WORKERS'COMPENSATION DECLARATION ��PLICATION �®� PLUMENG PERMIT[,'.!ereby affirm That I .�ve o'certificate of consent to self 20-0026 DPW 6/87 insure, or a certificate of Workers'Compensation Insurance, 7BA667A or a,certifted copy theFf ec. 3800, Lab. C.) _ '�� =-_ � �p COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS ❑ fdlicy Nam pang ,_C' Certified copy is hereby furnished. BUILDING ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE). ADDRESS Certified copy is filed with the county building inspec- NUMBER FIXTURE OR ITEM (� FEE tion pa t nt. ��i�f ,�� `, _ LOCALITY T=le City Ca- 9177-S Date �Appli4ant�/►/V��Uti/� 1 WATER CLOSET �'7 NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS', BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER — 01 YjM Tao (This section need not be completed If the work Involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this St- permit is issued, I shall not employ any person In any manner SINK "e-AT—k—CITY Temle City TEL.NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR 818-2866677 Date Applicant CLOTHES WASHER f ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL.NO:' Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm.that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS / 440 P2. P3Y (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM. FINAL VALIDATION a ' License Number d Lic. Class DATE " V FINAL Contractor "^"" Date BY eiGl:i,y n' 131 am exempt under Sec. _.._I` �, 10 W B.&P.C, for this reason Date: Plan.check fee p •� �' 1 Z �� I'AIL .t.:r�'6� 60— PLUMBING PERMIT ISSUING FEE$ i_I S Signature TOTAL FEE C-9E ' 126.6 - SINGLE FAMILY Plan check applicant L•`? i'3�. HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License ;y)+sl"—)ilii:j -;r-.t Law for the following reason (Section 7031.5, Business and Address �� F1 City �' `53 t IE`i.L..Fn t. Professions Code): Cit Tel. No. r tri ❑ I, 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 appligoltion and state that the above information is correct. I agre to comply with all County ' ordinances and laws regul ring Plumbing, and hereby authorize re a entafives of t ' unty to enter upon the above-men oned' perty fo t ection 6!p ses. SEE REVERSE FOR EXPLANATORY LANGUAGE nature of Permittee Dat 7"667 DBB 17 7-31 APPLICATION FOR PERMIT DEPARTMENT OF BUMDING AND SAFETY COUNTY OF LOS ANGELES 2- WILLIAM J. FOXY CRIER ENGINEER PERMIT NO. FOR APPLICANT TO FILL IN DISTRICT R P �za-'7G r-Jr PLUMBI READY FOR REC VED BY DATE ISSUED FIRST INSPECTION ADDRESS 8300 FAST VAI I FY Rl yn CITY ROSEMEAD TEL.No. ADDRESS ADDRESS COUNTYn �p LOCALITY /Aiyv�Y✓ C.yG.! LICENSE 93M SE NO. EXPIRES •S� , N E74REST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) 0.50 III ADDRESS BATH TUB 0.50 CITY TEL. No. SHDWER 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) ® O.SO APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOS I LAUNDRY TUB OR TRAY @ 0.50 ANSBLES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER J GAB SYSTEM-13—CUTLETS 0 0.50 OF THE RESIDENTIAJL PROPERTY DESCRIBED ABOVE. SIGNATURE CF WATER HEATER @ 0.313 PERMITTEE. SLOP SINK D.SD INSPECTION RECORD FLMM SINK 0.5D FLOOR DRAIN 0.50 DISHWASHER @ 0.50 _ DRINKING FOUNTAIN (!I 0.80 URINAL O.SO - Q HOUSE SEWER 0.50 _Z MISCELLANEOUS — 10 <a. Yf F r i K r/�,wa�' jt l1�1 Ir 0! APPROVALS DATE /�INSPECTORIB NAME ROUGN PLUMBING / 6 / �o BAS PIPING GAS VENT CESSPOOL @ 1.00 CESSPOOL SEPTIC TANKS SEPTIC TANK DRAIN ( ) PIT ( ) 1.00 SEWER PERMIT . 1.00 GAS 'TEST UTILITY CO.NOTIFIED _.-I( /1�{), TOTAL FEE ra �-FNALsu 76A667-CE617 6.60 APPLICATION FOR PLUMBING PERMIT � COUNTY OF LOS ANGELES. DEPARTMENT OF COUNTY ENGINEER BUII. R AND SAFETY DMSION BUILDING JOHN A. LJIMBIE. COUNTY ENGINEER ADDRESS WILLIAM A.JENSEN.SUPT OF BUILDING Jol LOC FOR APPLICANT TO FIM IN NEAREST . NUMBER FIXTURE OR ITEM OWNER WATER CLOSET p BATH TUB AADDDRESS 6 /s CITY TIiL NO. : SHOWER- LAVATORY `EONTRACTOB `: SIIiS ADDRESS cr e ' DISHWASHER CITY TEL NO. 4 e CONTRACTOR'S ❑ LAUNDRY TOB REGISTRATION NO. IcS S COU CLOTHES WASHES DISTRICTNO. GROUP ZON CESSEDBY WATER HEATJiB GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD tq - po O ° OR FIXTURE $ E/ APPROVALS DATE INS ECTaR'S SIGN TUBE _ PERMIT $ 2100 UNDER SLAB WORK TOTAL FEE ROUGH PLUMBING 'f GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT { •Of//� w WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. u ✓ rs I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES f�j LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVR DESCRIBED RESIDENTIA PERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMUfu6mmIm Ell TE `,lFINAL �✓ l X �fl/rrs'! 9� VALMATIO ROBERT A.WOOD, SUPERVISING MECHANICAL ENWR Uf0 3 6 4 5 % V"'A 9 5 A 8.0 0 v