HomeMy Public PortalAbout4835 ARDEN DR_Plumbing__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1004270004
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: I FEES PAID BUILDING ADDRESS: I
ITR: 11148 LT: 5 BL: A 1 4835 ARDEN DR I
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917804051 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1
18585-015-007 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: B5 LOCALITY: TEMPLE CITY, Cl
1 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 1 I
(TENANT: I TOTAL FEES 43.95 (ISSUED ON: PROCESSED BY: PLAN BY: I
I 104/27/10 SR 1
1OWNER: TEL. NO: 1 IFINAL Dj= FIN L Y: CODE: 1
ILAN THA DOAN (310) 800-3909- i
14835 ARDEN DR
ITEMP 917804051 1 I E�CAIIPTI N OF WORK I
I IGAS LINE FOR HVAC SYSTEM I
(APPLICANT: TEL. NO: I
IPHD BUILDER INC. (626) 589-2027- I I
110050 GARVEY AVE 101 I ISPECIAL CONDITIONS: I
IEL MONTE CA 91732 I I I
(CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1
IPHD BUILDER INC. (626) 589-2027- 1 1
110050 GARVEY AVENUE #101 LIC. NO 1 (UNDER SLAB WORK I
EL MONTE, CA 91732 868680 B i (WATER SERVICE
IPLASTIC YIN METAL YIN I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 I I I I
I - 1 IROUGH PLUMBING I I I
LIC. NO: I I I I
IGAS PIPING I I I
I I IGAS VENT I I
IHOT WATER HEATER I
I 1PLUMBING FIXTURES I I
I I I I I I
ILAWN SPRINKLERS I
I I I I I I
I I IGAS TEST I1 11
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I I (UTILITY COMPANY NOTIFIEDI I
I ICWV I
I I I I
I I IGRAY WATER SYSTEM I I
I I I I I I
I I I I I I
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I I I I I I
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I I I I I I
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I IREPORT ID: DPR263 ROUTE TO: SS0508 I 1 I I
I I I I I
COUNTY'OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1003240001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
ITR: 11148 LT: 5 BL: A 1 4835 ARDEN DR
1 1FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917804051
ASSESSOR INFORMATION NUMBER: 1 1 NEAREST CROSS STREET:
18585-015-007 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B5 LOCALITY: TEMPLE CITY, Cl
. 107 BATHTUBS/SHOWERS 2.00 FIX 32.401 1
(TENANT: 125 LAVATORIES/SINKS 2.00 FIX 32.40 JISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
145 WATER CLOSET/URINAL 2.00 FIX 32.40 103/24/10 SR 03/24/11
1 1 TOTAL FEES 124.95' 1 1
1OWNER: TEL. NO: 1FI4qAL DATE FI Y: CODE: 1
1LAN THA DOAN (310) 800-3909- 1 1 /
14835 ARDEN DR 1 1 ✓, \��� 1
1TEMP 917804051 1 lEleSCRIPTIbN OF WORK 1
1 1 1PLUMBING FOR 2 BATHROOMS REMODEL 1
I I I I
1APPLICANT: TEL. NO: 1 1 1
1PHD BUILDER INC. (626) 589-2027- 1 1
110050 GARVEY AVE 101 1 1SPECIAL CONDITIONS: 1
1EL MONTE, CA 91732 1 1 1
I I I I
I I I I
1CONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE 1
1PHD BUILDER INC. (626) 589-2027- .1 1 1
110050 GARVEY AVENUE #101 LIC. NO 1 1UNDER SLAB WORK 1 1 1
1ELMONTE, CA 91732 868680 B 1 1 1 1 1
1 1 1WATER SERVICE 1 1 1
1 1 1PLASTIC Y/N METAL Y/N 1 1 1
1ARCHITECT OR ENGINEER: TEL. NO: 1 1 1 1 1
1 - 1 1ROUGH PLUMBING 1 1 1
1 LIC. NO: I 1 1 1
1I 1GAS PIPING 1 1
I I I I I I
1 I 1GAS VENT 1 I 1
I 1 1 I I I
1 I 1HOT WATER HEATER 1 1
I 1 I I I I
1 I 1PLUMBING FIXTURES 1 1
I I I I I I
1I 1LAWN SPRINKLERS 1 1
I I I I I I
1 1 1GAS TEST 1 1 I
1 1 1UTILITY COMPANY NOTIFIED( 1 1
I I I I I I
I 1CWV I 1 1
I I 1 I I I
1 1 1GRAY WATER SYSTEM 1 1
I I I I I I
I I I I I I
I I I I I I
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I I I I I I
I I I I I I
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I I I I I I
1 1 1 1 1 1
1 1REPORT ID: DPR263 ROUTE TO: BS0508 1 1 1 1
I I I I I I
WORKERS'COMPENSATION DECLARATION 76A667A
I hereby affirm that I have a• certificate of consent to self cE,17 (=-60)_, APPLICATION FOR. PLUMBING PERMIT
insure, or a certificate of Workers'Compensation Insurance,or
a certified copy thereo (Sec. 3800,Lab. C.)
