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Home My Public Portal About5120 BALDWIN AVE_Plumbing__ (2) D.B.S.-17 25M SETS 12-45 APPLICATION FOR PERMIT .DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBINGWM. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH _ FIXTURES COMPLETE •-, TIA READ FOR EIVED DATE ISSUED HEATER CESSPOOL SEPTIC TANK � FIRST INSPECTION GAS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY .JOE NAME ADDRESS tIl ADDRESS LOCALITY DNEAREST - IL CITY _ TEL.No. CROSS ST. COUNTY .. >., CERT.No. EXPIRESNAME LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL 3 ADDRESS NORTH O - CITY _ TEL.N0. 1AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. t4 D OWNER CORRECTIONS w SOUTH DESCRIPTION OF WORK a BATH TUB FURNACE SHOWER DISHWASHER A LAVATORY REFRIGERATOR 0 KITCHEN SINK ---__WATER SOFTENER FLOOR SINK --_—SAND TRAP _.-SLOP SINK _ FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME __ WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I I —METER GAS -SODA FOUNTAIN OUTL GAS PIPING GAS VENT I I CESSPOOL —TOTAL NUMBER OF FIXTURES " _ SEPTIC TANK CESSPOOL SEPTIC TANK SEWER I TOTAL FEE UTILITY CO.NOTIFIED I FINAL I i i' D B S 17 25M SETS 6 46 / APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WM J FOX CHIEF ENGINEER NATURE OF INSTALLATION DI 1 GROUP O PERMIT NO- ROUGH FIXTURES COMPL.E7E / YJ HEATER CESSPOOL SEPTIC TANK CEIVED BY READY FOR DATE ISSUED FIRST INSPECTION A& MISCELLANEOUS �— APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB d, NAME ' ADDRESSld�/ W /meq NI< m ADDRESS e� LOCAL � d CITY NEARF�T J .O!',�+ � TELrNo C4089 BT /7 COUNTY CERT No r PIRES m NAME (J LOCATION OF SEPTIC TANK, OR CESSPOOL' z MAIL ' n NORTH O ADDRESS CITY TEL No IAM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OFFQUALIFICATION PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE ® _ > OWNER CORRECTIONS SOUTH J t DESCRIPTION OF WORK i BATH TUB FURNACE p ir SHOWER DISHWASHER Q LAVATORY REFRIGERATOR KITCHEN BINK WATER SOFTENER FLOOR BINK BAND TRAP GLOP SINK FLOOR DRAIN WASH TRAY ' URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR S NAME WATER HEATER DENTAL LAVATORY - ROUGH PLUMBING METER GAS SODA FOUNTAIN OUn CiAB PIPING GAS VENT CESSPOOL TOTAL NUMBERL�EPTIC FIXTURES SEPTIC TANK CE8SPOO, TANK / t/ U SEWER B' TOTAL FEE UTILITY CO NOTIFIED FINAL DEPARTMENT OF COUNTY ENGINEER V PLUMBING 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDING WILLIAM J FOX COUNTY ENC3INEER ADDRESS 4 FOR APPLICANT O FILL IN LOCALITY 1B BUILDINGp� „J� I CROSS ST ADDRESS L .GT LOCALITY DISTRICTGR ZON1% ERM�� NEAREST � ` spec AyT CROSS ST J RECE�B Ready for Inspection �D��SU�� OWNER G�/�`f ``fit. QQQ INDUSTRIA MAIL ADDRESS WASTE APPROVAL �S /� INSPECTION RECORD CITY p��, a k 0-0 .,TE NO t � I PLUMBER 1�I �j , ADDRESS 1 CITY S&*Z_ TEL NO (9>1'-6 44rSl El STATE LICENSE NO �1 �� U 4,t? ❑COUNTN J PERMIT FEES Q _z NUMBER TYPE OF FIXTURE OR ITEM FEE d WATER CLOSET(TOILET) @ 080 $ O BATH TUB @ 080 SHOWER @ 080 LAVATORY(WASH BASIN) @ 0 80 K TCHEN SINK @ 0 80 (/ LAUNDRY TUB OR TRAY (P 0 80 SLOP SINK @ 080 FLOOR SINK @ 080 FLOOR DRAIN @ 080 DISHWASHER @ 0 80 DRINKING FOUNTAIN @ 080 URINAL @ 080 GAS SYSTEM OUTLETS @ 1 00 WATER HEATER @ 1 00 MISCELLANEOUS APPROVALS DATE INSPECTOR S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING TOTAL FEE GAS PIPING 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI GAS VENT CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES w� I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN ER OF TH ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED SIGNATURE �� , OF PERMITTEE _ - �_ ��.A - FINAL �`� ^, 76A667 DBS 17 1/53 Q r COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1401080016 BUILDING AND SAUTY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285 0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS ITR 10821 LT 1 BL 001 1 1 5120 BALDWIN AV I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803901 1 ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 18585 007 001 101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY CAI 107 BATHTUBS/SHOWERS 1 00 FIX 16 20 1 TENANT 121 HOSE BIBB(S) 1 00 FIX 16 20 JISSUED ON PROCESSED BY PLAN BY I 125 LAVATORIES/SINKS 1 00 FIX 16 20 101/08/14 SR 145 WATER CLOSET/URINAL 1 00 FIX 16 20 I OWNER TEL NO 147 WATER HEATER(S) 1 00 WTH 16 20 1FL�A" `TF N BY CODE 1 IFLORENCIA PILPA TOTAL FEES 108 80K(^J 15120 BALDWIN AVE I 1 TEMPLE CITY CA 91780 IDESCRIPTION OF WORK (BATHTUB/SHOWER HOSE BIBB LAVATORIE WATER CLOSET AND IWATER CLOSET 1 (APPLICANT TEL NO 1 IKATIGBAK MAGNO (909) 267 8749 I 1 1961 CALLE HERMOSA 1 ISPECIAL CONDITIONS 1 ISAN DIMAS CA 91773 1 1 ICONTRACTOR TEL NO 1 1APPROVALS DATE INSPECTOR SIGNATURE 1 IM S K BUILDERS (909) 267 8749 1 I 1 1961 CALLS HERMOSA LIC NO 1 1UNDER SLAB WORK I I ISAN DIMAS CA 91773 720840 I I IWATER SERVICE I I IPLASTIC YIN METAL YIN I 1ARCHITECT OR ENGINEER TEL NO 1 IMENOR PETER (323) 255 3934 I IROUGH PLUMBING 1 I 1 11511 OAK GROVE DRIVE LIC NO 1 I I ILOS ANGELES CA 90041C28539 1 IGAS DIPING I I I I 1 1 IGAS VENT 1 I I I I I IHOT WATER HEATER 1 I I I I IPLUMBING FIXTURES 1 I I 1 I I I 1 (LAWN SPRINKLERS I I I I IGAS TEST I 1 I 1UTILITY COMPANY NOTIFIEDI I I ICKV I I IGRAY WATER SYSTEM I 1 1 1 I I I I I I I I I I I I I I I I I 1 I I I I 1 1* ADDITIONAL DATA ON FILE 1 1 IREPORT ID DPR263 ROUTE TO BS0508 1 1 I I I I 'WORKERS COMPENSATION DECLARATION 76AG67A I✓hereby affirm that I have a certificate of consent to self CE e17 (z 60) APPLICATION FOR PLUMBING PERMIT {� insure or a certificate of Workers Compensation Insurance or I i J a certified copy thereof(Sec 3800 Lab C) �, �� COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company f 0 Certified copy is hereby furnished FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING 51,04V i yO � ADDRESS L Certified copy is filed with t county building inspection NUMBER FIXTURE OR ITEM • FEE WATER CLOSET ��- LOCALITY Dated TEL NEAREST / ,{ BATH TUB CROSS ST Ld��+� fYZCJiZ� CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE SHOWER OWNERf�L��'/(� esd MAIL c CL (This section on need not be completed if the work involved j -� ADDRESS /'�/As. d�Oy ` � by the permit is for one hundred dollars ($100) or less) CITY TEL CONTRACTOR No7-7 t— U I certify that in the performance of the work for