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Home My Public Portal About9822 BROADWAY_Plumbing__ "AsgT APPLICATION FOR PLUMBING PERMIT DBS6IJ 355' DIVISION OF BUILDING AND SAFETY DepaRtment of County Engineer. `• ♦ County of Los Angeles - WM.J. FOX, COUNTY ENGINEER BUILDING ADDRESS CASSATT D. GRIFFIN. SUPT of BUIIOING LOCALITY FOR APPLICANT TO FILL IN NEAREST �+ n " CROSS ST. ) OWNER /� �' [�� /r DISTgyCT NO. I GROUP MAIL qq - .T,9'N xcrox Fon I Nse[CTION ADDRESS yL J Y//l/ l INDUSTRIAL CITY Rn TEL. NO. WASTE APPROVAL PLUMBER J.-1JA1 N(;- -S R INSPECTION RECORD ADDRESS -LICENSE NO. c—c, `t-o [4dinn- NUMBfR TYPE OF FIXTURE OR ITEM. FEE \,nT TO Li n. G1' Gra.....•!� WATER CLOSET (TO]LET) $ CY II.JJ b hnr•R. .L.� On�li.�.�� BATH TUB SHOWER LAVATORY (WASH BASIN) KITCHEN SINK I — w DISH WASH Eft I ' LAUNDRY TUB OR TRAY CLOTHES WASHER ' ILI TOTAL NO. az 0.80 a - O APPROVALS '- GAS SYSTEM OUTLETS @ 1.00 _ DATE INSPECTOR'S SIGNATURE WATER HEATER @ 1.00 UNDER SLAB WORK A� (� ROUGH PLUMBING PERMIT s 1 oo - - GAS PIPING TOTAL FEE O GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ.THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES t- l 'i+ rll A/, „ PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REG15TERED AND/OR GAS TEST LICENSED AS REQUIRED BY.LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM. THE LEGAL OWNER OF THE ABOVE UTILITY CO. NOTIFIED DESCRIBED RE90E L PRO pp SIOFPERMTTEE FINAL 1 Q'S�. ..P llil/i.. — J WILLIAM J. FOX, CoU TV ENGINEER VALIDATION R. A. WOOD, CHIEF PLBG. INSPECTOR ^jC.09 .2`2 3 OCT20 3 4.4 0 �'��ORKERS'COMPENSATION DECLARATION 'p lmPLIC TION FOR PLUMBING BIND PERMIT sIr ue,or affirm:that f Workers' acertificate of consent to self ra - �76A667A PW•4/87 - F'91r Y- PY lItl 1'l W'�M�ID Iltl Y'(�V� Y sure,or a certificate of Workers'Compensation Insurance,or d CE 817(REV. 8/86) cerµfiedyJcc1�opy.thereof (ec 36.{.) ' Policy-NN ny - COUNTY OF LOS ANGELES -DEPT OF tPUBLIC'WORKS n Certified copy is hereby furnished. . ' , /'— FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINGr Cernfi d c filed with the county'building inspection _ ADDRESS .2,L Liz C of "am 1, _ NUMBER FIXTURE OR ITEM (?a FEE LOCALITY t .. -_ WATER CLOSET(TOILET)- �� DateApplicont NEAREST CERTIFICATE OF EXEMPTION ROM-'WORKERS' BATH TUB - -CROSS ST. COMPENSATION INSURANCE - - OWNE y SHOWER - ' (This section need not be completed if the work involved by. MAIL . the permit is for one hundred dollars ($100)or lass.) LAVATORY -- ADDRESS 7 I certify that in the performance of the work for which this per- .SINK.. mit.is issued;.) shall not employ any person in any manner so - CITY TEL. NOLj<J�- Z as to become subject to the Workers'Compensation Laws; DISHWASHER ' CONTRACTO -C Date Applicant - CLOTHES WASHER NOTICE TO APPLICANT: If, after making'this Certificate of Ex- ADDRESS p emption, you should become subject to the Workers'Compen- SWIMMING POOL RECEPTOR f.' _ sation provisions of the Labor Code;you must forthm with comp- LAWN SPRINKLER SYSTEM CIT ��/[' TEL N0j�1_S/Lf- ly with suchprovisions or this permit shall be deemed revok- - - STATE n G / LIC. .Lc ed. . . - WATER HEATER LICENSE NO. /� J f 6 CLASS-20 x:56 -8 LICENSED CONTRACTORS DECLARATION �DLWRICT NO. OCESSED I hereby affirm that ham GAS SYSTEM OUTLETS licensed under provisions of Chapter t 9(commencing wilh Section 7000)of Division 3 of the Business OUTLETS OVER U fed Professions Code, and my license is-in full force and ef- 5 PER SYSTEM FINAL VALIDATION a q se - - Jcense Number 2 J/37 6 Lic. ClobC"lli G"//�) - DATE _ - - O FINA cccc Contra .x BY O QI'omexempt u er Sec � � -� � W y B 8P"C. for this reason - - D to .. Plan check fee t Dae: • PLUMBING PERMIT ISSUING FEE 5 - -Signature) TOTAL FEE - - _ SINGLE FAMILY HOME OWNER-BUILDER DECLARATION - - Plancheck applicant , I hereby affirm that am exempt from the Contractor's License Name- S' Low for the following reason (Section 7031.5,-136siness and Professions Code): .