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Home My Public Portal About6639 CLOVERLY AVE_Plumbing__ 76 A 667—CE 817 468 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES u DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY ` FOR APPLICANT TO FILL IN(PR NT OR TYPE) a NEARESY CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE . OWNER WATER CLOSET 1.50 MAIL BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY TEL. NO. LAVATORY 1.50 CONTRACT SINK I.50 ADDRESS jW DISHWASHER 1.50 CITY _ TEL. NO CLOTHES WASHER 1.50 STATE LIC LICENSE CLA SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE PRO SSED BY LAWN SPRINKLER SYSTEM 2.00 ^ a- WATER HEATER 1.50 WASTE APP u OVAL GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD O OUTLETS OVER .30 J 5 PER SYSTEM Ldd N Z, o Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE a APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City. Tel. No. HOT WATER HEATER, I HEREBY ACKNOWLEDGE THAT 1 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 REOUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO - RESIDE IN,THE ABOVE SCRIBED RESIDENTIAL PROPERTY. FINAL CP r SIGNATURE d k4s JACK R. ALLEN, SUPERVISING MECHANICAL ENG'R. OF PERMIT /0 '1� PERMIT VALIDATION rtS K• iM.O. CASH PLAN CIIECK ALQDATION 11K. M.0. CASH ! J 76A667-CE*817 2-66 CITY OF TEMPLE CITY APPLICATION FOR PLUMBING PERMDTB 2631a COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND JOHN A LAMBIESCOUNTY ENGINEER AFETY DIVISION ADDRESS `1902 LAlesa7dro COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY Temple City FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE ' OWNER S171ith WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS same SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 CONTRACTOR General Installation Co. SINK 1.25 ADDRESS 6558 West Blvd. DISHWASHER 1.25 CITY Los Angeles TEL. NO. PL 3-2541 LAUNDRY TUB 1.25 STATE LICENSE NO. C-36 151839_ LIC CLASS CLOTHES WASHER 1.25 DISTRICT NO, GROU . ZONE PROCESS9D BY WATER HEATER 1.50 a GAS SYSTEM OUTLETS 1.50 INDUSTRIALWASTE APPROVAL CD OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD rJ 7 WATER SOFTENER 1 I Ready for Inspection Now o U 7 C C�//e ws uik'' 'YC/' g Jc/c LaL W . � `c5g�e �c`i��iN•C-i. APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT 5 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE ? GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION _ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT 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 SIGNARESIDEATURE THE ABOVE DESCRIBED RET T1A4,p R0,� , `/s/f/7// UTILITY CO. NOTIFIED SIGNATURE OF PERMITTEE _ FINAL �- r ALIDATION JACK R. ALLEN CM.O. CASH SUPERVISING MECHANICAL ENG'R. 76A667-CE#817 4-67 - rJ APPUCAT�ON FO R �LUMMNG PERWT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING j JOHN A. LAMBIE,.COUN.TY ENGINEER ADDRESS6C; G�L04907- COLEMAN W..J,ENKINS,; SUP'T.'OF BUILDING LOCALITY �- %sf1/ FOR APPLICANT TO FILL INCROSSSST. (12l J/`f7,0 NUMBER F FIXTURE OR ITEM EACH' FEE OWNER WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS SHOWER 1 25 CITY G TEL. NO. LAVATORY 1.25 CONTRACTOR /6r 1 SINK 1,25 ADDRESS ®� l� DISHWASHER 1.25 CITY . TEL. NO.gyzo 57,3 STATE LIC ' LAUNDRY TUB 1.25 LICESE NO/ CLASS N .{y CLOTHES WASHER r 1.25 DISTRICT NO. GROUP I ZON PROCESSED BY WATER HEATER 1.50 ,6 ey ice! GAS SYSTEMOUTLETS 1.50 INDUSTRIAL WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INS ECTION RECORD pr O _ o U L N APPROVALS' DATV INSPECTOR'S SIGNATURE PERMIT $ 2 �� UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CO AND AGREE TO COMFLY WITH ALL COUNTY OR AND S AT LAWS' REGULATING HOT WATER HEATER I PLUMBING. I HEREBY CERTIFY AT 1 M' ROP Y EGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REOUI D BY L S A GECO N Y AND STATE OF GAS TEST CALIFORNIA OR THA I AM T E L A O N ,AND INTEND TO RESIDE IN,THE AB CRI ED ES E TI P OPER T UTILITY CO. NOTIFIED SIGNATURE OF PERMITT r - ' FINAL ALIDATION JACK R. ALLEN CK. M.0. CASH SUPERVISING MECHANICAL ENG'R. ` r L& 8 6 9 JANI 6 5 0 3 . Q WORKERS'COMPENSATION DECLARATION o o n I hereby affirm that I have a certificate of consent to self 76A667A �L��0� �O� a�� v�� o�� insure,"or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof (Sec. 3800, Lab.. C.) .'