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Home My Public Portal About6154 BURTON AVE_Plumbing__ TION WORKERS'that t I have a certificate of corse APPLICATION FOR PLUMBING PERMIT 1 hereby affirm That have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) orlcertified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES // BUILDING AND SAFETY Pal ❑icy�NQ. �Q� Company 3r �'E' fc'i`•(y Certified copy is hereby furnished. FOR APPLICANT i0 FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS tion deport ent. NUMBER FIXTURE OR ITEM C FEE / LOCALITY �L Date ;S2i �� Applicant � WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CR O55 ST. LGx'7 r COMPENSATION INSURANCE / SHOWER OWNER ,e (This section need not he completed if the work involved by the permit is for one hundred dollars ($100)or less.) LAVATORY MAIL ADDRESS I certify that in the performance of the work for which This permit is issued, I shall not employ any person in any manner SINK CITY 5 L TEL. NO. so as to become subject to the Workers'Compensation Lows. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS _5 %I, Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY �� TEL. NO. LAWN SPRINKLER SYSTEM p } with comply with such provisions or Ihis permit shall be STATEmay,! LIC. p deemed revoked. WATER HEATER LICENSE NO._V'. L� CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. ROCESSED BY I hereby affirm that GAS SYSTEM OUTLETS e am licensed under provisions of Chapter 9 Q (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER O. and Professions Code,and mmyylilicennse is in full force and effect. 5 PER SYSTEM FFIIAN EL �— VALIDATION V License Numnb)ef%2';4 , Y Lic. Class -"IF ContractQr/� 6 / ` Date s^ BY AL �- / V ❑ ++ 1L I am exempt under Sec. N B.BP.C. for this reason ► Plan check fee Date: PLUMBING PERMIT ISSUING FEES � O Si nature B TOTAL FEE - 1 Q fi r Plan check applicant 7: r 0 0 0,0 5 SINGLE FAMILY / HOME OWNER-BUILDER DECLARATION Name �- ��y .( a 4 6. S_ C I hereby affirm that I am exempt from the Contractor's License [Address G'/r� w/' ' Low for the following reason (Section 7031.5, Business and - ' u 4 6 5 (� Professions Code): City Tel. Ngg7�'�`r/lam S C 13-P3 I, as owner of the property, will do the work and the structure is not intended ar offered for sale (Section pool7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for s the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Leader'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 Stale laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above entione operty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date 7 , W ' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affifirmrm that I have a certificate of consent to self 76A667A insure, or a certificate of Worker= Compensation Insurance, CE 817(REV. 10/81) ` or o certified copy thereof (Sec. 3800, Lob. C. COUNTY OF LOS ANGELES BUILDING=AND SAFETY Policy No. Company Certified copy is hereby furnished. FORAPPLICANT TO FILL IN(PRINT OR TYPE) BUILDING F-1Certifiedcopy is filed with the county building inspec- ADDRESS tion department. NUMBER FIXTURE OR ITEM r@ FEE LOCALITY Date Appliront WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE OWNER (This section need not be completed If the work involved by SHOWER the permit Is for one hundred dollars ($100)or less.) LAVATORY MAIL ADDRESS certify that in the performance of the work for which this SINK CITY / L TEL. NO. permit is issued, I shall not employ any person in any manner , �sr. (�7Q-/3�(7% so as to become subject to the War mpensation Laws. DISHWASHER CONTRACTOR 4D on w✓ Applica t - CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, a r making this tertificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY U`�i s�� TEL NO LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE (3�[—� LIC. O deemed revoked. WATER HEATER LICENSE NO. G J CLA55 LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROO ED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETSll (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER v and Professions Code, and my license is in full force and effect. 