- s,Address - - • I, as owner of the property, will do the work and the City Tel. No. - - .ilJ7 ;}j I,5;0 structure'i's not intended a,offered for sale(Section 7044, D i s TEM= Business and Professions Code). - - ' CONSTRUCTION LENDING AGENCY TOTAL 4b'- 50, 1 hereby affirm that there is a construction lending agency fory - _ -It X (r� rr(� the performance of the work.for which this permit is issued - (Sec. 3097, Civ. C.). - - - - CHANGE - • ,Oji Lender's Name - Lender's Address - • I, _ I ICdI 111 t-ILLI_1 +r i I certify Ihci have read this applicationand state that the '' 10714 + AN 1�L t . above information is correct. I agree to comply with all County D ordinances and State ws regulating Plumbing, and hereby authorize repres to ves of this County to enter upon the - above- ntione pert f h ---1? %IdSEE REVERSE FOREXPLANATORYLANGUAGE f Signature 'P inee ate + WORKERS' COMPENSATION DECLARATION APPLICATION PP IC TION FOR PLA A BING 'PERMIT 'eby, affirm that I have a certificate of consent to self in- � b�ADPW 4/B] P9 IL i"i Ytl YJ�H�ID II CI Ir ,Hi t� r a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) ' H'coEyy thggr�egqf((Sec.3800, Lob.C ir5a a o A4`tSY 073 COUNTY-� �Kj � COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS - lomP Y . Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) - BUILDING (•/ _ Certified copy is filed with the c nty'building inspection ADDRESS 22bill �JA It d par tment. NUMBER FIXTURE OR ITEM @ FEE LOCALITY - CMPL� LI ;� WATER CLOSET(TOILET) Date ' ~�Applican� _ NEAREST _LLD �� „ r - CERTIFICATE OF EXEMPTION R M RKERS' BATH TUB CROSS Si. - A. COMPENSATION INS ANCE SHOWER OWNER �K�I I„ _ (This section need not be completed if the work Involved by MAIL •the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS d PZ I certify that in the performance of the work for'which.this per- ;• - mit is issued, I shall not employ any person in any manner so SINK CITYT ^ TEL. NO.. g� �j�7 as to become.subject to the Workers' Compensation Laws. DISHWASHER [' C 7. CONTRACTOR V S S Date ApplicantCLOTHES WASHER - _ ADDRESS P� NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption, you should become subject to the Workers'Compen- CITY GLH !?� TEL. NO.`7�7!' !'L. 96 sotion provisions of the Labor Code,.you must forthwith comp- ly LAWN SPRINKLER with such provisions or this permit shall be deemed revok- - STATE •HCl^•fir rj, Z LIC. C'/^G ed. WATER HEATER LICENSE NO. Jr5 / / V LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that.I am'licensed under provisions.of Chapter GAS SYSTEM ( OUTLETS f n O 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER [/G Esc—s/ci and Professions Code, and jmy license,is in full force and ef- 5 PER SYSTEM FINAL 7 :8_� / VALIDATION >_ ajg]7 V CJl0_ DATE J o 0 License Number Gc. Class 0 pp y, d FINAL Contractord,i 5:l Q��Date �j4 q2 BY �` /v" O I am exempt under Sec. - W a B.BP.G'fof this reason - D Z Plan check fee � , Date: PLUMBING PERMIT ISSUING FEE $ �3 Signature - .. TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name Law for the-following reason (Section 7031.5, Business and .�;•.