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Home My Public Portal About6033 AGNES AVE_Plumbing_4/8/1966_ r 76A667 CE4'817 6 65 a � n APPLICATION FOR PLUMBING ERM COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FAD LADIINJOHN A LAMBIE COUNTY ENGINEERSSCOLEMAN W JENKINS SUPT OF BUILDING ALITYFOR APPLICANT TO FILL IN AREST SS ST NUMBER FIXTURE OR ITEM EACH FEE 6 t OWNER ✓� WATER CLOSET 31 251. BATH TUB 1 25 Z� ADDRE SHOWER 125 CITY TEL NO LAVATORY 125 CONTRACTOR SINK 125 ADDRESS DISHWASHER 125 CPfY TEL NO STATE LI C LAUNDRY TUB 1 25 LICENSE NO CLASS CLOTHES WASHER 125 DISTRICT NO GROUP ONE PRO SED BY WATER HEATER 150 d / r GAS SYSTEM OUTLETS 1 50 INDUSTRIAL CL WASTEAPPROVAL 0 OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD V 0 H V w D_ N Z APPROVALS DATE INSPECTOR S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE O GAS PIPING I 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 HOT WATER HEATER PLUMBING I 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 O RESIDE IN THE ABOVE SCRIBED RESIDEN I�L9PE RTY UTILITY CO NOTIFIED SIGNATURE OF PERMITTEE FINAL VALIDATION CK M O CASH ' LA'W 1° 1 0 0 APR 8 5 D a,�,)- 0- r' ION DECLARAT WORKER'Shave a certificate of consent to se A 76A666DPW9/89 APPLICATION FOR PLUMBING PERMIT 76A667A I hereby affirm that I have a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or a certified copy whereof(Sec.3800 Lab. C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No. Company Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM Q FEE LOCALITY Date Applicant WATER CLOSET 0 NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER / e- MAP BOOK �3 PAGE Off. PARCEL O O 7� (This section need not be completed if the work involved by the permit is for one hundred dollars($100)or less.) OWNER t s S I certify that in the performance of the work for which this permit 2 LAVATORY J is issued, I shall not employ any person in any manner so as to SINK MAIL s g AL`,DDRESS -� become subject to the Workers' Compensation Laws. ��/ ) DISWASHER CITY TEL.N Date Applicant CLOTHES WASHER CONTRACTOR NOTICE TO APPLICANT: If, after making this Certificate of Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.NO. I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER A (commencing with Section 7000) of Division 3 of the Business and STATE LIC. 0 Professions Code,and my license is in full force and effect. GAS SYSTEM OUTLETS LICENSE NO. CLASS 0 OUTLETS OVER DISTRICT NO. PROCESSED BY a: 5 PER SYSTEM �Q d 0 License Number Lic.Class Q I-- FINAL 0 DATE Gbt..F,... �� VALIDATION a Contractor Date (n ( I am exempt under Sec. FINAL ZBY B.&P.C.for this reason Signature Date: Plan check fee , PLUMBING PERMIT ISSUING FEE$ EJTOTAL FEE Plan check applicant Flt_;:i :m SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Address Code): _ City TeL No. T TAT f AL19 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, _'Ynr h, Civ. C.) I J ! !!!'i i € l 6 l r:y Lender's Name v 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 authorize representatives of this County to enter upon the above-mentioned property for inspection pu oses. P`' SEE REVERSE FOR EXPLANATORY LANGUAGE 1— Q .)o— 2 Sig t re of Permittee Q date S COUNTY OF LOS ANGELES TEMPLE CITY # 0508PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL-0508 9709170008 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE (818) 285 0488 EXT LEGAL D FEES PAID BUILDINGD E S 7 TR 6561 LT 57 06033 AGNES AV � FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP-CA-917801708 ASSESSOR INFOR14ATION NUMBER NEAREST CROSS STREET 5385 027 007 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID A2 LOCALITY TEMPLE CITY 07 BATHTUBS/SHOWERS 2 00 FIX 32 70 TENANT 21 HOSE BIBB(S) 2 00 FIX 32 70 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 25 LAVATORIES/SINKS 2 00 FIX 32 70 09/17/97 UT 09/17/98 45 WATER CLOSET/URINAL 2 00 FIX 32 70 OWNER TEL NO 47 WATER HEATER(S) 1 00 WTH 16 35 FINAL DATE FINAL BY COD SYU YI SHENG CHAO YU HUAN (818) 286 5880 51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 35 6033 AGNES AV TOTAL FEES 191 25 1 ' TEMP 917801708 DE OF WORK PLUMBING FOR NEW ADDITION AND GAS LI FOR NEW HEATING AND AIR COND SYSTEM APPLICANT TEL NO YU (818) 287 3518 6025 HART AVE SPECIAL CONDITIONS TEMPLE CITY CA LES S CONTRACTOR L NO APPROVALS DATE INSPECTOR SIGNA URE J P SERVICES (818) 575 4816 11019 S SCHMIDT RD LIC NO UNDER SLAB WORK EL MONTE CA 91733 B * �� /1D WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT0 R TEL 0 p LIC NO GAS PIPING GAS VENT f0 BL C KS HOT WATER HEATER o PLUMBING FIXTURES D O LA N SPRINKLERS O � GAS TEST UTILITY C" 1(1 �vv CwV GRAY WATER SYSTEM , * ADDITIONAL DATA ON FILE REPORT ID DPR263 ROUTE TO BS0508