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Home My Public Portal About9963 BROADWAY_Plumbing__ ^3 — lf „r y DEPARTMENT OF COUP= ENGINEER P L U M B ' N V DIVISION OF BUILDING AND SAFETY �dZI PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDING WILLIAM J. FOX, COUNTY ENGINEER ADDRESS p ��(/0—„�•y'�•y(�/ FOR APPLICANT TO LL IN LOCALITY BUILDING NEAREST ADDRESS CROSS ST. DISTRICT Q. GROUP ZONE P ERM NO LOCALITY 6 NEAREST CROSS ST. RECEIVED BY Ready for InsOectlsn DATEpISSU E�D�["//� OWNER /J1�'q�t�L NOW s INDUSTRIAL MAIL ADDRESS Same WASTE APPROVAL CITY TEL.ND. INSPECTION RECORD PLUMBER GENERAL INSTALLATION CO. � _`� ADDRESS 311 E. 80th Street L.A. 3 ,�✓�'�'y�� %��_l�r ^�-^ �� CITY TEL.NO. Pleasant 3-2541 36-123470 ❑STATE LICENSE NO. 787 n COUNTY J PERMIT FEES i JU.EIER TYPE OF FIXTURE OR ITEM FEE E WATER CLOSET(TOILET) @ 0.80 $ 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 GAS SYSTEM..............OUTLETS @ LOD WATER HEATER @ 1.00 MISCELLANEOUS WATER SOFTENER 1 00 APPROVALS DATE INSPECTOR'S SIGNATURE UNDERSLAB WORK PERMIT $ 1 00 ROUGH PLUMBING TOTAL FEE 2 GAS PIPING OD , 1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI. GASVENT CATION AND STATE THAT THE ABOVE AIS CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINNCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN• ER OF THE ABOYE DESCRL13ED RESIDENTIAL PROP RJY. UTILITY CO.NOTIFIED SIGNATURE S � OF PERMITT _.. .....__..... ._ _ _........_...... .. FINAL 76AG67 DBS 17 1/53 411, APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES r. WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP zO E P RMIT NO. ROUGH _ FIXTURES OM 5 6"/G 8 / HEATER I—I CESSPOOL (�ISEPTIC TANK RSC/ /_ Erv�D'`BY D-T6q,I-6UED READY FOR 9 FIRST INSPECTION GAB MISCELLA EOU APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY _�- `/.-� G� JOB R, HANE 4:Y1 (�/� K.`s•1i'�"K�r C.•..' �/ � C.ADDRES6. ADDRESS , .�J/J/ 4i ��./dem e,a n.. LOCA yCin _ .�:f' /..(iLTF-1= NO•,cat CR09 .e.! COUNTY" b " CERT.NO. E%PIRES S NAME d/ LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL.NO. 1 AM THE LEGAL POSSESSOR OP THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QQ�UALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED q ABOVE. 3 OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK Q z_ BATH TUB FURNACE 13 SHOWER DISHWASHER D LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR BINK SANDTRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INEP[OTOR'•KAM[ WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER GAS SODA FOUNTAIN GAS PIPING I I OUTL GAB VENT I I CESSPOOL _�TOTAL NUMBER OF FIXTURES L]�.� SEPTIC TANK I I CESSPOOI SEPTIC TANK / L� •� SEWER S UTILITY CO.NOTIFIED TOTAL FEE FINAL D.B.S.-17 25M SETS C-46 APPLICATION FOR PERMIT DEPARTMENT OF 'BUILDING AND SAFETY COUNTY OF LOS ANGELES �` , Wm. J. FOX. CHIEF ENGINEER F=GA TURE OF INSTALLATION DISTRICT-No. GROUP ZO ff P RMIT NO. FIXTURES GH HE MEB SPOOANE IUB SEPTICTANK ��/�//RECEIVED BY READY FOR DATE ISSUED CSi� // L. FIRST INSPECTIONPPL ANT ILLI EAVILY OUTLINED PORTION ONLY.IoB ADDRESS LOCALITY NEAREST TEL.No. (. CROSS ST. . EXPIRES -�b K NAME M LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL 3 ADDRESS NORTH O CITY 7ER 1 AM THE LEGAL PABOVE L ANGELES COUNTY CERTIFTION,RiAM THE LEGAL OWNDESCRIBED ABOVE. D CORRECTIONS SOUTH J DESCRIPTION OF WORK O o, It 0 s t s ' z _BATH TUB FURNACE A n +C� '/J Q, // �HOWER DISHWASHER _LAVATORY REFRIGERATOR / KITCHEN BINK WATER SOFTENER j /d .v`f FLOOR SINK SANOTRAP SLOP BINK FLOOR DRAIN —Y WASH TRAY /L URINAL APPROVALS --L—WATER CLOSET V DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER� GAS PIPING GAS SODA FOUNTAIN I,-33-y) OUTL _ GAS VENT I CESSPOOL I I TOTAL NZI=EPTICTANKSEWER OF FIXTURES SEPTIC TANK I CESSPOI I B UTILITY CO.NOTIFIED I (O�1 y - I O TOTAL FEE '6 FINAL WORKERS' COMPENSATION cafe of corse .-. APPLICATION FOR PLUMBING PERMIT hereby affirm that have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10781) or o certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy Na. Company Certified copy is hereby furnished. / /� ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) LDING ADIDRESS 6 (Y. r Certified copy is filed with the county building inspec- NUMBER FIXTURE OR ITEM tion departmepp t. C� FEE LOCALITY l `r_� I iJW ��II" WATER CLOSET NEAREST Date A licant CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST. COMPENSATION INSURANCE OWNER eo�! (This settlor need not be completed if the work involved by SHOWER ^[ the permit is for one hundred dollars ($100)or less.) LAVATORY MALI RE55 /II I certify that in the performance of the work for which this 111+ permit is issued, I shall not employ any person in any manner SINK CITY..E.p� C�� TEL. NO.