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Home My Public Portal About5221 BARELA AVE_Plumbing__ ,76AG67+CE#817 5169 APPLICATION FOR PLUMBING PERMIT . =' COUNTY .OF LOS ANGELES DEPARTMENT' OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION HnRElss .J . JOHN A.. LAMBIE,:COUNTY ENGINEER 1 WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY I ' FOR APPLICANT TO FILL IN NEAREST /J CROSS ST. II,UCrIY NUMBER FIXTURE OR ITEM EACH FEE OWNER U �(/ Al WATER CLOSET 51.25 MAIL- BATHTUB 1.25 ADDRESS a I Al SHOWER 1.25 .CITY_ TEL..NO. LAVATORY 1.25 'CONTRACTOR L SINS 1.25. ADDRESS DISHWASHER 1.25 .:!PITT TEL.NO. LAUNDRY TUB 2S CONTRACTOR'S STATE ❑ REGISTRATIOXeM. Coum ❑ CLOTHES WASHER 1.25 DISTRICT NC. G=P .( NE /PR. ESSED'BY WATER HEATER 1:50• GAS SYSTEM OUTLETS 1.50 D WASTE I ROYAL 0 OUTLETS OVER 3 PER SYSTEM 90 INSPECTION RECORD ea • ff Z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK �,�+"""'�_ ROUGH PLUMBING j I ..�.��'• TOTAL FEE 31 ISO 'GAS PIPING I D HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION •Gi4S'V.EN7' ANSTATE 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 t 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 y _ SIGNATURE OF PERMITTEE. FINAL LIDATION ROBERT A.WOOD CK. M. CASH SUPERVISING MECHANICAL ENG'R Y;.. WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I have a certificate of consent to self in- 26DPW 4/90 sure,ora certificate of Workers'Compensation Insurance,ora 76A667A 667 certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING � j7�j.�� y All,Certified copy is filed with the county building inspection ADDRESS ZZ � (`j j� L/`i - J V department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY ' Date Applicant WATER CLOSET(TOILET) NEAREST 41, CERTIFICATE OF EXEMPTION FROM WORKERS' ��1ns BATH TUB CROSS ST.SHOWER COMPENSATION INSURANCE OWNER C"kR1�-rl Sufi (This section need not be completed if the work involved by MAIL �1 rp� 66 17� the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS �� AP,6LA AV, I certify that in the performance of the work for which this per- Z SINK CITY �y� TEL. NO. mit is issued, I shall not employ any person in any manner so �G�' ��—�j� os to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you.should become subject to the Workers'Compen- CITY TEL. NO. sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY /� I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and m license is in full force and ef- 5 PER SYSTEM FINAL v VALIDATION fect. HOSE BIB DATE 2 d License Number Lic. Class O FINAL U Contractor Date BY tY O El I am exempt under Sec. �® (� rLU U B.&P.C. for this reasonC{10111". f na Plan check fee == Date: PLUMBING PERMIT ISSUING FEE$ 3D =,`03 HEMS' 107.90 z Signature TOTAL FEE u� 1 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant TOTAL 10 7 -_80 I hereby affirm that I am exempt from the Contractor's License Name E{Fsa 107.80 Law for the following reason (Section 7031.5, Business and Professions Code): Address CHANGE 1130 ❑ I,,as owner of the property, will do the work and the City Tel. No. structure is not intended or offered for saleSection 7044, i t t ' Business and Professions Code). ( pop. 5346 =tr lsrr, 5346 i AN .1 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 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 purposes. i�ft11ef SEE REVERSE FOR EXPLANATORY LANGUAGE XSignature of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0307090021 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING AD AV TR: 15683 LT: 63 FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803849 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BLACKLEY 8589-012-004 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 07/09/03 JK 01/05/04 OWNER: TEL. NO: FINAL DATE FINAL B't-f CODE: LIU ROBERT YUNG-PING;SUN CHRISTINE (626) 285-8176- 5221 BARELA AV TEMP 917803849 DESCRIPTION OF WORK GASLINE FOR HVAC APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO UNDER SLAB WORK WATER SERVICE ARCHITECT OR ENGINEER: TEL. N0: PLASTIC Y/N METAL Y/N LIC. N0: ROUGH PLUMBING GAS PIPING GAS VENT HOT WATER HEATER i PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: RS0508