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Home My Public Portal About5033 CAMELLIA AVE_Plumbing__ DEC WORKERS't I have c certificate cafe of APPLICATION FOR PLUMBING PERMIT I hereby affirm that 1 have o certifirare of ransent to self /bAM7A w b, 99 City ,., �•r^ - - •insure or o certificate of Workers" Compensation Insurance, CE 817(REV. 10/BI) •City �0�J, 3'e^ie plo City or a certified copy thereof (Sec. 3800, Lob. C.) _ COUNTY OF LOS ANGELES `y BUILDING AND SAFETY Pal i'cy No. :001al 6 Company QC!J � - 't 1 Certified copy is hereby furnished. ;�. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ., j" Certified copy is filed with the county builrig inspec- _ ADDRESS '{ ys^,v •tion department. NUMBER FIXTURE OR ITEM- @FEE LOCALITY q y WATER CLOSET NEAREST *Date�. dq a.*^(a.r!Applicant �'fs$O�' <.4—�mdB. E CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB - - CROSS ST. TA 1;)iiel TJrJJVf,- COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work Involved by e the permit is for one hundred dollars $100)orJass. MAIL P _ ( J lAVA10RY - ADDRESS r+n V� AT A 'm 1 certify shot in the performance of the work far which this _ permit is issued, I shall not employ any person in any manner SINK CITY r TEL. NO. so os to become subject to the Workers'Compensation Laws. DISHWASHER" - -- CONTRACTOR Date Applicant CLOTHES WASHER l ADDRESS NOTICE TO APPLICANT; If, atter making this EPltificate of -O Exemption, you should become subject to the-Workers SWIMMING POOL RECEPTOR - ' CITYTEI. Na Compensation provisions of the labor Coda, youLAWN SPRINKLER S must forth- SYSTEM R with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER '- LICENSE NO.]L 1 .' CL LICENSED LICENSED CONTRACTORS DECLARATION g 6 ®_ DISTRICTLJO. - PROCESSED BY GAS SYSTEM OUTLETS r I hereby affirm that I am licensed under provisions of.Chapter 9 Y e � '='' ;•,� ' ' (commencing with Section 7000) of Division 3 of tFie Business OUTLETS OVER �`� ,'�.-.yp C., ,.~` 6�.' and Professions Code, and my license is in full force and effect. 5 PER SYSTEM' alt, INAL VALIDATION O .��03CI 0.411 DATE U License Number Lic. Class--.: '". Ld FINAL Contractor 717 .0 2212' i" Date 6ACs - 'BY t% I am exempt under Sec. j Q B,&P.C. for this season plan check fee 4: Date: d� PLUMBING PERMIT ISSUING FEE$ Signature - • TOTAL FEE f'-I fm Plan check applicant SINGLE FAMILY - HOME OWNER-BUILDER DECLARATION' Name I hereby affirm that I am exempt from the Contractor's License a Law for the following reason (Section 7031.5, Business and Address - -y Professions Code):' - ' ❑ .. ,. _ City�,, Tel. No. I, as owner of the property will do the work and the structure is not intended or offered for safe (SectionT'► 7044, Business and Professions Code). "e,jot le,nt n 1 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for • �� as,"� the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). +. ileIglh; 'a kp''.5y ' Lender's Name (�rflsh e'f FU.Yi Lender's Address - - I certify that I have read this application and state that Ahe 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 entet upon the above-mentioned property for Inspection purposes. _ SEE REVERSE FOR EXPLANATORY LANGUAGEy - Signature of Perri Date 7BA667 17 6-50 it APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING ��' COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO. PLUMBER RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS BUILDING CITY TEL. NO. ADDRESS COUNTY LOCALITY LICENSE NO. EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET (TOILET) @ 0.50 $ 1 ADDRESS BATH TUB @ 0.50 I CITY TEL. NO. SHOWER @ 0.50 I 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ 0.501 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ 0.50 STATE LAWS REGULATING PLUMBING. 