HomeMy Public PortalAbout5333 CAMELLIA AVE_Plumbing__ DEpa7tTM7CNTI' OF COUNTY EN I �' PLUMBING 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
OOU= OF LOS ANGST, BUILDING
WILLIAM J. FOX, CouHry ENOIINCER ADDRESS
FOR APPU TO FILL LOCALITY C
BUILDING NEARESTT �\8�1
CRO&8 BT.
ADDRESS lC
DISTRICT N0. GROUP ZONE PERMIT M0.
LOCALITY
NEAREST
CROSS ST. BEC13VED BY RMdy for luvoetloi DATE ISSUED
OWNER
MAIL INDUSTRIkt
ADDRESS WASTE APPROVAL
CITY T N0. INSPECTION RECORD
PLUMBER f
ADDRESS %7.24
CITYasp TEL NO. {I
A 11 W " ff d r
LICENSE N0. UNTY _ S1• J
PERMIT S i
HUMMER TYPE OF FDcnlmlc am ITEM ri[ Q
WATER CLOSET(TOILM ! am 0
BATH TUB • o.eo �
HOWER ! om go
LAVATORY(WASH BASIN) • 0-80 O
KITCHEN&INK ! 0.810 11710
A4 A-I'mr-
LAUNDRY • E.M 10
SLOP BINK • 0.80
FLOOR BINK •.St a J_
FLOOR DRAIN ! sm
DISHWASHER • 0.80
DRINKING FOUNTAIN • OJM
URINAL 0�
GAS SYSTEM OUTLETS 1.00 Q
WATER HEATER • 1.10
MI86ELLANEOUS
APPROVALS
DATE IN8PECTOjrS SIGNATURE
UNDER&LAE WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE �n GAS
PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAB VENT
CATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY BAB TEST
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN. -
ER OF THE ABOVE D RIBED RESIDENTIA PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTE
FINAL
T&&NT DB81T 1/67
O R
y �mCOMPENSATION°�o�'m = i:� "APPLICATION P P L�C A T I O N FOR PLUMBING N G P E R M I TI herebafffirtbtI I ° to self < 1-.a,
tnsure, pt a certificate pf Workera'Compensatlon Insivance,or
■certi�Ied copy thereof(Seo-.3800,Lab.C.) LLL...III
COUNTY OF LOS ANGE S � BUILDING AND SAFETY
Policy-No. Cornpany-
Cartftiecj copy iahprsby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
Certified co.py.le HIAd With the County bull NU A ER FIXTURE OR rrEM FEE ADDRESS 5 333 N. �IIlell a A
ding inspection
departmaht. WATER CLOSET — LOCALITY
Date Applicant NEA T
BATH TUR `� CROSS 8T. Blackley
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE SHOWER OWNER TaMeS LT. Chevalier
LAVATORY MAIL
(This sectkyn need not be ��let�ed tf the work brvOhed A D D R ESS
_I N. Camellia IT"
by the pptmtt is for One handfed dollen (�1 O(}) or 1e�a) SINK L
CITY rji� a TEL.NO. _
I certify that in the performance of the work for which this DISHWASHER
permit Is lartued, I shall not employ any person in any manner CONTRACTOR
2
so as to become subject to the Workers'Compensation laws. CLOTHES WASH ERI. O
~� ADDRESS .
V `
Date Applicant fSWIMMINGPObL RECEPTOR `
NOTICE TO gPLICANT: If, after making this Cettificate of CITY TEL.NO.
Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC.
Compensation provisions of the Labor Code, you must forth- Z
With comply with such provisions or this permit &hall be WATER HEATER LICENSE NO. CLASS
deemed revoked. G-AS SYSTEM OUTLETS /DISTRICT NO.
SEED BY
LICENSED CONTRACTORS DECLARATION OUTLETS OVER L/ 'r
I hereby affirm that I em licensed under provisions of Cfiapter B PER SYSTEM
9 (commencing Wfth Section 7000) of DfvWon 3 of the Buri- FINAL
ness and Professions Coda, and my ilcgnse Is In full force and DATE fe.>
effect.
FINAL
License Number Lic.Class- BY
Contractor Date
I am axempt.tfom the licensing regdtrements u I am a Plan check fee
ltcgnsed afChtt&4'igr a registered professional engineer PLUMBING PERMIT ISSUING FEE$
Acting In my pr6 nal capacfty`(Section 7051, Bus-
Incas and Profeolons Code). f TOTAL FEE
i J
Lic.or Reg.No. Y ata Plan chock applicant
�0.04,3A
HOME OWNER-13UILDER DECLARATION NomaJamAR # oto 0 0 0 5
I hereby atfh-m that l-am exempt from the CQntractor's Address
Lir-ansa Law for the following rescan (Section.7031.5, Bud- try TN,No. .2�o 0 2 a 0.0
neo and Profeasfons Code):
ElI, as owner of the property, am exclusively contracting 0.0 0 25006
with licaujrd contractors to construct the .project
(Section 7044, Business and Profeaalons Coda). _ .0-604-81
CONSTRUCTION LENDING AGENCY
I hereby Ofirm that there Is a construction lending agency
for the performance of the work for which this permit is
issued(Sec. 3091,Civ,C.).
Lender's Name
Lsnder's Address
I certify tflat 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 SEE REVERSE FOR EXPLANATORY LANGUAGE
authorizp representativea of this County to enter upon the
*bove-mentioned pro for inspection purposes.
ys
V—sign"
0 ttee J Dale
J
COUNTY OF LOS ANGELES TEMPLE CITY f 0508 PLUBING PERMIT
` DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0001210008
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAIU- BUILDING
TR: 17780 LT: 6 5333 CAMELLIA AV: _
FEE DESCRIPTION: QUANTITY: UKIM: AMOUNT: TEMP CA 917883245
NEAREST CROSS STREET: BLACKLEY
8589-001-022 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 {GRID: A4 LOCALITY: TEMPLE CITY, C
13 DISHWASHER(S) 1.00 FIX 16.20
25 LAVATORIES/SINKS 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PIA BY: EXPIRES ON:
TOTAL FEES 60.15 01/21/00 VG U7 19/00
FI-NkL BT:,V Ce CODE:
CHEVALIER JAMES J;PATRICIA A (626)TEL.
86- 8548 - FINAL BATE�1 �
5333 CAMELLIA AV
TEMP 917803245
PLLPwING FOR KITCHEN REMODEL
WLICANT: TEL. NO:
BUILDERS LICENSED CONSTRUCTION (626) 798-7484-
SPECIAL CONDITIONS:
BUILDERS LICENSED CONSTRUCTION 626 798- 74 4- 05 PN(''ELES CO��T
1833 EL SERBIO LIC. NO UNDER SLAB WORK
PASADENA, CA 91104 _ 734735 B
WATER SERVICE
ARCHITECT DR ENGINEER: NO: / \ PLASTIC Y/N METAL Y/N
ROUGH PLUKBIWff---
LIC. N GAS PIPING
11111.1 -�
USB �oc� Wo FORK 3) ING FIXTURES
oLAWN SPRINKLERS
oGAS TEST
o�
'` 1 { 5
UTILITY COMPANY
46
c t
� Sewics Tha
i
REPORT ID: DPR263 ROUTE TO: 830508