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Home My Public Portal About5758 CLOVERLY AVE_Plumbing__ //�/�/yy ♦ c 78A887-CE#817 4-64 PLUMBIN PERMIT � i APPLICATION FOR PLUM N COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING JOHN A LAMBIE COUNTY ENGINEER ADDRESS WILLIAM A JENSEN SUP T OF BUILDING LOCALITY L FOR APPLICANT TO FILL IN NEAREST CROSS ST C+�1 NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 31 25 MAIL �AA BATH TUB 125 ADDRESS SHOWER 125 CITY i ` TEL NO LAVATORY 125 CONTRACT SINK 125 ADDRESS DISHWASHER 125 CITY TEL NO / LAUNDRY TUB 1 25 REGISTRATION AAL NNO COUNTY ❑ CLOTHES WASHER I 125 DISTRICT NO GROUP ZONE PROCESSED BY WATER HEATER ISO GAS SYSTEM OUTLETS I so WASTE I APPROVAL (� OUTLETS OVER 5 PER SYSTEM 30 INSPECTI N RECORD Jl V 1V CL N Z APPROVALS DATE INSPECTOR S SIGNATURE PERMIT 5 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE �� GAS PIPING f �. I HEREBY ACKNOWLILOGE THAT 1 HAVE READ THIS APPLICATION ! AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT I / WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER A,�r PLUMBING Mg- I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES l LICENSEDAS REQUIRED BY L S ANGELES COUNTY AND STATE OF GAS TEST I CALIFORNIA OR THAT I AM E LEGAL OWNER OF ANR INTEND TO RESIDE IN THE ABOVE DESC ED ESIOENTI PR RTV UTILITY CO NOTIFIED N � SIGNATURE OF PERMITTEE FINAL VALIDATIOoBERT A WOOD fr CK M o CASH SUPERVISING MECHANICAL ENG R LALO 5 6 5 SP 1_ 6 5 D 3.5 0 DRKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT \rm that I have a certificate of consent to self 76A667A zrtificate of Workers' Compensation Insurance, CE 817(REV. 10/81) ertified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY I m F,fllcy No. k Copany itCertified copy is hereby furn hed. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINGertified copy is filed with the county building inspec- ADDRESS IJ tion department. NUMBER FIXTURE OR ITEM n FEE LOCALITY y�J► WATER CLOSET Date pplicant Q,p-,u UZ&OX II NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER MOAASOA (This section need not be completed if the work involved by the permit is for one hundred dollars ($100)or less.) LAVATORY MAIL ADDRESS ?:� I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO. so as to become subject to the kers'Co nsa Laws. DISHWASHER CONTRACTO Date Applicant CLOTHES WASHER ADDRES NOTICE TO APPLICANT: If, afte making this Certificate of c► Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM YllJv CITY q,r� n TEL. NO. with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. _S7 () CLASS LICENSED CONTRACTORS DECLARATION DISTRICJ�NO. PRCiCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS /✓ (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER (- and Professions Code, and my license is in full force and effect. 5 PER SYATW FINAL VALITION ,C, DATE License Number4t'S 744b Lic. Class_ W FINAL Date — BY b ❑ 1 am exempt under Sec. B.BP.C. for this reason / Plan check fee � Date: ��{ PLUMBING PERMIT ISSUING FEE$ V � z 1 8 7. 1 1 A Signature TOTAL FEE rJ $� �� # 0 0 0 0 0 5 SINGLE FAMILY Plan check applicant 1 - . 30,50 HOME OWNER-BUILDER DECLARATION Name LiU v � 0 0 0 3 0 003505 I hereby affirm that I am exempt from the Contractor's License Address Low for the following reason (Section 7031.5, Business and 26-7__%7 ;.S )O-T- .04, 1 8-85 Professions Code): City-CA. 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 performa'nce 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. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorizerepresentat ves of This County to enter upon the above-maentio d pr erty o inspection purposes. �- SEE REVERSE FOR EXPLANATORY LANGUAGE )nature Permitt a Date • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0910290005 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 6561 LT: 696 5758 CLOVERLY AV I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917802551 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 18587-011-015 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl 1 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 (TENANT: I TOTAL FEES 43.95 JISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I 1 110/29/09 SR 10/29/10 OWNER: TEL. NO: IFINAL ATE FI Y: CODE: CHI MING HONG (626) 757-3528- 5758 CLOVERLY AV I Y /u TEMP 917802551 ID9,01CRIPTION OF WORK IGAS LINE FOR FAU 1 I I I I (APPLICANT: TEL. NO: IYENULONIS (909) 213-1640- I 1 1 12574 BRYCE COURT I ISPECIAL CONDITIONS: 1 ICOLTON, CA 92324 1 1 1 I I 1 I 1 I 1 I ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1 (ALLIED PLUMBING HEATING AND AIR (714) 998-4300- 1 1 1 1422 JENKS CIRCLE LIC. NO I (UNDER SLAB WORK I 1 I ICORONA CA 92880 610780 C20 I I I 1 I I I IWATER SERVICE I I1 II IPLASTIC YIN METAL YIN I 1 I (ARCHITECT OR ENGINEER: TEL. NO: II I I I I 1 - I IROUGH PLUMBING I I I i LIC. NO: I 1 11 1 I IGAS PIPING I I I I I I I I I I IGAS VENT I I I I I I I I I I IHOT WATER HEATER I I 1 I I I I I I I IPLUMBING FIXTURES I I 1 I I I I I I 1 1 ILAWN SPRINKLERS I I 1 I I I I I I I IGAS TEST I I1 I I I 11 I I I (UTILITY COMPANY NOTIFIED( I I I I I I I I I I ICWV I I I I I I I I I IGRAY WATER SYSTEM 1 1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I IREPORT ID: DPR263 ROUTE TO: BS0508 1 1 I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0911020001 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: I FEES PAID BUILDING ADDRESS: ITR: 6561 LT: 696 1 5758 CLOVERLY AV IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917802551 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: WORKMAN I 18587-011-015 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl 1 164 WATER PIPNG <= 1 1/2 1.00 LIN 16.20 (TENANT: I TOTAL FEES 43.95 11SSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1 1 111/02/09 SR 11/02/10 I I I I (OWNER: TEL. NO: I IFINAL DATE FI CHI MING CODE: (HONG, (626) 287-6790- 15758 CLOVERLY AV ITEMP 917802551 IDESCRI ION F WORK I IREPLACE WATER MAIN I I I I (APPLICANT: TEL. NO: I 1 I ISAME AS OWNER I I ISPECIAL CONDITIONS: 1 I I I I I I I I I I I I (CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER - I I I I LIC. NO (UNDER SLAB WORK I I I I I I I I I (WATER SERVICE I I I PLASTIC YIN METAL /N 1ARCHITECT OR ENGINEER: TEL. NO: 1 I I I I - I IROUGH PLUMBING-- LIC. NO: I I I I I IGAS PIPING I II I I I I I I I IGAS VENT I I I I I 11 1 IHOT WATER HEATER I I I I 1 11 1 IPLUMBING FIXTURES I I I I I I ILAWN SPRINKLERS I I I I I I I I I IGAS TEST I I I I I I 11 I (UTILITY COMPANY NOTIFIEDI I I I I 1-1 I I ICWV I I I I I i I I IGRAY WATER SYSTEM I I I I I I I I I I I I I I I I I I I I I I I I I I I i I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I i I I I I IREPORT ID: DPR263 ROUTE TO: BS0508 I I I I I I