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Home My Public Portal About5343 CLOVERLY AVE_Plumbing__ 76A667 (CE 617)-4/72 ` I w APPLICATI FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING MAKE CHECKS PAYABLE TO F7TeMle 5343 Cloverly V- HARVEY T BRANDT, COUNTY ENGINEER City FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST Olive CROSS ST NUMBER FIXTURE OR ITEM @ FEE . OWNER W. Nunamaker WATER CLOSET 1 75 MAIL BATH TUB 1 75 ADDRESS 5343Cloverl p SHOWER 1 75 CITY Temple City TEL NO 287-1640 LAVATORY 1 75 CONTRACTOR Lemke Air Conditioning Co. SINK 1 75 ADDRESS 4937 Encinita ave. DISHWASHER 1 75 CITY Te=le City TEL NO CLOTHES WASHER 1 75 STATE LICENSE NO '95617 LIC C-20 SWIMMING POOL RECEPTOR 1 75 CLASS DISTRICT NO GROUP ZONE FRO ESSED BY LAWN SPRINKLER SYSTEM 1 75 p / � WATER HEATER 1 75 INDUSTRIAL 1� WASTE APPROVAL Off. l GAS SYSTEM OUTLETS 1 75 1.7 INSPECTION RECORD V OUTLETS OVER 30 p 5 PER SYSTEM W O.. N 1 Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 00 TOTAL FEE APPROVALS DATE INSPECTOR S SICNATI.RE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel NO GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PER Y FINAL SIGNATU RE OF PERMITTE cie�- - PERMIT VALIDATION C-10 K M 0 CASH PLAN CHECK VALIDATION CK M 0 CASH �t�' 2 1 7 5 j31 JUL 12 ID 4 .7 5 76A667 -CE0817 5/63 APPLICATION FOR PLUM NG PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DMSION ADDRESS c� JOHN A LAM IE COUNTY ENGINEER _ WILLIAM A JENSEN SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $125 MAIL BATH TUB 1 25 ADDRESS 'L 1 � CITY L TEL NO SHOWER 125 LAVATORY 1 25- ,CONTRACTOR � l.. )3)7,4 LL/yyro/'14 z SINK 125 ADDRESS /i 0 G� DISHWASHER 1 25 CITY Z 17 ' 6/1 TEL NO LAUNDRY TUB 1 25 .CONTRACTORS STATE REGISTRATION NO / � COUNTY ❑ CLOTHES WASHER 1 25 . DISTRICT NO GROUP ONE PZOC. S D YWATER HEATER 1 500 - } 1 50 INDUSTRIAL GAS SYSTEM OUTLETS C WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM 30 U ItISPECTION RECORD o CL APPROVALS DATE INSPECTOR S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT �- f AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ✓� - �,` L WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING I _ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST �r CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL P RTY UTILITY CO NOTIFIED f SIGNATURE - OF PERMITTEE r a FINAL /VALIDATION ROBERT A WOOD CK M O CASH SUPERVISING MECHANICAL ENG R jt oa499-l'-S' mAy 6 5 D 3.50 . I - r i 7 OBS 17 APPLICATION FOR PLUMBING PERMIT .1 B6 I$IVISION OF BUILDING AND SAFETY Department of County-Engineer County of Los Angeles BUILDING JOHN A LAMBIE COUNTY ENGINEER ADDRESS \Jp( 7 CASSATT D,GRIFFIN, SUPT OF BUILDING �� LOCALITY FOR APPLICANT TO FILL INNEAREST ,L�y� i CROSS ST Y OWN , �/ r'{[�ts DISTRICT GR P ZQ E I READY FOR INSPECTION Al ADDRESS UZ /✓e e,,vl - INDUSTRIAL CITY TEL NO WASTE APPROVAL PLUMBER eO� d � sTcGt1/tj�./ INSPECTION RECORD ADDRESS C7 CITY e- /�/ TEL NO LICENSE NO NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $100 9C� BATH TUB @ $100 U SHOWER @ $1 00 LAVATORY (WASH BASIN) @ $100 KITCHEN SINK @ $100 !/ DISHWASHER @ $1 00 LAUNDRY TUB OR TRAY @ $100 CLOTHES WASHER @ $1 00 WATER HEATER @ $100 D GAS SYSTEM @ S100 �D APPROVALS DATE INSPECTOR S SIGNATURE UNDER SLAB WORK A PERMIT $ 1 00 ROUGH PLUMBING GAS PIPING TOTAL FEE !d GAS VENT 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY X WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES15-7 PLUMBING •� — v I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNERAF THE ABOVE UTILITY CO NOTIFIED DESCRIBED RESIDENTIA ROPERTY SIGNATURE OF PERMITTEE FINAL JOHN A LAMBIE COUNTY ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR CK Y 0 CASH LT",3 3 7 6- DEC 14 3 1 1 .0 0 in x - WORKERS'COMPENSATION DECLARATION 