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Home My Public Portal About5425 CAMBURY AVE_Plumbing__ 7eA6a I> a-50 APPLICATION FOR PERNUT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER _ FOR APPLICANT TO FILL IN DISTRICTNO. GROUP ZONE PERMIT NO. VALLt is u. �flco37 — to PLUMBER RECEIVED BY READY FOR /�DATEISSUED LC N FIRST INSPECTION /A —jo/ ADDRESS .JLiviAl. Z-Z/1.; BUILDING i//� /U� _ ,Ill/l.'•� /rr CITY ,,,, TEL Ik.. 5 ADDRESS .'. Vl P/ / COUNTY n - DSIIJ LOCALITY ._ wn / LICENSE NO. EXPIRES NEAREST PERNUT FEES CR'..ST. OWNER NUMBER TYPE OF FI%TURF OR ITEM � tlFEE MAIL WATERCLOSET (TOILET) C. 0.50 S �7IL ADDR EBB 7 �y��///✓ _.QKJ -A_/l�+- /�Xnf/'/l/�W/ 'D BATHTUB @ 0.50 CITY/Ji9m .!/� TEL. NO-4P 413J SHOWER @ 0.5011 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS O APPLICATION.AND STATE THAT THE ABOVE IS CORRECT AND LAVATORY (WASH BASIN) @ 0.50 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND / KITCHEN SINK @ 01501 STATE LAWS REGULATING PLUMBING. I CERTIFY THAT i POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.501 D OF THE ANGELES COUNTY LICENSE. OR 1 AM BTHEED LEGAL OWNER OF THE RESIDENTIAL-PROPERTY DESCRIBED ABOVE. GAS SYSTEM OUTLETS @ 0.50_, � 7.q� SIGNATURE OF WATER HEATER @ 0.501 CITU PERMITTE, �C��'/��LGClJ�1lf1HfY L1.L} I SLOP SINK @ .5INSPECTION RECORD U > II FLOOR SINK @ 0 O.SO0 I _ J FLOOR DRAIN @ O.SOI DISHWASHER @ 0.50 � DRINKING FOUNTAIN (ill O.SOI_ URINAL @_O_50 ,J I HOUSESEWER @ 0.50 1 Q MISCELLANEOUS C Q I APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING VI GAS PIPING GAS VENT CESSPOOL @ 1.001 CESSPOOL SEPTIC TANK: SEPTIC TANK SEWER PERMIT . I.oo GAS TEST ' UTILITY CO. NOTIFIED TOTAL FEE $ ��''Q Gi . FINAL �` .':DE Joeq IT I,-so DEPARTMENT OFLOS NG AND SAFETY' COUNTY J. FF LOS APPLICATION FOR PERMIT ANGELES by p 0� "U WILLIAM J. FOX, CHIEF ENGINEER D STR N. . RO P O . FOR APPLICANT TO FILL IN PLUMBER GENERAL INSTA 1 TRECEIVED BY READY FOR DATE ISSUED FI INSPECTION r ADDRESS 311 E. 80th STREET L. A. 3 — 'I iz 70, Leasant 3.2541 BUILDINGL ..''lI CITY TEL No. ADDRESS �r/...� Q 7H 14!=Lk COUNTY' 'i. LOCALITY LICE NSE=:ND; __ n EXPIRES NEAREST PERMIT FEES CROSS ST. I' 1 til . NUMBER TYPE CF FIXTURE OR ITEM FEE OWNER / p MAIL bhl WATER CLOSET(TOILET) 0.50 S ADDRESS b l BATHTUB @ 0;50 CITY TEL NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB DR TRAY @ 0.50 ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER OF THE RESIDENT%L PRI31PEZ DESCRISED ABOVE. GAS SYSTEM OUTLETS @ O.SO SIGNATURE OF�Y- WATER HEATER @ 0.50 PERMIT SLOP SINK @ O.SO INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ D.SO URINAL @ 0.50 J Q HOUSE SEWER @ 0.50 Z MISCELLANEOUS D APPROVALS DATE INSPECTOR'S NAME ROUGH PWMBING GAS PIPING GAS VENT CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 1 SEWER PERMIT 1.00 GAS TEST UTILITY CO. NOTIFIED TOTAL FEE 8 —`� FINAL WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT r I hereby,affirm that I have a certificate of consent to self 76A687A n insure, or a certificate of Workers' Compensation Insurance, CE 817(REV.8/88) or a certified copy thereof (Sec. 3800, Lab- C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING F-1 Certified copy is filed with the county building inspec- ADDRESS lion deportment. NUMBER FIXTURE OR ITEM C4i FEE LOCALITY WATER CLOSET Date Applicant 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 MAIL the permit Is for One hundred dollen ($100)or bas.) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person inanymanner SINK CITY TEL NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant 1 CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL. NO. LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC ' deemed revoked. WATER HEATER LICENSE NO. i - CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VALIDATION r DATE License Number , Lic. Class FIN.J BY AL `I �. Contractor 1 t - Dale C ❑ 1 am exempt under Sec kms". B.BP.C. for this reason , a. Plan check fee Date:- PLUMBING PERMIT ISSUING FEE$ h Signature �f. TOTAL FEE Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address Low for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. ❑ 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. f agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the abov menlioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508PLUMBING-PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS (PL 0508 9805.150014 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA `- PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 17002 LT: 28 r5425-CAMBURY AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: \TEMP CA-917802640 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8588-020-002 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY 47 WATER HEATER(S) 1.00 WIN 16.35 TENANT: 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.35 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: TOTAL FEES 60.45 05/15/98 UT 05/15/99 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: UNIVERSAL LIFE CHURCH INC �(�_/J� 4801 BIRCHLAND PL lG 17 TEMP 917804013 DESCRIPTION_OF-WORK- RELOCATE -WATER HEATE APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: PTAGELES Co --'°ACTOR: TEL. NO: p°✓ �/,. APPROVALS - DATE INSPECTOR SIGNATURE SHri._ OWNER - V WATER SRV,,-FK WATER C YIN F ARCHITECT OR ENGINEER: TEL. N0: 1 PLASTIC YIN i�;;TAL YIN - - ROUGH PLUMBIN LIC. N0: L.- _ . _ GAS PIPING GAS VENT HOT WATER HE ER PLUMBING FIXTURES y�• j �� __ - �„� LAWN SPRINKLERS GAB TEST ,(.�� ICl �•� UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTE -a REPORT ID: DPR263 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 (PLUMBING -PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL-0508'9901.280013 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 --�— PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING.ADDRESS: TR: 17002 LT: 28 55425- CAMBURYIAV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802640 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8588-020-002 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID:6A4 LOCALITY: TEMPLE CITY 65 WATER PIPING 2-3 IN 1.00 LIN 50.55 TENANT: TOTAL FEES 78.30 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 01/28/99 UT 01/28/00 OWNER: TEL. NO: FINAL DATE FINAL BY: �J LODE: UNIVERSAL LIFE CHURCH INC 4801 BIRCHLAND PL L l 111111 TEMP 917804013 DE5CRIP�TION- F-WORK— NEW 3_I NCH_P.I P.E.FOR.DRAI N.L--INE APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: PNGELES CO CONTRACTOR: TEL. NO: �S L�/J. APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO UNDER SLAB WORK WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. NO: �L ROUGH PLUMBING LIC. NO: llllltl GAS PIPING U�LW0�KS GAS VENT HOT WATER HEATE c ,4 sy PLUMBING FIXTURES \ vu y`- �� LAWN SPRINKLERS Q O r)d II - GAS TEST A O D ® ®6 UTILITY COMPANY NOTIFIED V6%%C t IOt Service -po WV RAY WATER SYST M REPORT ID: DPR263 ROUTE TO: 850508