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Home My Public Portal About5342 CAMELLIA AVE_Plumbing__ DEPARTMIMNT OF OOUNTY ENGINEER PLUMBING 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF IAS ANGFA,ffi BUILDING WILLIAM J. FOX, Coum-ry EMOINCCR ADDRESS -OY-Z0,411,��24 r FOR APPLJCANT TO RLL IN LOCALITY C�T BUILDING NEAREST ADDRESS +6CROSS&T• DISTRICT NO. GROUP ZONE PERMIT NO. LOCALITY /- I Q NEAREST 0ItoBS ST. RECEIVED BY RMAy ter lat}Mtlo■ 15ATE ISSUED OWNER oz PAIL INDUSTRIAL ADDBE88 WASTE'APPROV cITY TEL N0. INSPECTION RECORD PLUMBER r ADDRESS S. 01 TY /F TEL N0. T ATE LICENSE NO. / / �17�7 [] COUNTY J PERMIT FEES JL1M�iA TYR Or rWMX[ OR IT[M ME 0 WATER CLOSET OILM 0 LN D BATH TUB @ LN SHOWER ! am LAVATORY(WASH SAWN) 9.11111 1 Aro KITOHEN SINK I.SO LAUNDRY TUB OR TRAY I.SO SLOP SINK • I.IO FLOOR SINK @ G.SI FLOOR DRAIN ! L.M DISHWASHER 0 Y.p DRINKING FOUNTAIN ! LN URINAL 40 am GAS SYSTE■ OUTLETS ! 1.09 WATER HEATER 0 I.M MISCELLANEOUS APPROVALS DATE INS OTOWS SIGNATURE UNDER SLAB WORK PEFLMIT 1 00 ROUGH PLUMBING 55 r AA^�• " 8 TOTAL FEE AS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- GAS VENT CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AHD/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY OAS TEST AND STATE OF CALIFORNIA OR THAT 1 AN THE LEGAL OWN- ER OF THE ABOVE DWRIB� D TIAL PROP[BTY. UTILITY 00.NOTIFIED SIGNATURE g—[�fyJr OF PERNITTELA F1NAI. T&AM DBS 17 Cd b 12-53 70AG07A(Cfi S`17?) -A/7e APPLICATION PLUMBI PERMIT COUNTY OF LOS ANGELES DEPORTMENT OF COUNTY ENGINEER BVLDING AND SAFETY DIVISION FADDREZZ5�5 MAKE CHECKS PAYABLP TO: � Jt HARVEY T. ■RANDY, COUNTY 6NGi1NEiR .� FOR APPLICANT TO FILL IN (PRINT OR TY PEI S ST. 4 NUMBER FIXTURE OR ITEM O FEE OWNER WATER CLOSET BATH TUB ADDRESS Z SHOWER 6 CITY TEC. NO 'S LAVATORY p CONTRACTOR SINK ADDRESS DISHWASHER CITY NO. CLOTHES WASHER STATE LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR Df8)3}1GT NO. GROUP N OC B LAWN SPRINKLER SYSTEM 1•/J� WATER HEATER WASTE APPROVAL GAS SYSTEM OUTLETS 6 INSPECTION RECORD OUTLETS OVER 3 S PER SYSTEM OL O Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE 8 TOTAL FEE APPROVALS DATE ING PE oR'e SIGNATURE Plan check applicant. UNDER SLAB WORK �Z Name X !n ROUGH PLUMBING AddressCL7 L�� GAS PIPING Ci �' Tel. No GAS VENT 73 HOT WATER HEATER I HEREB .ACKNOWLEDGE TH I HAVE READ THIS APPLICATION MID STATE THAT TiAE ASOVR S CORRECT AND AGREE TO COMELY PLUMBING FIXTURES WITHALL COUNTY ORDINANCE$ AND STAT[ LAWS REGULATING GAS TEST PLUM SI NG. J HERESY CERTIFY THAT I AM PROPERLY REGISTERED AX /OR UTILITY CO. NOTIFIE LICENSED AS REQUIRED SY LOS ANGELES COUNTY ST [ OF CALIFORNIA 01� THAT11 AM THE GAL OWNER , A 1 NO TO RESIDE IN THE ABOVE'D RIS ESIDENTIA, O� FINAL 310NATU RE OF PERM( PERMIT VALIDATIONK M.0. CASH PLAN CHECK V (DATION CK. M CASH �f� WORKS WS`,,COMPENSATION DECLARATION APPLICATION FOR PLUMBING P E RM I T --{ herto,y affirm }hat I have a certificate of consent to self 76A667A Insure, or a certificate of Workers'Compensatlon Insurance, CE 817(REV. 10/81) or a certlfled copy thereof(Sec. 3800, Lob. C. COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company 4 Certified copy Is hereby furnished. .