76A687A APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self ce en (z-so) insure, ora certificate of Workers'Compensation Insurance,or a,ertified copy thereof(Sec 3800,Lab C) - C COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished FOR APPLICANT TO FILL IN (PRINT OR TYPE) ;ADDRESS NG Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE '�� 3, _department WATER CLOSET ITY � /Date Applicant ! STBATH TUB ST I(JCERTIFICATE OF EXEMPTION FROM WORKERS' J��COMPENSATION INSURANCE SHOWER W uiVtC�i►I (This section need not be completed if the work involved LAVATORY MAIL - r� �� „!• C } ADDRESS /�( Q (J�� by the permit is for one hundred dollars ($100) or less) SINKo- CITY 2�' F TEL NO �-�O 0 I certify that in the performance of the work for which this DISHWASHERU permit is issued, I shall not employ any person in any manner CONTRACTOW r4 cc so as to become subject to thp,4r ers' C pensation Laws CLOTHES WASHER 0 ADDRESS _ )'Date .d-�/ Applicant SWIMMING POOL RECEPTOR U �T NOTICE TO APPLICANT after makg this Certificate of CITY ! TEL NO d Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM Compensation provisions of the Labor Code, you must forth STATE LIC N Z ' O Q — with comply with such provisions or this permit shall be WATER HEATER LICENSE NCLASS deemed revoked GAS SYSTEM OUTLETS DISTRItT NO PR CESSED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER �i0? I hereby affirm that I am licensed under,provisions of Chapter 5 PER SYSTEM , �-7 4 9 (commencing with Section 7000) of Division 3 of the Busi F I 4AL \, nss and Professions Code, and my license is in full force and S DATE �® �, ® VALIDATION effect FINAL d License Number Lie Class BY 0. Contractor Date - I am4 exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer acting in my professional capacity (Section 7051, Bus PLUMBING PERMIT ISSUING FEE$ iness and Professions Code) 0 TOTAL FEE Lic or Reg No Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section 7031 5, Busi City Tel No ness and Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project :2 01 1.8 A (Section 7044,Business and Professions Code) CONSTRUCTION LENDING AGENCY # 0 0 0 0 0 5 I hereby affirm that there is a construction lending agency 2 0 0 1 0 010 Y for the performance of the work for which this permit is issued(Sec 3097,Civ C) Lender's Name ° ° ° 1 0 0 0 5 v Lender's Address 0 6 2 9-8 1 I certify that I have read this application and state that the above information is correct I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE / ordinances and State laws regulating Plumbing, and hereby o authorize represerltatives of this County to enter upon the ab *�Veoroperty�,for inspection purposesnttee e COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0608090018 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS ON FILE 5343 CLOVERLY AV FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803106 ASSESSOR INFORMATION NUMBER - NEAREST CROSS STREET 8590-004-007 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY, C 47 WATER HEATER(S) 1 00 WTH 16 20 TENANT TOTAL FEES 43 95 ISSULD ON PROCESSED BY PLAN BY EXPIRES ON 08/09/06 JK \ 02/05/07 OWNER TEL NO FIN LDATE FINAL BY CODE NUNAMAKER JOHN W CO TR (626) 286-6076- 5343 CLOVERLY AV � TEMP 917803106 DESCRIPTION OF WORK WATER HEATER CHANGE OUT APPLICANT TEL NO TEKAWA (310) 515-1311- 17111 S BROADWAY SPECIAL CONDITIONS GARDENA, CA 90248 CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE ACTION CONTRACTORS, INC (310) 515-1311- 17111 S BROADWAY LIC NO UNDER SLAB WORK GARDENA CA 90248 NONE ' WATER SERVICE PLASTIC YIN METAL YIN ARCHITECT OR ENGINEER TEL NO - ROUGH PLUMBING LIC NO GAS PIPING GAS VENT HOT WATER HEATER / PLUMBING FIXTURES / LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID DPR263 ROUTE TO BS0508 1 `