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Home My Public Portal About5909-5927 CLOVERLY AVE_Plumbing__ "Ooir�4C7)r817(REV.11/78) APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINGS NUMBER FIXTURE OR ITEM @ FEE ADDRESS 579 0 Y' - 17 e ft`s WATER CLOSET LOCALITY NEAREST BATH TUB CROSS ST. All SHOWER OWNER MAIL LAVATORY ADDRESS d C SINK CITY TEL,NO. DISHWASHER CONTRACTOR ' J CLOTHES WASHER ADDRESS i SWIMMING POOL RECEPTOR CITY � ,�, TEL.NO.�•�,�a;�� LAWN SPRINKLER SYSTEM STATE LIC. q WATER HEATER LICENSE NO. CLASS Ji GAS SYSTEM OUTLETS IL �c) APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER �J UNDER SLAB WORK 5 PER SYSTEM / (300 ROUGH PLUMBING a GAS PIPING GAS VENT @3 HOT WATER HEATER PLUMBING FIXTURES GASTEST;S sos e Plan check fee UTILITY CO.NOTIFIED If PLUMBING PERMIT ISSUING FEE$ B8 TOTAL FEE t7 FINAL e Plan check applicant PLAN CHECK VALIDATION Name Address City Tel. No. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE 10 COMPLY WITH ALL COUNTY ORDINANCES �g T81.5 A AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS # O O O o O 5 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 2 O O 1 3.00 PROPERTY. SIGNATURE r to O Q 1 a o o:c OF PERMITTEE 11. 1 9-7 9 DISTRICJKNO PR CE6SED BY INDUSTRIAL WASTE APPROVAL 76A667A of CE .11/78) L/ APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING (1 NUMBER FIXTURE OR ITEM Q FEE /: ADDRESS J /U (,�.z,6/e4 LOCALITY WATER CLOSET NEAREST BATH TUB CROSS ST. L/15� .ii-OM � OWNER 7 SHOWER MAIL LAVATORY ADDRESS r" _ SINK CITY TEL.NO. g 42631&2 DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR w CITY C TEL.NO. LAWN SPRINKLER SYSTEM STATE (� LIC. WATER HEATER LICENSE NO. f) r S CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING Q GAS PIPING GAS VENT ag HOT WATER HEATER PLUMBING FIXTURES LS GAS TEST Plan check fee UTILITY CO.NOTIFIED PLUMBING PERMIT ISSUING FEE$ TOTAL FEE FINAL v o / ..�✓ Plan check applicant PLAN CHECK VALIDATION Name AZ /?Xe Address i6jig � c City :909P Tel. No. pp tn I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE c 8 2 7.9 A THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION O O O O O I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE 2 O O 1 9.00 LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. 1 C" 0 t SIGNATURE q OF PERMITTEE 1 12 1 7,-79 DISTRICT NO. PROCESSED BY INDUSTRIAL WASTE APPROVAL 76A66?).CE 6J1 /7B) C', ,, APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES I BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ADDRESS NUMBER FIXTURE OR ITEM ® FEE LO(-ALIT WATER CLOSET ' NEAREST BATH TUB CROSS S SHOWER OWNER f LAVATORY �7 MAIL t7� ADDRESS i SINK CIT TEL NO DISHWASHER CONTRACTOIF' , CLOTHES WASHER ADDRE W19 -it SWIMMING POOL RECEPTOR CITY TEL NO LAWN SPRINKLER SYSTEM STATE V 61 LIC WATER HEATER LICENSE N CLASS GAS SYSTEM OUTLETS APPROVALS DATE CAS 51 ATURE OUTLETS OVER UNDER SLAB WORK 44 n 5 PER SYSTEM ROUGH PLUMBING r `^J e GAS PIPING s � GAS VENT HOT WATER HEATER PLUMBING FIXTURES GAS TEST Plan check fee UTILITY CO NOTIFIED PLUMBING PERMIT ISSUING FEE$ TOTAL FEE FINAL PLAN CHECK VALIDATION Plan check applicant In Name Address r /-3 5 T City Tel No aP-QST�3�°q -o(.� z/z.qh� ��t�«'�� ' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE 3 9 A THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS 0 0 0 0 0 5 REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN THE BOVE DESC IBE RESIDENTIAL 2 O 1 1 5 4 C PROPERTY 0O1ia00C) SIGNATURE t , OF PERM ITTEE 03-23-79 3-2 3—7 9 DISTRICT_W �ROCESD ( Y 5 ' 08 INDUSTRIAL WASTE APPROVAL WORKERS'COMPENSATION DECLARATION 20-0026 DPW 4/90 APPLICATION FOR PLUMBING PERMIT hereby, affirm that I have a certificate of consent to self in- 76A667A sure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. BUILDING FOR APPLICANT TO.FILL IN(PRINT OR TYPE) ❑ Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE . LOCALITY Date Applicant WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER Q (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS 0 I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner sois�� CITY C/ T TEL. NO. as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESS tion,you should become subject to the•Workers'Com en- SWIMMING POOL RECEPTOR em P Y I P CITY TEL. NO. sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM. FINAL VALIDATION fect. HOSE BIB DATE --z 3� r rs License Number Lic. Class - h FINAL �- .9_ a 42.1 10 Contractor Date BY tz TE 1 am exempt under Sec. TOTAst Trf1S 11— O = W B.BP.C. for this reason Plan check fee C!I pptf600. Date: PLUMBING PERMIT ISSUING FEE$ sf,(+,C ) i Signature SINGLE FAMILY TOTAL FEE HOME OWNER-BUILDER DECLARATION Plan check applicantsem• _CCs-j c; c,T I hereby affirm that I am exempt from the Contractor's License Name . ° tib i k 37 Law for the following reason (Section 7031.5, Business and Professions Code): Address u I, as owner of the property, will do the work and the City. Tel. No. 