�:7, A Pr ofessions'Code): Address t '7 1, as owner of the property,. will do,the work and the City Tel. No. structure is not intended or offered for sale(Section 7044, _ _ { ±TH!_; Business and Professions Code). CONSTRUCTION LENDING AGENCY D 10TAL =0 e'1 .. I hereby-affirm that there is o construction lending agency for L_i1Ct_i. _,:+fJ the'performance of'the work for which this permit is'issued - (Sec:-3097, Civ. C::). C jHNGF ISE' Lender's Nome • Lender's Address . rr 0 I certify that I have read this application and state that the 'tart •. HSI h above information is correct. I agree to comply with all County _ D ordinances and State lows regulating Plumbing, and hereby - out r e representor' es of this County to enter upon the a ave- c boned pr p y{ r spection purposes. r '12 2-7- 91) SEE REVERSE FOR EXPLANATORY LANGUAGE Signatur f Pe ittee Date - COUNTY OF LOS ANGELES TEMPLE CITY N 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LASTUNAS - PL 0508 0609150003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 13805 LT: 29 9822 BROADWAY FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802633 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BALDWIN 8588-016-004 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE. 597_ GRID: A3 LOC_ALITY.: TEMPLE CITY, C OS BACKFLOW DEVICE(S) 1.00 DEV 16.20 TENANT: 17 FLOOR DRAINS) 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 25 LAVATORIES/SINKS 1.00 FIX 16.20 09/15/06 SK 03/14/07 29 ROOF DRAINS) 1.00 FIX 16.20 OWNER: TEL. NO: 45 WATER CLOSET/URINAL 1.00 FIX 16.20 FINAL DA H�"A"�L BY: CODE: BECKWITH CHARLES E;.3OANNE K (626) 287-2820- TOTAL FEES 108.75 /\I Il 9822 BROADWAY n TEMP 917BO2633 DESCRIPT =OF'WOR PLUMBING FOR BATHROOM REMODEL APPLICANT: TEL. NO: WENDY WILSON S ASSOC. (626) 484-2161- 708 W. SIERRA MADRE SPECIAL CONDITIONS: SIERRA MADRE 91024 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE CHARLES MYRICK 1818) 371-3610- 1312 HIGHLAND AVE LIC. NO - �' '0 UNDER SLAM WORK DUARTE, CA 91010 849976 B - WATER SERVICE PLASTIC YIN METAL YIN ARCHITECT OR ENGINEER: TEL. NO: CALCIVIC ENGINEERING (818) 790-0473- ROUGH PLUMBING 4929 RUPORT LN. LIC. N0: - LA CANADA FLINTRIDGE, CA NONE GAS PIPING GAS VENT HOT WATER HEATER PLUM9ING FIXTURES LAWN SPRINKLERS - GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY 4 0508 PLUNBING PERMIT DEPARTMENT OF PUBLIC WORKS 9901 LAS TUNAS PL 0508 1206110042 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID BUILDING ADDRESS: 1 ITS: 13805 LT: 29 1 9822 BROADWAY _IEEE DESCRIPTION: QDANTITY: ❑OM: AMOUNT: ( TEMP CA 917802633 (ASSESSOR INFORMATION NUMBER: 1I NEAREST CROSS STREET: 1 18588-016-004 101 PERMIT ISSUANCE FEE .29.80 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl 1 140 WATER HEATER(S) 1.00 WTH 16.20 TENANT: I TOTAL FEES 44.00 11SSUED ON: PROCESSED BY: PLAN BY: 106/11/12 SR TOWNER: TEL. NO: /1 ( 'E FI1 B CODE: BECKWITH CHARLES E;JOANNE K (626) 287-2820- Il /�z 9822 BROADWAY TEMP 917802533 DISC'R TION F WORK R PLACE WATER HEATER APPLICANT: TEL. KHACHENJAN, MARINE (818) 982-6852- j 1SPECIAL CONDITIONS: � 11 I 11 (CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE PLUMBING INSTALLERS (818) 982-6952- 1_ 113400 SATICOY STREET LIC. NO IUNDSR SLAB WORK 1425 915215 1NORTH HOLLYWOOD CA 91605 WATER SERVICE I I (PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. NO: - ROUGH PLUMBING LIC. NO: 1GAS PIPING -- I IGAS VENTI ` IHOT WATER HEATER PLUMBING FIXTORES I I I 1 LAWN SPRINKLERS I I I 1GAS TEST I I I 1UTILITY COMPANY NOTIFIED( (GRAY WATER SYSTEM I I I 11 I I I I 11 1 i 11 I I I I I I I I 1 I I I I (REPORT ID: DPR263 ROUTE TO: BS0508 I I I I I I