1 CERTIFY THATICI POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 I ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER 1 OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.GAS SYSTEM OUTLETS @ O.50 I SIGNATURE OF WATER HEATER @ 0.501 PERMITTEE SLOP SINK @ 0.5o INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.501 DRINKING FOUNTAIN @ 0.501 URINAL @ O.50I J HOUSE SEWER @ O.50 I I Q MISCELLANEOUS I 0 I I � 0 I I APPROVALS DATE INSPECTOR'S NAME 1 I ROUGH PLUMBING 1 GAS PIPING GAS VENT CESSPOOL @ 1.001 CESSPOOL �I ISEPTIC TANK: 1 SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00I� SEWER PERMIT . . I 1.00 GAS TEST TOTAL FEE $ Z I UTILITY CO. NOTIFIED FINAL D.B.Sr1'1 25M SETS 11-46 APPLICATION FOR PERMIT DEPARTMENT OFNG AND SAFETY PLUMBING ' . COUNTY OFF LOS LOS ANGELES WM.J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT,NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE READY FOR HEATER CESSPOOL I-I BEPTIC TANK RECEIVED BY DATE ISSUED FIRST INSPECTION - AS MISCELLANEOUS . APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB r /f t~ ADDRESS . 7. C NAME .. W m ADDRESi/ LOCALITY n NEAREST L CITY TEL.NOj V CROSS COUNTY CERT.No EXPIRES C NAME tl LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL NORTH O ADDRE86 �w CITY TEL.No. 1 P AM THE LEGAL OSBEBSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. 3 - 34. •OWNER CORRECTIONS X.,e SOUTH J DESCRIPTION OF WORD z BATH TUB FURNACE SHOWER DISHWASHER D LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I a J METER v GAB SODA FOUNTAIN GAS PIPING OUTL _ 1 GAS VENTENNE I I _ CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOR SEPTIC TANK SEWER $ TOTAL FEE UTILITY CO.NOTIFIED .l� FINAL M.PENSATION '��°" f�� AWLI&TION FOR PLUMBING PERMIT I he rm have a certificate of consent to self In- 70,667A sure,or a certffl of Worker'Compensatfon Insurance,ora certified copy thereof(sec. 3900, Lab-C.) COUNTY OF LOS ANGELES DEPT._Q1 rPUSUC WORKS, Policy No.—Company ❑ CertNied copy Is hereby fumished. ❑ f-0R APPLICANT TO ALL IN(PRIM OR TYPE) �+� Certified copy Is filed with the county building Inspection ADDRESS�55 CJ deportmeAt. NUMBER RMURE OR ITEM Fff LOCALITY WATER CLOSET(TOILET) I}a + , te Applicant I ca n T NEAREST CERTIFICATE OF DTMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER LJG (This section need not be completed if the work Iwvofved by MAIL the permit Is for one hundred dollars ($109)or lea.) LAVATORY ADDRESS �27,-s I certify that In the performance of the work for whldh this per- mit is Issued, I shall not employ any�erson In any rnanner so SINK CrrY �� t TEL NO.29G as.to become subject to the Workers Compensation Laws. DISHWASHER CONTRACTOR Date. Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- emptfon,you should become subject to the Workers'Compen- � ING POOL Rf TOR CTy TEL NO. satfon provisions of the Labor Code,you must forthwith com LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revo� STATE LIC ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DtSTRICO. PROCESSED BY I hereby affirm thatl ns am licensed under provisions of Chapter GAS OUTLETS I N 9(coRimencing with Serrtfon 7000)of DJvlsion 3 of the Business OUTLETS OYER and Professions Code, and my license is In full force and ef- 5 PER SYSTEM FINAL l VAUDATION fact. HOSE BIB DATE >~ License Nyrnber Lic. Class _ a FINAL Contractor Dote BY 5 g I am exempt under Sec. ACCT.T �i B.BP.C_ for this reason Plan check feepoll33 3 fie' PLUMBING PERMIT ISSUING FEE 1 ITEMS Signature TOTAL FEE / TOTAL SINGLE FAMILY f�It�10 HOME OWNER-BUILDER DECLARATION Plan check applicant (*v I hereby affirm that I am exempt from the Contractor's License Name [ •00 Law for the following reason (Section 7031.5, Business and Professions Code): Addr"s I, as owner of the property, will do the work and the Clty Tel. No. _ 1 � 5/96 structure Is not Intended or pfferpd far.sale(Section 7044, Business and Professions Code). 