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 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 application and state that the , above information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authori representatives of this County to enter upon the above- ntioned property for inspection p7ses. S _f- SEE REVERSE FOR EXPLANATORY LANGUAGE Signat re of Permittee Date WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I have a certificate of consent to self in- 20-0026 DPW a/90 76A667A sure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so SINK CITY TEL. NO. as to become subject to the Workers' Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption, you should become subject to the Workers'Compen- CITY TEL. NO. sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS r 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER a. and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION O fect. HOSE BIB DATE U W License Number Lic. Class J FINAL ILL. Contractor Date BY r2 I am exempt under Sec. O B.BP.C. for this reason ► a Plan check fee � Date: PLUMBING PERMIT ISSUING FEE$ F Signature TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and Professions Code): Address I, as owner of the property, will do the work and the City Tel. No. 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 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 application and state that the , 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 enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY 44 0508 PLL!M?ihG PL MIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0408190010 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 2C5-0482 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 8526 LT: 10 BL: .001 -� 5925 5927 CLOVERLY AV _ FES DESCRIPTION: QUANTITY: UOM: AMI4'!: TEMP CA 917802126 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 8587-008-017 101 PERFiIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C _ 17 FLOOR DRAIN(S) 1.00 FIX 16:20 TENANT: 25 LAVATORIES/SINKS 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: LU SANDWICH TOTAL 'FEES 60.15 08119/04 JK 02/15/05 OWNER: — TEL. NO: 'f I bl4AT P.-^.L SY: CODE: - WANG JAW J;JEAN TRS 580 OLD MILL RD y�� Cr SMAR 9/1081632 �F'CRIP I N OF WORK — '. 1 FLOOR DRAIN L 1 SINK APPLICANT: TEL. NO: H D CONSTRUCTION (626) 456-4534- 4418 FANDON AVENUE SPtiIAL CONDITIONS: EL MONTE, CA 91732 I i ONTkAC?OR: - TEL. N0: - I (APPROVALS ii"i`� INSPECTOR SIC�i`�SRE� H D CONSTRUCTION (626) 695-0444-- 4418 95-0444- __ _ 4418 FANDON AVENUE LIC. NO I JUUNDER SLAB WORK �EL MONTE, CA 91732 636105 B x ( 1 _ — SIATEn SEr:VICE _ ,PLASTIC Y/N METAL Y/N _-- T 0R ENGINEER: — -- EL. NO: t _t ROUGH PLUMBING -� HOT HATED HEATER -- —I FLiJMBING FIXTURES I W I (LAWN SPRINKLERS --I - �— t i `UTfLITY COMPANY NOTF=_v' — cWV ' IGRAY WATER SYSTEM — I� I * ADDITIONAL DATA ON FILE REPORT ID: DPR263 ROUTE TO:,BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0411080012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID- FEES PAID BUILDING ADDRESS: TR: 8526 LT: 10 BL: .001 5925 5927 CLOVERLY AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802126 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 8587-008-017 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: LU SANDWICH 11/08/04 JK 05/07/05 OWNER: TEL. NO: FINL,AA� / NAL BY: CODE: PHU TRIEU LU - 5927 CLOVERLY AVE -- -- TEMPLE CITY CA 91780 DESCRIPTION OF WORK ADD GAS LINE PPLICANT: TEL. NO: K C PLUMBING INC. (626) 338-1575- 909 E. BARBARA SPECIAL CONDITIONS: WEST COVINA 91790 CONTRACTOR: --�-TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE K C PLUMBING INC. (626) 338-1575- 909 E. BARBARA AVE LIC. NO UNDER SLAB WORK WEST COVINA, CA 91780 741495C36 WATER SERVICE PLASTIC Y/N METAL Y/N t ARCHITECT OR ENGINEER: IEL. N0: - 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