HomeMy Public PortalAbout9623 CRAIGLEE ST_Plumbing__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0303200013
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
-LEGAL D: FEES PAID BUILDING ADDRESS:
ON FILE 9623 CRAIGLEE ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801409
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY BLVD
5383-014-011 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY
51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20
TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
03/20/03 JK 09/16/03
OWNER: TEL. NO: FINAL DATE ��I� NAL BY: CODE:
THUEN MARY E TR THUEN TRUST (626) 355-6178- �q u
9623 CRAIGLEE ST E116121II//IIII��� p A
TEMP 917801409 DESCRIPTION W K
HVAC C/0
APPLICANT: TEL. NO:
CONNOR A/C (626) 286-3157-
4931 ENCINITA AVE SPECIAL CONDITIONS:
TEMPLE CITY 91780
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
CONNOR A C (626) 286-3157-
4931 N ENCINITA LIC. NO UNDER SLAB WORK
TEMPLE CITY, CA 91780 403735 C38
WATER SERVICE
PLASTIC Y/N METAL Y/N
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
* ADDITIONAL DATA ON FILE
REPORT ID: DPR263 ROUTE TO: BS0508
DEPARTMENT OF COUNTY ENGINEER PLUMBING I
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES /
BUILDING (o
WILLIAM J. FOX, COUNTY ENGINEER ADDRESSJQ
F R APPLICANT TO FILL IN LOCALITY <
BUILDING NEAREST
ADDRESS CROSS ST. L1L/t,(A
DISTRICNO. 6 OUP ZON.0 PERMITN0.
LOCALITY 'fes I
NEAREST moi+
CROSS ST. RECEIVED BY Ready for Inspection DATE ISSUED
OWNER c�
MAIL INDUSTRIAL
ADDRESS WASTE APPROVAL
CITY TEL.NO.
INSPECTION RECORD
PLUMBER
ADDRESS �B g �..r/ry A�K►�
CITY TEL.N0.7?0 � 065�
(� ❑STATE
LICENSE N0. '.52 r3fCOUNTY f�
P RNIIT FEES
^7!J lA P_cR TYPE OF- FIXTURE OR ITEM FEE YC �✓a ^�� � �� �/� Z
WATER CLOSET(TOILET) @ 0.80
BATH TUB @ 0.80 O
SHOWER @ 0.80 d,
LAVATORY(WASH BASIN) @ 0.80 "o
KITCHEN SINK @ 0.80 V
LAUNDRY TUB OR.TRAY @ 0.80 C' a
SLOP SINK @ 0.80
FLOORSINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80'
DRINKING FOUNTAIN. @ 0.80
URINAL @ 0.80
GAS SYSTEM..-_. --.---OUTLETS @ 1.00 Q
WATER HEATER - @ 1.00 / no
---vvv------ MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
47 IrA GAS PIPING y m
TOTAL FEE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THI ApPLI.'� GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
IHEREp/
AND/OR LICERTIFY A
LICENSED AS REQUIREDPROPERLY REGISTERED
By
YLOS ANGELES COUNTY' GAS TEST �/Y i/Z
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN
ER OF THE ABOVE SCRIABEDD RESIDENTIAL PROPEfRTTYE I UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE. -................ ..........-.....-.......
FINAL
76A667 DBS 17 1/53
WORKERS'COMPENSATION DECLARATION 7ene67A (�p p p (�
I hereby affirm that, I have a certificate of consent to self cE sf i (z-ao) A I� P L I C A'T 0 O II�I FOR II— L�ley M B I N ..PE R M A T
insure, or a certificate of Workers'Compensation Insurance;or
a certified copy thereof(Sec.3800,Lab.C.)
COUNTY OF LOS ANGELES Ul LDIr A SAFETY '
Policy No. Compan _
Certified copy is hereby fu i ed. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDI
ADDRESS ,
Cer ifie copyis filed wit th cou t b it in 'n p tion NUMBER FIXTURE,OR ITEM 01 FEE
LOCALITY
d t WATER CLOSET
Date" 'Applicant 4 NEAREST
BATH TUBCROSS ST.
CERTIFICATE OF EXEMPTION FROM WORKERS' 11/2 Z101
COMPENSATION INSURANCE SHOWER „ OWNER
(This_ section need not be .comLAVATORY MAIL >_pleted if the work involved ADDRESS
by, the permit is •for one hundred dollars,($100) or,less.) SINK
CITY TEL.NO. / U
I .certify that in the-performance of the work for'which this DISHWASHER L7"� Co
perinif is issued, I shall not employ any person.in any manner CONTRACTOR a �
so as to become subject to the W,orkers';Compensation,Laws. CLOTHES WASHER O
ADDRESS /D ) U
Date Applicant SWIMMING POOL RECEPTOR LU
NOTICE.TOAPPLICANT:'If, after making this Certificate of CITY TEL. NO _ Q'7 N
Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE' LIC. z
Compensation,provisions of the Labor Code, you must forth !� LICENSE NO. GI-Z/ 'r CLASS--�e
With comply with such provisions or this permit shall be WATER HEATER.
deemed revoked. , GAS SYSTEM OUTLETS DISTRICT NO. RO SSED BY
LICENSED CONTRACTORS DECLARATION OUTLETS OVER
I hereby affirm that I am licensed under provisions•of Chapter 5 PER SYSTEM
9 (commencing with Section 7000) of Division 3 of the Busi- FINAL VALIDATI
Oeness and Professions Code, and my.license is in full force and DATE
effect.;
License Number`L ld_ �l ic.Class / FINAL
BY
Contractor ✓ ///� 155P 9/
F 71 I am exempt from the licensing requirements as I am ay Plan check fee c1 '
licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$
acting in,my' professional capacity (Section 7051, Bus-
iness and.Professions Code). ' �0_
TOTAL FEE Qr
Lic,or Reg.No. Date Plan check applicant
HOME OWNER-BUILDER DECLARATION Name, ( , ` 0 2 � p A
I hereby affirm' that I am exempt from the Contractor's Address v # o`0 0 0 0•5
License Law for the following reason (Section.7031.5, Busi City Tel_No.
ness and Professions Code): \b 2,° ° 1. 0,.00
❑ I, as owner of the property, am'exclusively contracting 0 0 0Q Q z
�.
with licensed contractors 'to construct '..the project °
(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 certifyPio
have re d is application and state that the
abov n
t. agree to comply with all County
ordi anc r gulatmg Plumbing, and hereby SEE REVERSE FOR EXPLANATORY LANGUAGE
aut riz f his County to ter upon the
abo e- or inspection purpo es.
Signature of Permittee Date