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Home My Public Portal About9867 WENDON ST_Plumbing__ WORKERS'COMPENSATION DECLARATION +' APPLICATION FOR KUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers'Compensation Insurance,I CE 817(REV. 10/81) or a certified copy thereof(Sec. 3800, Lab. C',) COUNTY OF LOS ANGELES. / / �' BUILDING AND SAFETY Policy No. Compan Poly Certified copy is hereby furnished. BUILDING Q67 6r�,y�eIv dam ve— Tilf, ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspec- ADDRESS O tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET Date AppMPROSS ST. eklele f es NEAREST CERTIFICATE OF EXEMPTITION FROM WORKERS' BATH TUB Af COMPENSATION INSURANCERrNOL (This section need not be completed if the work Involved by ' SHOWER OWNER 57—Ar/)T7— the permit is for one hundred dollars($100)or less.) ILAVATORY. ADDRESS el ir4 C w Won A v e . I certify that in the performance of the work for which this permit is issued, I shall not emplogrnaking n in any nner SINK CITY /a�� TEL.NO. so as to become subject to the Wpensat' n Laws. DISHWASHER l f CONTRACTOR ate/� pplica CLOTHES WASHER NOTICE TO APPLICANT: If, of eris Certificate ADDRESS Exemption, you should become subject to the War SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must f rth� CITY TEL. NO. LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO.. CLASS LICENSED CONTRACTORS DECLARATION ii DISTRICT NO. PR ESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER _" and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL //�� VALIDATION V a DATE License Number Lic. Class + Log FINA O Contractor Date BY V ma I am exempt under Sec. H D.BP.C. for this reason. Plan check fee -2'0 87-2 A Date:. PLUMBING PERMIT ISSUING FEE$ �O Signature # 0 0 0 0 0 5 '+ TOTAL FEE Plan check applicant ( 0 0 3 1L 5 0 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name o 0 o 3 lh 5 0 01 I hereby affirm that I am exempt from the Contractor's License Address i1 (112-84 Low for the"following reason (Section 7031.5, .Business and Professions Code): City Tel. No. 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 affirmthat 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 n State laws 7ort ulating Plumbing, and hereby authori rept�esentatives his County to enter upon the abov me oned prop inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE S,go'ture of Per ttee Date COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY WILLIAM J. FOX, County Engineer PLUMBING I ZONE PERMIT FOR APPLICANT TQ FILL IN DI5 GROUP� I. n � PLUMBER Belvedere Plumbing Co. RECEIVED BY READY FOR DATE ISSUED. FIRST INSPECTION ADDRESS 11900 Be Garvey Blvd. PR5 - �S`- " CITY El Monte, TEL No. r10-89836 ADD EUILDISS NG 9867 WendOn St. COUNTY $0$M 6/10/53 LOCALITYTemple City LICENSE NO. EXPIRE NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEMFEE OWNER Terry Clyde MAIL 2 WATER CLOSET(TOILET) @ 0.50 $1 ,60 ADDRESS 1 BATH TUB 0.50 1.$0 CITY TEL. No. 1 SHOWER a 0.50ABOVE 18 CORRECT 80 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS 2 LAVATORY (WASH BASIN) 0.50 1 O ANDAPPLICATION AGREE TO COMPLY WITH ALLAND STATE THATHCOUNTY ORDINANCES KITCHEN SINK @ 13.50 80 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOS 1 LAUNDRY•TUB OR TRAY @ 0.50 18 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER 1 GAB SYSTEM OF THE RESIDENTIAL PROPERTY DESC BED ABOVE. OUTLETS ® 0.50 SIGNATURE OF 1 WATER HEATER @ 0.50 —1100 PERMITTEE SLOP SINK a 0.50 INSPECTION RECORD FLOOR SINK 0 0.50 FLOOR DRAIN a 0.50 DISHWASHER a 0.50 DRINKING FOUNTAIN @ 0.50 �'+'_' �,/�>• +�� /F"�>/ /� URINAL @ 0.50 Q HOUSE SEWER 0.511 z C7 MISCELLANEOUS 13 r� A1-1 crlhok 71 .raGs1✓ - A/ APPROVALS Gt DATE INS/`PECTOR4 NAME ROUGH PLUMBING �� H GAB PIPING /Ick GAS VENT CEBSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT 1.00 GAS TEST / -7 ?