5 PER SYSTEM FINAL VALID ION • DATE � a License Number Lic. Class U FINAL U Contractor Date B d ' I am exempt under Sec. OF U 8.8P.C. for this reason W Plan check fee ► a.- Date: N PLUMBING PERMIT ISSUING FEE$ Z Signature TOTAL FEE EM-5-V Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I herebyoffirm that I am exempt from the Contractor's License Address /j'�'� TJ a Low for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. peeeee5 El I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section , ( o - 1650 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY o o e 16505 1 hereby offirm that there is a construction lending agency for the performance of the work for which this permit is issued 0 a 2 l —86 (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 lows regulating Plumbing, and hereby authorize r��entatives of this County to enter upon the abo ti ed property for inspect' n put oseS. P. y/ SEE REVERSE FOR EXPLANATORY LANGUAGE i e Signature of Permittee I Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1103190015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: ( FEES PAID BUILDING ADDRESS: 1 (TR: 29475 LT: 10 6154 BURTON AV N I (FEE DESCRIPTION: QUANTITY: BOM: AMOUNT: [ SGAB CA 917752653 (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: 15386-007-071 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY, CI 1 107 BATHTUBS/SHOWERS 1.00 FIX 16.30 [ 1 TENANT: 125 LAVATORIES/SINKS 1.00 FIX 16.30 11SSUED ON: PROCESSED BY: PLAN BY: 1 145 WATER CLOSET/URINAL 1.00 FIX 16.30 103/17/11 SR I I I TOTAL FEES 76.70 1 1 OWNER: TEL, NO: I IFINAL -(DATE FINN1LL�AY: CODE: I 16054, PBI CHING (626) 782-2550- I• 1 I�� l 16154 BURTON AVE. SAN GABRIEL CA 91775 1 IDE R PTION OF WORK I (PLUMBING FOR NEW BATHROOM (APPLICANT: TEL. NO: 1 11 1 SAME AS OWNER - ISPECIAL CONDITIONS: I CONTRACTOR: TEL. NO: [APPROVALS DATE INSPECTOR SIGNATURE [SAME AS OWNER LIC. NO UNDER SLAB WORK [ [WATER SERVICE PLASTIC YIN METAL YIN [ARCHITECT OR ENGINEER: TEL. NO: I ROUGH PL U ffiING _n / LIC. N0: h �� `N [GAS PIPING I II I [ I GAS VENT ( I IHOT WATER HEATER PLOMBING FIXTURES [ (LAWN SPRINKLERS IGAS TEST [ I I I [UTILITY COMPANY NOTIFIEDI I I II II IcwV I I I (GRAY WATER SYSTEM I I I I I I I I II I I [ I I I I I I II 11 I I I II I I I I I I I I I I 1 (REPORT ID: DPR263 ROUTE TO: BS0508 I I I I I I • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9901 LAS TUNAS PL 0508 1306100014 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0486 EXT: (LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 29475 LT: 10 1 6159 BURTON AV N I IEEE DESCRIPTION: QUANTITY: OOM: AMOUNT: ( SCAB CA 91]]52653 1ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LONGDEN 15386-007-071 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY CAI 1 107 BATHTUBS/SHOWERS 1.00 FIX 16.20 1 ITENANT: 25 LAVATORIES/SINKS 2.00 FIX 32.40 (ISSUED ON: PROCESSED BY: PLAN BY: 1 145 WATER CLOSET/URINAL 2.00 FIX 32.40 106/10/13 SR 1 163 WATER PIPING BR/FIX 3.00 FIX 20.40 1 1OWNER: TEL. NO I TOTAL FEES 129.20 IF AL DATE FINAL CODE: IWONG, VENA (626) 782-2550- 1 1 �� 1 16154 BURTON AVE I I� ITEMP 91]801]56 IDE CRIPTION OF WORK I ISATHTUE, LAVATORIE, 2 WATER CLOSETS, SINK AND REPIPE 3 1 1 IPLUMB ING FIXTURES (APPLICANT: TEL. NO: TAN YEW K (626) 25]-8900- 16]03 N GOLDEN WEST ISPECIAL CONDITIONS: IARCADIA CA I I I CONTRACTOR: TEL. NO: I JAPPROVALS DATE INSPECTOR SIGNATURE POLYVISION LAND CORP (626) 257-8900- 1 1 16703 N GOLDEN WEST LIC. NO I (UNDER SLAB WORK ARCADIA CA 91007 NONE I I IWATER SERVICE IPLASTIC YIN METAL YIN ARCHITECT OR ENGINEER: TEL. NO: (ROUGH PLUMBING LIC. NO: IGAS PIPING GAS VENT IHOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST I (UTILITY COMPANY NOTIFIED( GWS GRAY WATER SYSTEM I I I I I I I I I i � 111 I 1111 1111 I 1 lI 1111 11 I I 111 I 1111 I I I IREPORT ID: DPR263 ROUTE TO: BS0508 I