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Home My Public Portal About9914 BROADWAY_Plumbing__ ]6A66'/-CER81l 2-66 �_^ APPLICATION FOR PLUMBING PEFtI�IIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING h �] JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY An FOR APPLICANT TO FILL IN NEA SSTs . f,(��`-� NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS CI TEL. NO. SHOWER 1.25 LAVATORY LES CONTRACT R SINK 1.25 ADDRESS DISHWASHER 1.25 CITY TEL. NO. LAUNDRY TUB 1.25 STATE LIC ICENSE NO. CLASS CLOTHES WASHER 1.25 DIST CT NO. GRrP ZONE 17-ES ay— APPROVALS WATER HEATER 1.50 GAS SYSTEM-OUTLETS- - 1'50 s INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .00 INSPECTION RECORD U z 0 U W d N Z DATE INSPECTORE SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY TATE ACKNOWLEDGE THAT 1 HAVE READ TX19 APP KATION GAS VENT AN 9TATE THAT TME ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING, 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF.AND INTEND TO �lLt-GG RESIDE IN, THE ABOVE DESCRIBED RESIOENTI�RO ERTY. UTILITY CO. NOTIFIED SIGNATURE OF PERMITTEE FINAL � VALIDATIOU, , JACK R. ALLEN cK. M.o. CASH / SUPERVISING MECHANICAL ENG-R. L&5 3 1 6�8 OCT 17 5 D 725- IN WORKERS'COMPENSATION DECLARATION I APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to,self ' �6A667A. r insure, or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) / or a certified copy thereof (Sec 3800, Lob. C. n COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No�+ Ko pany S'FA P Fund' . Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with(J�}�{�,'e countI�yy bui1l in insfq#eec- ADDRESS y ",got +Q pc I,r/c� tion department. J4f006UtlCr$ ls'1G. NUMBER FIXTURE OR ITEM (rF FEE II- LOCALITY 1 eYut i c If Date 7-3o-Ry Applicant WATER CLOSET i NEAREST /� r CERTIFICATE OF EXEMPT N FROM WORKERS' BATHTUB — CROSS ST. LJ GA.'Q wi h Ave COMPENSATION INSURANCE SHOWER OWNER Mr II S ADDRESS (This section need not be completed if the work involved by the permit is for one hundred dollars ($100)or less.) ( LAVATORY [0 ' MAIL 9 I q r-QU W u I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner ISINK - CITY +e /e CFI TEL NO.LI slip-I3 O so as to become subject to the Workers Compensation Laws. DISHWASHER /'� f CONTRACTOR b K Dote Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY TEL. NO. t Compensation provisions of the Labor Code, you must forth- �1 Ors 7 yY-q 7� LAWN SPRINKLER SYSTEM L with comply with such provisions or this permit shall be STATE [� LIC. deemed revoked. ' WATER HEATER /c LICENSE NO.af 3 3 6q Z CLASS LICENSED CONTRACTORS DECLARATION C% DISTRICT NO. P OCESSED BY.� I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM -Z OUTLETS O (/ (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER a >' and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAVALIDATION d 0 License Number `1335-142 Li,. Class Q DAT K // FIN O Contractor n o 6v de /H note 7-30-&JBY 1- ❑ W I am exempt under Sec. w g B.BP.C. for this reason Plan check fee Op 3 7.�— ( PLUMBING PERMIT ISSUING FEE$ 'v S'gnaturer s ,f �Jo DM/ TAC TOTAL FEE (? Plan check applicant x3 1 3 2A SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name # 0 0 0 0 0 5 1 hereby affirm that I am exempt from the Contractors License 1 Law for the following reason (Section 7031.5, Business and Address zo'o 4 Q 50 Professions Code): City Tel. No. F F ❑ _ 40.50 I, as owner of the property, will do the work and the structure is net intended or offered for sale (Section , 8 0 1 -.84 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-menti ne property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE T-3o-8y ignature of Permittee Date _ ` COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0706050011 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 13805 LT: 37 I 9914 BROADWAY I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: I TEMP CA 917802618 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: BALDWIN 18588-016-012 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl _ 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 (TENANT: I TOTAL FEES 43.95 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1 106/05/07 SR 12/02/07 IOWNER: TEL. NO: 1FIy7Ai'�i��JJ,�� ,TE/) FjBY: CODE: (PERSON MEAL R;NANCY (626) 285-0441- I /�"�.Aly �111NJ 19914 BROADWAY I TEMP 917802618 1DESCRIPTION OF WORK 1GAS LINE TO OUTDOOR BBQ (APPLICANT: TEL. NO: SAME AS OWNER i ISPECIAL CONDITIONS: I II I I I I (CONTRACTOR: TEL. N0: (APPROVALS GATE INSPECTOR SIGNATURE (SAME AS OWNER LIC. NO 1 IUNDER SLAB WORK I I I WATER SERVICE IPLASTIC YIN METAL YIN (ARCHITECT OR ENGINEER: TEL. NO: I IROUGH PLUMBING LIC. NO: I I IGAS PIPING (GAS VENT IHOT WATER HEATER 1 I I IPLUM3ING FIXTURES (LAWN SPRINKLERS 1 (GAS TEST IDTILITY COMPANY NOTIFIED(-,]-� 'Cw 1 (GRAY WATER SYSTEM 1 I I I I I I IREPORT ID: DPR263 ROUTE TO: BS0508 I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0707240003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 13805 LT: 37 9914 BROADWAY (FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: 1 TEMP CA 917802618 (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: BALDWIN 18588-016-012 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl 11 CLOTHESWASHER(S) 1.00 FIX 16.20 1 ITENANT: 113 DISHWASHER(S) 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1 125 LAVATORIES/SINKS 1.00 FIX 16.20 07/24/07 SR 01/20/08 1 1 151 IOW PRS GAS 5 OUTLET 1.00 SYS 16.20 1 1 10WNER: TEL. NO: I TOTAL FEES 92.55 IF1NAL DATE FINAL FINAL BY: CODE: 1 IPERSON NEAL R;NANCY (626) 285-0441- 1 116-134 1 19914 BROADWAY ITEMP 917802618 1 IDESCRIP ION OF WORK IKITCHEN REMODEL REPLACE PLUMBING @ KITCHEN SINK, WASHER/DYERI I HOCK UP & MORE STOVE GAS LINE (APPLICANT: TEL. NO: 1 1 IWATSON (626) 836-8350- 1 1150 S. BALDWIN AVE ISPECIAL CONDITIONS: ISIERRA MARE 91024 1 (CONTRACTOR: TEL. N0: 1APPROVALS DATE INSPECTOR SIGNATURE 1 IWATSON CUSTOM CONSTRUCTION INC. (626) 836-8350- 1 1 1150 S. BALDWIN AVENUE LIC. NO 1UNDER SLAB WORK 1 1 ISIERRA MADRE, CA 91024 388016 B 1 1 1 1 1 IWATER SERVICE I I IPLASTIC YIN METAL YIN 1ARCHITECT OR ENGINEER: TEL. NO: 1 IROUGH PLUMBING LIC. NO: 1 I GAS PIPING GAS VENT 1 (HOT WATER HEATER (PLUMBING FIXTURES LAWN SPRINKLERS 1 I I1 1 IGAS TEST (UTILITY COMPANY NOTIFIED( I Gwv 1 1 GRAY WATER SYSTEM I I I I I IREPORT ID: DPR263 ROUTE TO: BS0508 I I I I I I