-'7 r.! TOTAL FEE $ UTILITY .NOTIFIED 11 10 20 L co FINAL 16A667 DBS#17 6-52 307 76A667%'ICE817 12/59 Nr •APPL.ICATIO FOR-PLUMBING PERMIT � COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ' B�JILDIInG� iN� SAFETYIVISION svlLDnvG OHN M IE, COUNTY NGINEER ADDRESS WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN CROSS ST . 1 NUMBER FIXTURE OR ITEM OWNER WATER CLOSET MAIL SATS TOB ADDRESS ' &TY TEL.NO. SHOWER LAVATORY CONTRACTOR f7 C6 SINS ADDRESS 2gl DERWASHER CITY ` TEL. NO. f G CO CTOR'S STATE LAUNDRY TOB REGISTRATION NO. J COUNTY ❑ CLOTHES WASHER DISTRICT NO. GROUP I ZONE P SED BY WATER HEATER GAS SYSTEM INDUSTRUIL WASTE APPROVAL INSPECTION RECORD y� a O v ra O • r V 4 i W 51PER MITURE $ I i;. APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT ; jL UNDER SLAB WORK TOTAL FEE ROUGH PLUMBING f i' " GAS.PIPING I HEREBY ACKNOWLEDGE THAT I 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 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY.AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIUTILITY CO.NOTIFIED SIGNATURE •. 167 i OF PERMITTE FINAL ®p Al f ATION ROBERT A.WOOD, M,O, C"H SUPERVISING MECHANICAL ENG'R I I U.' 4 0 a: 7 5 p 4.00 s' 7SA667-CERS17 12-84 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISIONADDRESS JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS,SUPIT OF BUILDING, LOCALITY FOR APPLICANT TO FILL IN7!77 NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 CONTRACTO SINS 1.25 ADDRESS DISHWASHER 1.25 CITY TEL. NO LAUNDRY TUB 1.25 CONTRACTO 'S STATE on REGISTRATION NO. f COUNTY ❑ CLOTHES WASHER 1.25 DIST •RICT NO. GRO P ZONE PROCESSED BY WATER HEATER 1.50 J`o t1 GAS SYSTEM OUTLETS 1.50 WASTE APPROVAL d OUTLETS OVER-5 PER SYSTEM .90 INSPECTION RECORD v ASts �„� r • O '�� OW. N Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT S 2 00 UNDER SLAB WORK vi ROUGH PLUMBING TOTAL FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER I PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES V LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST t CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED r SIGNATURE OF PERMITTEE FINAL 0VIALCK. M. IDATION ROBERT A.WOOD O. CASH SUPERVISING MECHANICAL ENG•R Lt_ j�o 3 7 8 31 JUL 2 8 5 D 5.0 N '7,8A887-CE#817 12-84 .• %!3 /�� C . APPLICATION COUNTY PERMIT COUNTY OF LOS ANGELES. DEPARTMENT OF COUNTY ENGINEER- BUILDING AND SAFETY DIVISION BUILDING- JOHN A:LAMBIE. COUNTY ENGINEER-, ADDRESS COLEMAN W. JENKINS,SuPli DF BUILDING.,_ LOCALITY FOR APPLICANT,TO FILL IN NEAREST �v�� CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATERCLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS SHOWER 1.25 CITY_ . TEL. NO. LAVATORY 1.25 .9ONTRACTOB ' SINS 1.25 ADDRESS DISHWASHER- 1:25 CITY TEL..NO LAUNDRY TUB 1.25 CONTRACTOR'S / STATEon REGISTRATION NO. - ,,/ COUNTY ❑ CLOTHES WASHER 1.25 DISTRICT NO.' GROUP ZONE PROCESSED BY.. ' WATER HEATER '1.50 GAS SYSTEM OUTLETS' 1.50 INDUSTRIAT. WASTE.APPROVAL OUTLETS OVER 5 PER SYSTEM .30 "INSPECTION RECORD V r r �+ J/ z . • APPROVALS DATE INSPECTOR'S SIGNATURE i PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL'FEE GAs.PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLIGTION .GAS VENT ' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY . WITH) 'ALL' COUNTY ORDINANCES AND STATE LAWS REGULATING 140T WATER HEATER Y 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 I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED r SIGNATURE J OF PERMITTEE FINAL "IlDATION ROBERT A.WOOD CK. M.'O. CASH SUPERVISING MECHANICAL.ENG'R LtIGo 3'7 8 '3 JUL2.8 5