� so as to become subject to the Workers'Compensat(iIoon` Laws. DISHWASHER 1 � CONTRACT ORSC) Date Applicant 111CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS YEA�` C e- Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR r. ' Compensation provisions of the Labor Code, you must forth- CITY LLJrOI N TEL. N05�Jr� with comply with such provisions or this permit shall be LAWN SPRINKLER SYSTEM STATE LIC. / I deemed revoked. WATER HEATER LICENSE N0.313�6 N5' CLASS G- �6 LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER N :and Professions Code,and/may license is in full force and effect. 5 PER SYSTEM FINAL r.., / VALIDATION d ( License Number3)1067 � Lic. Class^� y DATE `rte/ ��[� V G,�,, FINAL 1'ConnactorSzry0eTq41C ✓01-'rDate 9-itil—'I BY C O ❑ I am exempt under Sec. 8.8P.C. for this reason N1, r/ Plan check fee Z Date: �'�`t � ��( PLUMBING PERMIT ISSUING FEE S 957S'gnature OTAL FEE Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 1 1 H C A I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and 0 0 0 0 0 5 Professions Code): City Tel. No. ' ❑ I, as owner of the property, will do the work and the P-.- 71050 structure is not intended or offered for sale (Section 7044, Business and Professions Code). °.�. v.J e ^. t CONSTRUCTION LENDING AGENCY (i S 1 4 -84 1 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-menfione4 property for inspection purposes. .�/MQ 0 SEE REVERSE FOR EXPLANATORY LANGUAGE •7 l / � Signature of Permittee Dote COUNTY OF LOS ANGELES TEMPLE CITY # 0508LUMSTNG P IT DEPARTMENT (IF PUBLIC WORKS 9701 LAS TUNAS CP1-0508-9906100015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL D: FEES PAID BUILDING ADD SS: TR: 13805 LT: 2 99_63-§ROADWAY FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: tEjjP_CA-91'7802635 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8588-015-002 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY 47 WATER HEATER(S) 1.00 WTH 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 06/10/99 UT rA 12/07/99 OWNER: TEL. NO: FINAL D TE CODE: HENSON FRANCES A - / 9963 BROADWAY (004. Q TEMP 917802635 DESCRIPTION UF WUKK/ CHANGE-OUT-9F-VAF -HEATR APP CA : TEL. NO: MARSH PLUMBING (818) 407-1247- 7229 VARNA ST. _ SPECIAL CONDITIONS: N. HOLLYWOOD, CA - - I.J F,��GELES . CONTRACTOR: TEL. NO: ��/,, APPROVALS DATE INSPECTOR SIGNATURE MARSH PLUMBING (818) 407-1247- J • 7229 VARNA AVE. -- LIC. NO UNDER SLAB WORK .. NORTH HOLLYWOOD, CA 91605 16425B/L WATER SERVICE 1 /�! " PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. NO: - ROUGH PLUMBING LIC. N0: I� ( GAS PIPING GAS VENT li HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED Serce Yhaq�0 CWV vi c GRAY WATER SYSTEM * ADDITIONAL DATA ON FILE REPORT ID: DPR263 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY K 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0704190011 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 265-0488 EXT: (LEGAL ID: FEES PAI➢ BUILDING ADDRESS: ITR: 13805 LT: 2 9963 BROADWAY (FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: ( TEMP CA 917802635 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BALDWIN 18588-015-002 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl 147 WATER HEATER(S) 1.00 WTH 16.20 TENANT: i TOTAL FEES 43.95 11SSUED.ON: PROCESSED BY: PLAN BY: EXPIRES ON: 104/19/09 JK 10/16/07 OWNER: TEL. NO: (PINpZ, jJDATE FIN CODE: BENSON FRANCES A 19963 BROADWAY K TEMP 917802635 DESCRIPTION OF WORK IMOVE HOT WATER HEATER FROM I SIDE LAUNDRY ROOM TO OUTSIDE APPLI CANT: TEL. N0: BIENEK ROOFING CONSTRUCTION, INC. (000) 499-1340- 1 12 MCLAREN #H (SPECIAL CONDITIONS: (IRVINE, CA 92618 I I ICONTEACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE 1BIENEK ROOFING CONSTRUCTION, INC. (800) 999-1340- 1 12 MCLAREN #H LIC. NO 1UNDER SLAB WORK (IRVINE, CA 92618 885157 j WATER SERVICE ARCHITECT OR ENGINEER: TEL. NO: 1 (PLASTIC YIN METAL YIN - (ROUGH PLUMBING LIC. NO: GAS PIPING I I GA5 VENT . I HOT WATER HEATER PLUMBING FIXTURES ` I I I I I 1LAWN SPRINKLERS 1 GAS TEST _ (UTILITY COMPANY NOTIFI ED Cw GRAY WATER SYSTEM I I I I I I I I I I I I - (REPORT I➢: DPR263 ROUTE TO: BS0508 I I I I I