Loading...
HomeMy Public PortalAbout9433 BLACKLEY ST_Plumbing__ 76A667A (OE 8176) -4/77 rn APPLICATI N F R PLU M B ING PERMIT READY FOR FINAL WSPECTION BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM FEE ADDRESS WATER CLOSET LOCA ITY NEAREST / BATH TUB CROSS ST. SHOWER OWNER LAVATORY MAIL ADDRESS SINK CITY �g 7�g� p {TEL.N_ DISHWASHER CO EIC INSTALLERS AL LERS CLOTHES WASHER ADD 92® E. GRAND AVE SWIMMING POOL RECEPTOR LAWN SPRINKLER SYSTEM CIT YTEMPLE CI N' . ,�o7C� STATE LIC. WATER HEATER LICENSE tj 7 67 CLASS GAS SYSTEM OUTLETSvv DIST jJCT�1NO. GROUP I ZONE PR ESSED BY OUTLETS OVER b 5 PER SYSTEM INDUSTRIAL V WASTE APPROVAL C:) INSPECTION RECORD W d N Plan check fee PLUMBING PERMIT ISSUING FEE$ TOTAL FEE p� Plan check applicant APPROVALS DATE INSPECTOR'S SIGNATURE Name UNDER SLAB WORK Address ROUGH PLUMBING L Tel.No. GAS PIPING EREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GASVENT ABOVE IS CORRECT AND AGREETOCOMPLY WITH ALL COUNTY ORDINANCES E LAWS REGULATING PLUMBING. HOT WATER HEATER EREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST NER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL . UTILITY CO.NOTIFIED RERMITT�E FINAL PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.0. CASH 2 2 2 ni=JiR 5 0 1 0.0 C ��` 78A887•CE#817 10-62 APPLICATION FOR PLUMBIN PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ,/33 JOHN A LAMBIE, COUNTY ENGINEER ADDRESS �- WILLIAM A JENSEN, SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST ROSS ST NUMBER FIXTURE OR ITEM EACH FEE ''ll OWNER WATER CLOSET $1 25 e) MAIL / BATH TUB 125 ADDRESS SHOWER 125 CITY TEL NO ij CONTAACTO i ` LAVATORY 125 0l SINK 1 25 ADDRESS q7 Ad DISHWASHER 125 CITY CONTRACTOR S `` l TEL NO/ STATE LAUNDRY TUB 1 25 REGIAT ON NO (O p7Q 36 COUNTY ❑ CLOTHES WASHER 1 25 -3\ DISTRICT NO GROUP E P SEED BY WATER HEATER 1 50 (� � CJ(/ Li t 150 INDUSTRIAL GAS SYSTEM—OUTLETS-0 WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM 30 IIN�NSPECTION RECORD /j A V II _ Lu r C APPROVALS DATE r � INSPE(`TOR S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK J� G- ROUGH PLUMBING TOTAL FEE S 6 v GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER J PLUMBING 1 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES ZA LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST �'1 CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO I/ / RESIDE IN,THE ABOVE SCRIBED RESIDENTIAL P PERTY UTILITY CO NOTIFIED 1 SIGNATURE '• A / OF PERMITTEE �/L..l� FINAL (j LIDATTON ROBERT A WOOD cK Mo CASH SUPERVISING MECHANICAL ENG R L,AC,,o4 3 2 8JAN13 5 A 1 5.00~ CE 817 IRE V.6/781 APPLICATION ®R PLUM ING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING �'�0 ® Q .A i 49 Y �i NUMBER FIXTURE OR ITEM @ FEE ADDRESS q� �0 WATER CLOSET LOCALITY NEAREST BATH TUB CROSS ST. I,es SHOWER OWNER LAVATORY MAILADDRESS �:° SINK CITY TEL.NO. DISHWASHER CONTRACTOR AWAY) `Tai SP4 CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITY C-pQ LQAA TEL.NO. LAWN SPRINKLER SYSTEM STATE /� �1 LIC. WATER HEATER LICENSE NO. ���D Ca CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING a 0 GAS VENT Mo HOT WATER HEATER PLUMBING FIXTURES GAS TEST Plan Check fee UTILITY CO.NOTIFIED PLUMBING PERMIT ISSUING FEE$ r" TOTAL FEE FINAL Plan check apoicont �y �� PLAN CHECK VALIDATION Name Address LREQUIRED �.