7811 1 t CONSTRUCTION LENDING AGENCY. I hereby affirm that 41here 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 appJlcation and state that the ► above Information Is correct. I agree to comply with all County ordinances and State.laws requlating Plumbing, and hereby autho representat of this County to enter upon the abo tloned perry spaction pu SEE REVERSE FOR EXPLANATORY LANdUAGE Sign ura o rmittee Da fv COMPENSATION DECARADON APPLICATION FOR PLUMBING PERMIT Irm that I have a certificate of consent to self 76rb67A (,it Of Temple Cit ure Ur a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) Y P y or a cerfifled copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. 2019 .6 Company SCIF 8472 Certified copy Is hereby furnished. FOR APPUCANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy Is filed with the county building Inapec- ADDRESS 5033 N tlon department. NUMBER FIXTUREOR ITEM Q FEE WATERCLOSEr LOCALITY Temple Cit Date A-3 —R7 _Appll4ant G-GnA Al T1811--all NEAREST CERTIFICATE OF DCEMPTIpN FROM WORKERS' BATH TUB CROSS ST. La Rosa T)ri-Ve COMPENSATION INSURANCE SHOWER OWER (Thts section need not be cgmpleted H the work Invol1v by MAIL the permh Is for one hundred dollars(=100)or leu,) LAVATORY ADD{ I certify that In the performance of the work for which this permit Is Issued, I shall not employ any person In any manner SANK CITY 286-6730 to as to become subject to the Workers Compensation Laws.- DISHWASHHt Date A—licant CLO ASHER NOTICE TO APPUC4NT: If, after making this Certificate of ADDRESS 6558 West Bld. Exemption, you should become subject to the Workers' SWVrAI RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRIN G1YLoa Pmcreles TEL —2 with comply with such provision or this permit shall be STATE L1C deemed revoked. 1 WATER HEATER6. 0 uCENsE No.15183 9 C36 LICENSED CONTRACTORS DECLARATION DISTRICT NO. BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM ] a t (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professlons Code,and my Ilcense Is in full force and effect. 5 PER SYSTEM FINAL DATE VALIDATIo License Number 151 83 9 Llc. Class t^_3 f; J FI $. Contractor W.O. Proyin Data 4-55 BY 0.' I am exempt under Sec. L O BAP.C. for this reason Plan check feW e (' Date. PLUMBING PERMIT ISSUING FEE; 10 50 Z Signature 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 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 5 9 9 A structure Is not Intended or offered for sale (Section , 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY # 5 o 0 0 0 0 I hereby affirm that there Is a construction lending agency for I o 0 1 6 5 0 the performance of The work for which this permit Is Issued (Sec. 3097, Civ. C.)_ o . ..1 6506 Lender's Name '1 1.2 0„8 6 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 a and State lws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentloned pro for Inspection Purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE t � ' Igna ure o erml a Date CO( W OF LOS ANGELES TEMPLE CITY # D508 PLUKBING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TURAS PL 0508 9702060012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: ---FEES PAID WILDING TR: 14467 LT: 28 5033 CAMELLIA AV: FEE DESCRIPTION: QUANTITY: UCPU AMOUNT: TEMP CA 9178038554 ASSESWR IN NEAREST CROSS STREET: 8589-014-015 07 BATHTUBS/SHDWUS 1.DO 'FIX 16.35 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY 11 CLOTHESWASHER(S) 1.DO'FIX 16.35 25 LAVATORIES/SINKS 2.00 FIX 32.70 ISSIJED PROCESSED BY: PLAN BY: EXPIRE 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.35 02/06/97 . TC 02/ TOT FEES 81.75 • TEL. W: FINAL DATE FINAL BTWQ,� EAD�S DOUGLAS G;OGLESBT-EIAAkRDY A (818) 286-7028- 5033 CAMELLIA AV L Z TEMP 917803854 ADDITIONAL PLUMBING OR ADDITION APPLICANT: TEL. 100: �1- a�Plie SAME AS ONiER - "��j SPECIAL CONDITINS: \�% DATE INSP SE AS CAM - Y TEL. LI AMC. NOd O 'DOD SLAB WOR WATER SERVICE 5 - . PLASTIC T/11 METAL T/N ARCHITErT OR ENGINEMI: TEL —NO: ROUaH PLUMBING GAB PIPING a tl G I ym .70 WlkTER HEATER PLUMBING FIXTURES GAS TEST CWV REPORT ID: DPR263 ROUTE TO: BS0508