.COUNTY OF LOS ANGELES . BUILDING AND SAFETY Policy No. Company 6M7-g � 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 FEE v� LOCALITY e r Date�-�� Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM W RS' BATH TUB. CROSS ST. CAMIOVO 96AL COMPENSATION INSURANCE SHOWER OWNER N6J (This section need not be completed i4 the work involved by MAIL ADDR / the permit is for one hundred dollars ($100)or less.) LAVATORY ESS 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 B TEL NO. so'asto become subjecttothe:Workers'Compensation Laws. u [� DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS Wy NOTICE TO APPLICANT: If, after making this Certificate of $45. W. Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CI7Y�®� � TEL. NO. LAWN SPRINKLER SYSTEM 7 with comply with such provisions or this permit shall be STATEss��qp LIC. n ! & deemed revoked. U WATER HEATER 42 ®® LICENSE NO. A d+�TCJ CLASS q LICENSED CONTRACTORS DECLARATION U DISICT NQ.,,- ROCESSED BY J 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 SYSTEM DATE ' /�1 r" FINAL !/J[/'! VAL ATION License Number Lic. Class Fl 1= Contractor Date B ❑ tJ am exempt under Sec. 6 614 A Lu B.&P.C. for this reason Plan check fee # ° ° °,°,° 5. • , Date: PLUMBING PERMIT ISSUING FEE ,'Signature ' TOTAL FEE i6 so o o 0 1 6 5061 Plan check applicant' " SINGLE FAMILY 0 3'0 3 7 8:7 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Address- Professions Code): City Tel. No. ❑ I, as owner of the property, will do the work:and the structure is not intended or offered for sale (Section D 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_A_ddress 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 ab ve-mentione property for inspection purposes. ® SEE REVERSE FOR EXPLANATORY LANGUAGE Signature ermittee Date - COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0103150015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: ON FILE 6639 CLOVERLY AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ARCD CA 910077716 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: CAMINO REAL 5382-010-030 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J1 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 1.00 FIX 16.20 TENANT: 25 LAVATORIES/SINKS 2.00 FIX 32.40 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 45 WATER CLOSET/URINAL 2.00 FIX 32.40 03/15/01 UT 09/11/01 47 WATER HEATER(S) 1.00 WTH 16.20 OWNER: TEL. NO: TOTAL FEES 124.95 FINAL DATE FINAL BY: CODE: ANDERSON, THOMAS E (626) 447-3923- 6639 CLOVERLY AVENUE Coca I TEMP 917803504 DESCRIPTION OF WORK# NEW PLUMBING FOR 1 AND 1.5 BATH ADDITION APPLICANT: TEL. NO: SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: / y ii APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO !'?� �/ a �� UNDER SLAB WORK WATER SERVICE -1.r ��„rFJ` �'�� PLASTIC Y/N. METAL Y/N ARCHITECT OR ENGINEER: TEL. N0: �� ROUGH PLUMBING II a LIC. NO GAS PIPING -- --_ - GAS VENT HOT WATER HEATER - PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED G CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0202010002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: .(626) 285-0488 EXT: LEG L_.ID:: FEES PAID BUILDING D SS:. ON FILE 6639 CLOVERLY AV FEE DESCRIPTION: QUANTITY.:, UOM: AMOUNT: ARCD CA 91007771,6 - TSSESSOR INFORMAT 0 NUMBER:f NEAREST"CROSS`STREET: CAMINO REAL 5382-010-030 01 PERMITl:SSUANCE'FEE L, ,.1! r 27.75 THOMAS PAGE:':596 GRID: J1 LOCALITY: TEMPLE CITY 51 LOW PRS GAS 5 OUTLET 11.00 SYS 16.20 TENANT: - TOTAL FiES 43.95 ISSUED ON- P OCESSED BY: PLAN BY: EXPIRES ON: 02/01/02 JK 07/31/02 OWNER: TEL. NO: FINAL DATE FIN L BY: CODE: ANDERSON, THOMAS E (626) 447-3923- n*�� 6639 CLOVERLY AVENUE" TEMP 917803504 DESCRIPTION OF RK, GAS LINE FOR HVAC APPLICANT: TEL. 0: SAME AS OWNER SPECIAL CONDITIONS: f CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO UNDER SLAB WORK WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR NGINEER: TEL. NO: i ROUGH PLUMBING LIC. NO.! ' ! - GAS PIPING GAS VENT HOT WATER HEATER P UMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTI IED ------ - CWV GRAY WATER SYSTEM I i. j REPORT] ID: `DPR263 ROUTE TO: BS0508 g