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Home My Public Portal About6323 AGNES AVE_Plumbing__ 76A667 OBS 17 11-SO APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY �' COUNTY OF LOS ANGELES WILLIAM J FOX, CHIEF ENGINEER c FOR APPLIC T TO FILL IN DISTRICT NO GROUP I ZONE P=MI-U NLI. :- 2- PLUMBER PLUMBER RE EIV D Y READY FOR pp_ooyy ,, '' DAT 1 UED FIRST INSPECTION'l fel m' �/t •-u.��4L s� TL ADDRESS �. BUILDING I CITY + o� TEL.NO ADDRESS COUNTY a LICENSE NO / ` EXPIRES LOCALITY NEAREST PERMIT FEES CR09B ST NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER w j MAIL ,r WATER CLOSET(TOILET) @ O 50 19 ADDRESS BATH TUB O 513 CITY TEL NO SHOWER O 50 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) D 50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0513 AND STATE LAWS REGULATING PLUMBING I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ O 50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE OAS SYSTEM OUTLETS @ 050 SIGNATURE DF WATER HEATER 050 PERMITTE _ SLOP BINK Co D 50 INSPECTION RECORD FLOOR BINK @ O SO FLOOR DRAIN 050 DISHWASHER Q O SO DRINKING FOUNTAIN O 50 URINAL 050 J Q HOUSE SEWER O SO _Z MISCELLANEOUS O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT �e CESSPOOL @1 DO CESSPOOL SEPTIC TANK SEPTIC TANK DRAIN ) PIT ) 1 OO SEWER PERMIT t DD GAS TEST UTILITY CO NOTIFIED TOTAL FEE & Z y T —r FINAL .p.GDa✓� L ERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT {� rm ihat I have a certificate of consent to self 76A667A L� a certificate of Workers Compensation Insurance CE 817(REV 10/81) or a certified copy thereof (Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No P�3 16 ComponyTRR.Fp4O_p T_ ❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec ADDRESS 612'1 N_ Agnpc; tion department NUMBER FIXTURE OR ITEM Q FEE LOCALITY WATER CLOSET Temple Cit Date 127 T 127 Applicant PVRAMTI RTTTT-n R NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS ST LOn den COMPENSATION INSURANCE OWNER (This section need not be completed if the work Involved by SHOWER the permit is for one hundred dollars'($100)or less ) / LAVATORY _6016ADDRES63 2 3 N. Acfnes I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner SINK CITY Temple TEL NO 2 8 5 4 8 2 2 so as to become subject,to the Workers Compensation Laws DISHWASHER CONTRACTOR PYRAMID BUILDERS Date Applicant ! CLOTHES WASHER ADDRES NOTICE TO APPLICANT If after making this Certificate of Bernardino Exemption you should become subject to the Workers SWIMMING POOL RECEPTOR CITYTEL N ,Compensation provisions of the Labor Code, you must forth LAWN SPRINKLER SYSTEM Covina 6 7 1342 with comply with such provisions or this permit shall be STATE I LIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO 961SSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS '� 0 (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code and my license is in full force and effect 5 PER SYSTEM FINAL �� VALID TION ?: µ DAT 0_ License Number 4 0 0 2 8 9Lic Class B L FI i U Contractor 7 y S2 7 W ❑ I am exempt under Sec U B 8P C for this reason Lil Plan check fee - ® CL Date Z PLUMBING PERMIT ISSUING FEE$ Signature r TOTAL FEE ;27625A SINGLE FAMILY Plan check applicant # o o 0 o a 5 HOME OWNER BUILDER DECLARATION Name pygAMTp BUILpEgS I 4 Q 5 0 1 hereby affirm that I am exempt from the Contractor s License Address Law for the following reason (Section 7031 5 Business and e m o 40.505 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 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 r 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 jaws regulating Plumbing and hereby t authorize representatives of this County to enter upon the above mentioned property for inspection purposes ^ SEE REVERSE FOR EXPLANATORY LANGUAGE 7/27/87 f '� Signature of�Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0207310010 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT ADDRESS-LEGAL ID FEES PAID BUILDING ON FILE 6323 AGNES AV FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917801402 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LONGDEN 5383-021-016 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID Al LOCALITY TEMPLE CITY 51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20 TENANT TOTAL FEES 43 95 1S QED ON PROCESSED BY PLAN BY EXPIRES ON 07/31/02 JK 01/27/03 OWNER TEL NO F�NAL DATE FIN COD BRYAN 8 TANJA JOHNSON (626) 285-1969- 6323 AGNES AV U - TEMP 917801402 DESCRIPTION O NEW HVAC SYSTEM APPLICANT TEL NO JORDANAIR (626) 963-3313- 129 S HACIENDA SPECIAL CONDITIONS G L EN DORA '-- CONTRAC OR TEL(626)N963 3313- �� '$9�� APPROVALS DATE INSPECTOR SIGNATURE 129 S HACIENDA AVE LIC NO f/✓ UNDER SB WORK GLENDORA, CA 91741 560429C208 WATER SERVIC PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER �� ROUGH LIC NO c-- �� GAS PIPING - -- -- -- - - - --- ams r Abd UATER PLUMBING UAW SPRINKLERS l uvs 7csT UTILITY cWV GRAY WATER SYSTEM * ADDITIONAL DATA ON FILE REPORT ID DPR263 ROUTE TO BS0508