� ew6 L�Imo' Tel.No. EREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION AND STATE _ ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES E LAWS REGULATING PLUMBING. PERMIT VALIDATION HE CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS ? n o 0,0 0 BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT IAM THENER OF,AND INTEND TO RESIDE IN THE A VE DESCRIBED RESIDENTIALr,. VRE < l! r0MITTEE DISTRICT 0. P CESSED Y INDUSTRIAL WASTE APPROVAL ION WORKER'S I have a certificate of consent to 20-0026 DPW 9/89 APPLICATION FOR PLUMBING PERMIT ,7f�A6Cy�A I hereby affirm that I have a certificate of consent to self insure, or a certifi1�te of Worker's Compensation Insurance, or a certified co--y thereof(Sec.3800 Lab.C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No. Company IL—JI 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 ) FEE LOCALITY Date Applicant � WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' ' BATH TUB CROSS ST. COMPENSATION INSURANCE ASSESSOR PARCEL V � Q2 'MAP BOOK PAGE, (This section need not be completed if the work involved by the SHOWER n permit is for one hundred dollars($100)or less.) a OWNER I certify that in the performance of the work for which this permit LAVATORY v is issued, I shall not employ any person in any manner so as toMAIL SINK ADDRESS33 6-/TI.�EL� become subject to the Workers'Compens ion Laws. EV DISWASHER CITY. TEL.NO.!�ygs}- e� Date 11=1Applicant CLOTHES WASHER CONTRACTOR 25 P1 N)TAI i/ Qr1 J n_ NOTICE TO APPLICANT: If, after making this Certificate of �L�- Exemption, you should become subject to the Workers' Compensation SWIMMING POOL RECEPTOR ADDRESS provisions of the Labor Code, you must forthwith comply with such o,EK1 provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.TEL.NO. f� }_ I hereby affirm that I am licensed under provisions'of Chapter 9 STATE LIC.WATER HEATER ( ��`` '' ����✓✓ uu�a Pe 0 (commencing with Section 7000) of Division 3 of the Business and GAS SYSTEM OUTLETS LICENSE NO. � CLASS (� Professions Code,and my license is in full force and effect. OUTLETS OVER DISTRICT NO. PROCESSED BY 0 5 PER SYSTEM License Number Lic.Class FINAL n l VAdDA"fION W eWt014t DATE yl J\ cC_ Contractor Date •••--- -- r_1 $FINAL - t- Z I am exempt under Sec. ` Y ':' ?• B.&P.C.for this reason _6;�_ s,i_i'f Vii_ @ = 65 Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ Signature © ; 'I-- a i i_i ❑ TOTAL FEE ` Plan check applicant SINGLE FAMILYtil if if--f ii I s�:'f i_f:'"I HOME OWNER-BUILDER DECLARATION Name -"' I hereby affirm that I am exempt from the Contractor's License Law L; = ;: for the following reason (Section 7031.5, Business and Professions Address iM'r�`` Code): City Tel. No. EJ 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 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 pro�inspectiopu ,1 SEE REVERSE FOR EXPLANATORY LANGUAGE K I 4 //—/a—I Signature of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0308110007 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGA ID: FEES PAID BUILDING ADDRESS: ON FILE 9433 BLACKLEY ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803141 ASSESSOR INFORMATION NUMB R. NEAREST CROSS STREET: SERENO 8590-003-039 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 /� TENANT: TOTAL FEES 43.95 SUED ON. PROCESSED BY: PLAN BY: EXPIRES ON: 08/11/03 JK 02/07/04 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: GREENE ROBIN (626) 286-2952- p 9433 BLACKLEY ST V - I I-- o-j TEMP 917803141 DESCRIPTION OF WORK GASLINE FOR FURNACE APPLICANT: TEL. NO: AIR-TRO INC 1630 S MYRTLE AVE SPECIAL CONDITIONS: MONROVIA 91016 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE AIR-TRO INC. (626) 357-5311- 1630 S. MYRTLE AVE. LIC. NO UNDER SLAB WORK MONROVIA, CA 91016 258228C10 WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. N0: - ROUGH PLUMBING LIC. NO: GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED ! 7 CWV GRAY WATER SYSTEM * ADDITIONAL DATA ON FILE REPORT ID: DPR263 ROUTE TO: BS0508