�-1f FOR APPLICANT TOfILL IN(PRINT OR TYPE) BUILDING,{� �/s• Ix Certified copy Is filed with the aunty building Inspec- ADDRMpNUMBER FIXTUREOR ITEM O FEE J 'bG / f'\tion d nt.� 01 LOCALITY date Appligon WAT6tCLOSET t ARtST RT GATE OF FROM RIUERS' BATH TUB � CROSS ST. COMPENSATION INSURANa O►hR� (This section need not be cofnpW"fF the work 1mvhod by SHOWER the pem*Is For one hundred dollars(=100)or lees.) LAVATORY MAR I certify that In the performance of the work for which this ADDRESS permit is Issued, I shall not employ any person In any manner SIM( crry TEL No. so as to become subject to the Workers'Compensation Laws. DISHWASHER Date A—llcant CLOTHES WASHER �x NOTICE TO APPLICANT: If, after making This Certlficate of ADDRESS . Q r I Exemption, you should become subject to the Workers SWUNMItJG POOL RECEPTOR CITY Ta- (/�y Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSIT M / Jd with comply with such provisions or this permit shall be STATE L1C ^ deemed revoked. WATER HEATER LICENSE NO. LICENSED CONTRACTORS DECLARATION Dtsmtu No. � BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS JL' (commencing with Section 7000) of Dlvlslon 3 of the Business OUTLETS OVER and Profeesions Code,and m license is In full force and effect. 5 SYSTEM 9L Y /� �// 6 _ o� vAL o License Ny 1c Cia •-w`d A16- V Con • BY O ❑ I am exempt under Sec B.BP.C, for this reason Plan check fee _ Date. PLUMBING PERMIT ISSUING FEE; Sl�oaturo TOTAL FEE ?j Plan check appllcant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name � 171,5A I hereby affirm that I am exempt from theContractors License # 0 0 0 0 0 5 Law for the following reason (Section 7031.5, Business and Profdsslons Code): City Tel. No. '1 - - 2250 ❑ I, as owner of the property, will do the work dnd the structure Is not Intended or offered for sale (Sectionloopo o o 2 2506 7044, Business and ProfessTons Code). CONSTRUCTION LENDING AGENCY 0320-85 1 hereby affirm that there Is a construction lending agency for the performance of fbe work for which this permit Is Issued (Sec. 3097, Clv. C.k Lenders Name Lender's Address I certify that L e read this application and state thgt the above infer Is correct. I agree to comply with all County ordinances S e laws regulating Plumbing, and hereby authorize as nter upon the abov or Inspection pu SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permlttee e r = COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT 9I tl Fwreb�affirm that I have a certificate of consent to self In- 7&A667 DPW x/07 sure,or d certificate of Workers'Compensation Insurance,or a C � 8/86 certified copy thereof (Sec. 3800, Lab. C.) Po ( ) - .+. COUNTY OF LOS ANGELES DEPT� .- F'PUgLIC WQRKS, , licy No. Company - ❑ Certified copy Is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDI ] / r Certffled copy Is filed with the county building Inspection ADDRESS 1 department. NUMBER FIXTURE OR ITEM 8 FIT Luny Date Applicant WATER CLOSET(TOILET) � NE�EST CERTIFICATE OF D(EMPTION FROM WORKERS' BATH TUB 6 GZOSS ST' COMPENSATION INSURANCE OWnER CM-19 iacHon rw*d not be completed if the work Involved by MAIL ' the p@rmM Isior one hundred dollars (=100)or leas.) LAVATORY ADDRESS C McL&A I certify that Irl the performance of the work for which this per- SINK mit Is Issued, I shall not employ any person In any manner so CTY ki_ TEL NO. alio becorne subject to the Workers'Compe on Lawf. DISHWASHERr coNTRAcroR !LC t Date - Applicant CLOTHES WISHER NOTICE TO APPLICANT: If, after ma g this Certificate of Ex- SWIMM1i�POOL �TOR ADDRESS 31 ! � erriptlon,you should become sub, to the Workers'Compen- ryI saflon provisions of the Labor e,�you must forthwith comp- LAWN SPRINKLER SYSTEM CITY �'� TEL NO • 7- 3 ly with such provisions or thli permit shall be deemed revok- STATE LIC ed. WATER HEATER UCQYSE tJO.qj 3 C1A55 �� LICENSED CONTRACTORS DECLARATION DISTRICT NO. BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS /1 9,(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER C/ pnd Professions Code, and my license Is In full force and ef- S PER SYSTEM fact. / DAA a , VA ATIQN L7cense Numbery/I137 Lic. Class C- Sv (/ O Cghtractor rC� 1 Date b . 17- J R 0 O I am exempt under Sec. W B.BP.C. for'thls reason Plan check fee , Date: PLUMBING PERMIT ISSUING FIE$ 9 9 23 A . Signature , TOTAL Fly # o o •`o o Jr SINGLE FAMILY Ilcantk check a ' HOME OWNER-BUILDER DECLARATION Plan cPP I c ? 3 4,5.0- 1 hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and o c o 3 1h 5 0 6 Professions Code): Address 0.61 788 1, as,"ner of-the property, will do the work and the City Tel. No. structure Is-hot Intended or offered for sale(Section 706", Business and Professlons 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, Clv. C.). Lender's Name Lender's Address I certify that I have.read this appticatlon and state that the ' above Informatlorl Is correct. I ogres to comply with all County ordlnances and State lows regulating Plumbing, and hereby authorize representatives of this County to enter upon the bbove me Ion property for Inspection purposes.- ' l2 I SEE REVERSE FOR EXPLANATORY LANGUAGE \ SI lure of ermlttee Date ' COUNTY OF L09 ANGELES' TEMPLE CITY 1 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNA.9 PL 0508 1403100006 HULLOING AND SAFETY / LAND DEVELOPMENT TE1IPT.F: C= CA 91780 PHONE: (626) 285-0488 ETT: LEGAL ID: FEES PAID BUILDING d)DRZSS: ON FILE 5342 CAMELLIA AV FSH DESCRIPTION: QUANTITY: DON: AMOUNT: TEMP CA 917803244 ASSESSOR INFORMATION 3UMBER: CREST CROSS 9TR=: 8589-002-016 01 PERMIT ISSUANCE FEE 27.80 TTlOM9LS PAGE: 597 GRID: ASL ICCALITY: T24PLE CITY 07 BATHTUBS/SHOWERS 1.00 FII 16.20 TENANT: 25 LAVATORSS.9/SINES 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLAN BY: 45 mki-ER CLOSETJ0RnuLL 1.00 FIX 16.20 03/10/14 SR 'DOTAL FEES 76.40 OWNER: TEL. 190: DATE F Y: CODE: LAM, WIMPLE (626) 864-3653- ,f� 5342 CAMELLIA AV Z(('� '( 1..� TEMP 917803244 PTION OF EARS SHOWER, LAVATORTE AND WATER CLOSET APPLICANT: TEL. NO: JESUS COVARRUBIAS (626) 215-7318- 2213 '-LUNG LEAF AV SPECIAL CONDITIONS: ROSEMEAD CA 91770 . CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE QUALS'I'Y RESTORATION AND (626) 215-7318- R13HABILLIT TION LIC. NO WIDER SLAB WORK 2213 FALLING LEAF AVE 656275 ROSEMEAD CA 91770 WATER SERVICE - PLASTIC YIN METAL YIN ARCHITECT OR ENGINEMR: TEL. NO: R.000H.-PIZM 1210 LIC. NO: GABS PIPING GAS VENT HOT WATER HEATER PIA1GING FIXTURES LAWN 8PRI41LERS GAS TEST VPII= COMPANY NOTIFIED CWV GRAY WATER SYSTEM * ADDITIONAL DATA ON FILE REPORT ID: DPR263 ROUTE TO: BS0508