which this DISHWASHER /� O permit is issued I shall not employ any person in any manner O �v so as to become subject to the Workers Compensate ,n, Laws CLOTHES WASHER ADDRESS U LU Dat J Applicant � '� SWIMMING POOL RECEPTOR d NOTICE TO APPLICANT If after making this Certificate of CITY TEL NO Cl) Exemption you should become subject to the Workers LAWN SPRINKLER SYSTEM STATE LIC Z Compensation provisions of the Labor Code you must forth LICENSE NO CLASS with comply with such provisions or this permit shall be WATER HEATER deemed revoked GAS SYSTEM OUTLETS DISTRICT NO PROCESSED BY LICENSED CONTRACTORS DECLARATION �O �✓ OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi FINAL l VALIDATION ness and Professions Code and my license is in full force and DATE effect / FINAL lr(/1 ✓ —"t License Number Lic Class BY Contractor Date i I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051 Bus iness and Professions Code) TOTAL FEE m Lic or Reg No Date Plan check applicant HOME OWNER BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractors Address 9 1 2 7 8 A License Law for the following reason (Section 7031 5 Busi City Tel No ness and Professions Code) # 0 0 0 0o 5 I as owner of the property am exclusively contracting " 2 o 0 1^9 0 0 with licensed contractors to construct the project (Section 7044 Business and Professions Code) 01400x CONSTRUCTION LENDING AGENCY 2 2-8 1 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 application and state that the l 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 upon the ` abov mentioned property for inspection purposes �1-22 Signa of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING+PERMIT • DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ' L PL-0508-9907280006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 1 PHONE (626) 285 0488 EXT i l LEGAL ID FEES PATD BUILDING ADDRESS TR 10821 LT 1 BL 001 } 5120 BALDWIN_AV1 FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803901 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET 8585 007 001 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY 03 BACKWATER VALVE(S) 1 00 VAL 46 95 TENANT 07 BATHTUBS/SHOWERS 1 00 FIX 16 20 ISSUED ON PROCESSED BY PLAN BY EXPIRES 0 11 CLOTHESWASHER(S) 1 00 FIX 16 20 07/28/99 UT O1/24/00 13 DISHWASHER(S) 1 00 FIX 16 20 OWNER TEL NO 47 WATER HEATER(S) 1 00 WTH 16 20 FINAL DATE FINAL BY CODE PILPA,FLORENCIA I 51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20 5120 BALDWIN AVE 60 DWV REPAIR OR ALTER 1 00 SYS 16 20 S- TEMPLE CITY, CA TOTAL FEES 171 90 DESCRIPTION-OF-WORK GAS-L-INE-FOR-NEW-HVAC SYSTEM-AND-P UMBING F R REMODEL APPLICANT TEL M S K BUILDERS (909) 592 3465 129 W THIRD STPECIAL CONDITIONS SAN DIMAS, CA GI 11 �ES Co MCONTRACTOR TEL S K BUILNAPPROVALS DATE INSPECTOR SIGNAT BUILDERS (909) 592 3465 �.�� V�r� 129 WEST THIRD STREET LIC NO UNDER SLAB SAN DIMAS, CA 91773 720840 B WATER �, PLASTICEYINCEMETAL YIN ARCHITECT 0 ENGINEER / LIC NO / ROUGH ttt///rrr, 1 11 111 � � GAS GAS VE NT U ULBUC W®�KPLUMBING FIXTURES � 0 R HEATER at LAWN ERS X GAS TEST 0 ® ®y -U=TY COMPANY O 46,�c Service rba�� ' cwv GRAY WATER K REPORT ID DPR263 ROUTE TO BS0508