��//'' COUNTY OF LOS ANGELES /� ' BUILDING AND SAFETY
Polic�No.V zr6 Company
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
Certified co NUMBER FIXTURE OR ITEM FEE ADDRESS
copy is filed with t - count building inspection _
rle tm LOCALITY
WATER CLOSET
DateApplicant �.� NEAREST 1 v� �a1�
BATH TUB CROSS ST. l�e•�
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE SHOWER OWNER
MAIL L ��•��;; ''
(This section need not be completed if the work involved ADDRESS CL
by the permit is for one hundred dollars ($100) or less.) SINK0
CITY TEL. NO. �� U
I certify that in the performance of the work for which this DISHWASHERir I� O
permit is issued, I shall not employ any person in any manner CONTRACTOR � /'I1�1
so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER ADDRESS , U
Date Applicant ` G � W
SWIMMING POOL RECEPTOR O.
NOTICE TO APPLICANT: If, after making this Certificate of CITY It& TEL. NO.�(���6 to
Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC.
Compensation provisions of the Labor Code, you must forth- /c,
with comply with such provisions or this permit shall be WATER HEATER LICENSE NO. �(a �7 S CLASS
deemed revoked. DISTRICT NO. PR ESSED BY
GAS SYSTEM OUTLETS
LICENSED CONTRACTORS DECLARATION OUTLETS OVER
I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM
9 (commencing with Section 7000) of Division 3 of the Busi- FINAL
ness and Professions Code, and my license is in full force and DATE VALIDATION�� `�
effect. J
License Number & Lic.Class lot BY AL .
Contractor nrtC� Date 12
I am exempt from the licensing requirements as I am a Plan check fee
licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ Q 0 /3/5(
acting in my professional capacity (Section 7051, Bus-
iness and Professions Code). TOTAL FEE tJ G
Lic.or Reg.No. Date Plan check applicant
HOME OWNER-BUILDER DECLARATION Name "�n l)'•t C1,
I hereby affirm that I am exempt from the Contractor's Address VtCtT(_, ;4 8 9 5 A
License Law for the following reason (Section.7031.5, Busi-. Cit Tel. No. q-3-7 Wo'o o o o 5
ness and Professions Code):
I, as owner of the property, am exclusively contracting 2'- 0 2 Q 5 0
with licensed contractors to construct the project
(Section 7044, Business and Professions Code). o`o o 2 0,5 0-6
CONSTRUCTION LENDING AGENCY O'7 1 2-.8 2
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
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 repre entatives of this County to enter upon the
abovonentio property for inspection purposes. G
Signature of Permittee Date
Or"
DEPARTMENT OF COUNTY ENGINEER � � � '
NG
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES �yy� �e
BUILDING D ✓� r��/�
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS i vf9
FOR APPLIC NT TO FILL IN LOCALITY _ L - O J'-
BUILDING NEAREST
ADDRESS ale� CROSS ST.
DISTRICT NO. GROUP ZONE PERMIT NO.
LOCALITY C0� �'® ��
NEAREST /J fj] ,p C 7�
CROSS ST. /`�A PA q �J �. RECEIVED'BV Ready for Inspection DAT9E'155�ULE�DC
OWNER 1� �fJ
MAIL D ���66d��� INDUSTRIAL
ADDRESS WASTE APPRO AL
CITY ] TEL,NO, INSPECTION RECORD
PLUMBER (�y�& � //)7/�� ��"
ADDRESS L) % ff/ .
