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HomeMy Public PortalAbout6027 CLOVERLY AVE_Plumbing__ 1=ia A 067--CE*81 7-97 ea APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING /_ 2 p�U JOHN A LAMBIE COUNTY ENGINEER ADDRESS lD lill) 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 51 25 � BATH ,PUB 1 25 ADDRESS 715 Ook SHOWER 125 j 1,26� CITYJempte CU4TEL NO LAVATORY 125 CONTRACTOR PwtkeA gL=b SINK 125 ADDRESS 14617l- 6�a wn a Ul)&- DISHWASHER 125 41REVSHTRATION CITY fkAkd uuyL 6X Ak TEL N04Ed-81127 STAT LAUNDRY TUB 125 NO 197747 COUNTY] CLOTHES WASHER 1 25 DISTRICT NO GROUP ZONE PROCESSED BY WATER HEATER 1 50 0 / GAS SYSTEM OUTLETS I SO INDUSTRIAL 0 WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM 00 I INSPECTION RECORD U � L O Lu e 7c e,� z_ 1/0 5 g 9 � APP )WS„ DATE INSPECTOR 5 SIGN_ ATUPE PERMIT $ 2 00 UNDER 6htr14B'WORK ��� �t/j ROUGH PLUMBING 4 A -77 TOTAL FEE GAS PIPING �~ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT ,� AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER L PLUMBING '� 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LE AL OWN AN INTEND TO RESIDE IN THE ABOVE DE ED IDE OP UTILITY CO NOTIFIED SOF PERMIET FINAL LIDATION ROBERT A'�WOOD V V cK M o CASH SUPERVISING MECHANICAL ENG R iK,'o '' 7 0 3--13 JUL 15 5 D 1 1.2 5~ d 76A667 -CE#817 4-64 APPLICATION FOR "PLUMBI G PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION INEAREST UILDING JOHN A LAMBIE COUNTY ENGINEER DDEss WILLIAM A JENSEN SUP T OF BUILDING OCALIFOR APPLICANT TO FILL IN ROSS ST NUMBER FIXTURE OR ITEM EACH FEE OWNER ko2'Z- WATER CLOSET $125 MAIL BATH TUB 125 ADDRESS -£ SHOWER 125 CITY TEL NO LAVATORY 125 CONTRACTO SINK 1 25 ADDRESS DISHWASHER 1 25 CITY 4_f,, Ltr&_", TEL NOCTOR'S STA LAUNDRY TUB 125 RECON RATIION NO 2�1 Z COUNTY CLOTHES WASHER 1 25 DISTRICT NO ROUP E P E BY WATER HEATER 1 50 ' d GAS SYSTEM 1so INDUSTRIAL-OUTLETS- a. WASTE APPROVAL O OUTLETS OVER S PER SYSTEM 30 INSPECTION RECORD U t =t4t V W a N Z APPROVALS DATE INSPECTORS SIGNA,TURE�' PERMIT $ 2 00 UNDER SLAB WORK / f ROUGH PLUMBING v TOTAL FEE GAS PIPING IH ACKNOWLEDGE THAT I HAVE READ THIS A LIGATION GAS VENT AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBfap R DENTIAL PROPERTY UTILITY CO NOTIFIED _ SIGNATURE v OF PERMITTEE FINAL VALIDATION ROBERT A WOOD v (f M O CASH SUPERVISING MECHANICAL ENG R ';At03 0 3 1L JA 24 5 D 3.25 — - 76�-r A667�CE#B 71 2 62 TEMPLEC�T APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADDRESS (� �/`O �� JOHN A LAMBIE COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS sr NUMBER FIXTURE OR ITEM EACH FEE ' OWNER G G�` WATER CLOSET $125 MAIL BATH TUB 125 ADDRESS CITY TEL NO SHOWER 125 LAVATORY 125 CONTRACTOR q,,0" „ SINK 125 ADDRESS /,2 DISHWASHER 1 25 CITYt LAUNDRY TUB 1 25 CONTRACTOR S STATE ❑ REGISTRATION NO COUNTY ❑ CLOTHES WASHER 125 DISTRI T NOG ZONE PpOCGSSED BY WATER HEATER 1 50 J GAS SYSTEM OUTLETS 150 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD �. 0. p U Lu oL CL 4A z APPROVALS DATE r`INSPECTOR S SIGi4TURE PERMIT $ 2 QQ UNDER"SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING [ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ( ' / AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT ! j WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL ROPERTY UTILITY CO NOTIFIED SIGNATURE ? l I OF PERMITTE L FINAL LIDATION ROBERT), WOOD r cK M o CASH SUPERVISING MECHANICAL ENG R X11 � 2 6 8 1" AIIN15 5 D 3�-50w 7EA887-CE#617 4-64 APPLICATION FOR PLUMBING �QMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FADDRESS JOHN A LAMBIE COUNTY ENGINEER OZ LQV� L' WILLIAM A JENSEN SUP r of BUILDING �&/� � / rFOR APPLICANT TO FILL IN NEARC1 NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 3125 MAIL BATH TUB 125 ADDRESS SHOWER 125 CITY TEL NO LAVATORY 1 25 CONTRAC GCt e N Z�LS SINS 125 ADDRESS Z LGQ DISHWASHER 125 CITY ,q �( p�(/'ri d TEL NO �d-7 LAUNDRY TUB 125 REGISTRATION NO �:�>' I COUNTY CLOTHES WASHER 125 DISTRICT NO GROU ZONE PRO BED BY WATER HEATER 1 SO GAS SYSTEM OUTLETS 1 50 INDUSTRIAL a WASTE APPROVAL 0 OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD V J O G a N Z APPROVALS DATE INSPECTOR S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING ��/ram �J7FJ�d°G� It�✓ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT y AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES A LICENSED AS REQUIRED BY LOS,ANGELES COUNTY AND STATE OF CALIFORNIA O HAT 1 AM THE LEGAL OWNER OF AND INTEND TO GAS TEST RESIDE IN TH ABO SCRIBED POIDENTIAL PROPERTY UTILITY CO NOTIFIED L �O f v SIGNATURE `Il OF PERMITTEE FINAL LIDATION ROBERT A^WOOD cK M o CASH SUPERVISING MECHANICAL ENG R Ao 3 8 9 4-0 JUL 21 5 D 3.50- 77::�-,Vok 1-iv COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT affirm that I have a certificate of consent to self 76A667A insure or a certificate of Workers' Compensation Insurance CE 817(REV 10/81) ora tified copy thereof (Sec 3800 Lob C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY P❑olicyNN � y t'� lNd' Compansff: Lo Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS tion department NUMBER FIXTURE OR ITEM a FEE LOCALITY 6 09 Date :!U App lic , WATER CLOSET�lL :�� CROSSSST CERTIFICATE OF EXEM TION FROM WORKERS BATH TUB COMPENSATION INSURANCE OWNER e(,(_X-1�� (This section need not be completed if the work involved by © SHOWER MAIL the permit is for one hundred dollars ($100)or less ) 0 LAVATORY a ADDRESS I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner SINK QO CITY TEL NO -��'7i� so as to become subject to the Workers Compensation Laws t DISHWASHER CONTRACTOR A Date Applicant r CLOTHES WASHER ADDRESS 3 t 3 f( 0,-r m) NOTICE TO APPLICANT If after making this Certificate of Exemption, you should become subject to the Workers SWIMMING POOL RECEPTOR CITY TEL NO CN Compensation provisions of the Labor Code you must forth- LAWN SPRINKLER SYSTEM / •,'� with comply with such provisions or this permit shall be STATE LIC deemed revoked 0 WATER HEATER LICENSE NO 500 5-11"1 CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO_ID BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS G (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code and my license is in full force and effect 5 PER SYSTEM FINAL >� V IDATION License Number- n Lic Class DATE 0 O 7 FINAL U Contract Datel 1-�u�7 BY / O ❑ 1 am exempt under Sec U B 8P C for this reason X 6 7 4.6 A OWJ Plan check fee DateC/)PLUMBING PERMIT ISSUING FEE$ # o o o o o 5 Z Signature TOTAL FEE I o o34,50 Plan check applicant o 0 0 3 4,5 0 5 SINGLE FAMILY HOME OWNER BUILDER DECLARATION Name r S1,6LrC \,N S�,T&C- 03,26-87 I hereby affirm that I am exempt from the Contractor s License Law for the following reason (Section 7031 5 Business and Address �l45 N IN (r'roq) Professions Code) City -tenTel No l IL ❑ 1 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 performance of the work for which this permit is issued (Sec 3097 Civ C ) Lender s NamedA= 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 gnature of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0101160026 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILG ADDRESS TR 6561 LT 311 6027 CLOVERLY AV FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802026 ASSESSOR INFORMATIONNEAREST CROSS STREET WOODRUFF 5385-006-008 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J3 LOCALITY TEMPLE CITY 07 BATHTUBS/SHOWERS 2 00 FIX 32 40 TENANT 25 LAVATORIES/SINKS 3 00 FIX 48 60 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 45 WATER CLOSET/URINAL 2 00 FIX 32 40 01/16/01 UT 07/15/01 TOTAL FEES 141 15 OWNER TEL NO FINAL DATE F BY CODE VERRELL ALFRED A,ADELA (626) 287-4718- 6027 CLOVERLY AV I Z� �� TEMP 917802026 n5GRIPTION PLUMBING FOR BATHROOM EMO LING APPLICANT TEL NO SAME AS OWNER _ SPECIAL CONDITIONS CONTRACTOR TEL NO / APPROVALS DATE INSPECTn SIGNATURE SAME AS OWNER LIC NO i�/ w '`� ��� UNDER LA TK _ �/ �`* ✓� 6-'Z i `` c�.t Iii 1� WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER TEL NO LIC NO � -�E-.J ROUGH i _ _ _ GAS PIPING - -- -- ---- -- — - - GAS VENT HOT WATER HEATER % i \� I ♦ J 1-- -- - -- --- - - - j` PLUMBING FIXTURES IN LAWN SPRINKLERS A// GAS f ST UTILITY COMPANY NOTIFIED GRAY WATER S REPORT ID DPR263 ROUTE TO BS0508