CITY -re 0, Irl 1140� TEL.N0. Q 6 d R 0
[ $TATE
LICENSE N0. v [j'COUNTV J
PERMIT FEES z
'JUMCER TYPE OF FIXTURE OR ITEM FEE Vr
WATER CLOSET(TOILET) @ 0.80 $ m
O
BATH TUB @ 0.80
SHOWER @ 0.80
LAVATORY(WASH BASIN) @ 0.80
KITCHEN SINK @ 0.80
LAUNDRY TUB OR TRAY @ 0.80
SLOP SINK @ 0.80
FLOORSINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN- @ 0.80
URINAL @ 0.80 pp
GASSYSTEM------A.....OUTLETS @ 1.00 �(y!
WATER HEATER @ 1.00
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE & GAS PIPING
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT ¢r
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
ROPERLY REGISTERED
AND/OR LICENSED IAS REQUIREDABYPLOS ANGELES COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN-
ER OF THE ABOVE , ESCqIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE `-.ifl - r' � � F v' n ;.
FINAL D,/����4 ��/tsu•�ryse+�='l
7GA667 DES 17 /53
WORKERS'COMPENSATION DECLARATION 76A687A APPLICATION FOR PLUMBING PERMIT
I hereby affirm that I have a certificate of consent to self cE a17 (z-so)
insure, or a certificate of Workers'Compensation In.urance,or ''j—
a certified dd/r copy
tther,`e/of(Sec. 3800,La .C.) COUNTY OF LOS ANGELES 7 / �� BUILDING AND SAFETY
Po iVo. .0 Company
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING j/
ADDRESS Jk
Certified copy is filed with e c un building inspection NUMBER FIXTURE OR ITEM • FEE
Daterie rt nt. LOCALITY
Applicant WATER CLOSET NEAREST
BATH TUB CROSS ST. p'Lt�–tit/
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE SHOWER OWNER
MAIL
(This section need not be completed if the work involved LAVATORY ADDRESS
by the permit is for one hundred dollars ($100) or less.) a
SINK CITY TEL.NO. 0
I certify that in the performance of the work for which this DISHWASHER _ J. 0
f
permit is issued, I shall not employ any person in any manner CONTRACTOR (J'`/
so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER 0
ADDRESS.
Date Applicant SWIMMING POOL RECEPTOR W
NOTICE TO APPLICANT: If, after making this Certificate of CITY TEL.NO. L.
Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM to
Compensation provisions of the Labor Code, you must forth- STATE CLASS z
with comply with such provisions or this permit shall be
WATER HEATER LICENSE NO. /
deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. PRO ESSED By
LICENSED CONTRACTORS DECLARATION OUTLETS OVER d�
I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM
9 (commencing with Section 7000) of Division 3 of the Busi- FINAL �sr��/ 1 VALIDATION
ness and Professions Code, and my license is in full force and DATE
effect.
License Number Lic.Class
BY = ,
Contractor KiI l( L CJ�_J Date L�
ElI am exempt from the licensing requirements as I am a Plan check fee �`'
licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ 4 315
acting in my professional capacity (Section 7051, Bus-
iness and Professions Code). TOTAL FEE -5-- SU
5 Lic.or Reg.No. Date Plan check applicant
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm that I am exempt from the Contractor's Address 0
License Law for the following reason (Section 7031.5, Busi- City Tel. No. 3 c 6 0 �,9 R
ness and Professions Code):
I, as owner of the property, am exclusively contracting o o o o o 5
with licensed contractors to construct the project
(Section 7044, Business and Professions Code). 2 0 0 1 2,50
CONSTRUCTION LENDING AGENCY 0 0'0 1 2 5 0.63
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is 09.02-82
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 SEE REVERSE FOR EXPLANATORY LANGUAGE
ordinances and State laws regulating Plumbing, and hereby
author' representatives of this County to enter upon the
above entione property for inspection purposes.
61-gnatW of Permittee Da