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HomeMy Public PortalAbout10206 DAINES DR_Plumbing__ 76A667 17 8-49® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY Ir"I'LUMBING 1 COUNTY OF LOS ANGELES WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. 10 6 -7 o �1 Jr-f 1' --P�-irSt.�'F RECEIVED BY READY FOR DATE ISSUED PLUMBER FIRST INSPECTION ADDRESS / .�'6!/ /� ' BUILD ING j � CITY h"6) d204 TEL. NO. ADDRESS 1 L1 COUNTY d LOCALITY LICENSE NO. EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL V WATER CLOSET (TOILET) 0.50 ADDRESS BATH TUB @ 0.50 CITY TEL. NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK @ O 50 STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESIDENTIA ISA PERTY DESCRIBED ABOVE. GAS SYSTEM OUTLETS @ O 50 SIGNATURE OF WATER HEATER @ 0.50. PERMITTE SLOP SINK @ o so INSPECTION RECORD FLOOR SINK @ O 50 FLOOR DRAIN @ O 50 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL @ O s0 J HOUSESEWER @ 0.50I Z' MISCELLANEOUS a Ir O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS 'PIPING GAS VENT CESSPOOL @ 1 00 CESSPOOL SEPTIC TANK SEPTIC TANK - I DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT 1.00 GAS TEST UTILITY CO NOTIFIED TOTAL FEE s FINAL 76A667 17 s=ae ® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY an 1 COUNTY OF LOS ANGELES PLUmb6442 WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT-NO. GROUP ZONE ON PERMIT NO. 74- PLUMBER �'S� f-� RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTI / ADDRESS �j A' �Q,J�1l t/ CITY TEL NO / '� ADDREBUILDING SS c: �� �!/—'`�1/ v n COUNTY yn I r� LOCALITY LICENSE NO v V t EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET (TOILET) Q O 50 I S I f ADDRESS� 501 4,*-.46 4--v4--vI BATH TUB Q O 50 I I CITY v TEL NO ..3/jp SHOWER Q O 50I 1 HEREBY CKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND 7-71 LAVATORY (WASH BASIN) Q O 50 I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND �1 KITCHEN SINK Q O Sol STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY Q O 501 ANGELES COUNTY LICENSE OR 1 AM THE LEGAL OWNER OF THE RES[DEN IAL PROPERTY DE CRISED ABOVE. GAS SYSTEM__1_ OUTLETS Q O 50 I SIGNATURE OF WATER HEATER @ O Sol PERMITTEE �k. SLOP SINK @ O 501 INSPECTION RECORD FLOOR SINK Q O 50 FLOOR DRAIN Q O 50 I DISHWASHER Q O 501 DRINKING FOUNTAIN Q O 501 URINAL @ O SOI .. ..I HOUSE SEWER Q O 501 I Z MISCELLANEOUS I 1 I� 0 I I O 1� 1 I � _ I APPROVALS DATE/ INSPECTOR'S NAME 1 ROUGH PLUMBING f 'A11 I 1 GAS PIPING 1 GAS VENT V I CESSPOOL Q 1 00 1 CESSPOOL SEPTIC TANK I 1 SEPTIC TANK I DRAIN ( ) PIT ( ) Q 1 001 1 SEWER PERMIT l 1.00 GAS TEST UTILITY CO NOTIFIED I TOTAL FEE I $ �� FINAL WORKERS' COMPENSATION DECLARATION 20-0026 DPW 4/87 APPLICATION FOR PLUMBING PERMIT eI reby, affirrn that 1 have a certificate of consent to self in- 76A667A re,or a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) certified copy thereof (Sec. 3800, Lab. C.) I . `fl 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 10 0'/' S 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 /sx,_ r �� s (This section need not be completed if tFie work involved by MAIL the permit is for one hundred dollars ($100) or less.) I LAVATORY 60— ADDRESS / \ I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so CITY TEL. NO. as,to become subject to the Workers' Co pensation Laws. DISHWASHER CONTRACTOR ,"S, Date`�7��Z�� Applicant CLOTHES WASHER V ADDRESS S—S.Z NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption, you should become subject to the Workers'Compen- CITY T TEL. sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM i ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. 3�U y Z-- CLASS C'_Z b LICENSED CONTRACTORS DECLARATION DISTRICT NO. {?/ PROCES BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM Z__OUTLETS 9(commencing with Section 7000)of Division 3 of'the Business OUTLETS OVER ✓ (f(((JJJ and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL 7 VALID ION fect. DATE License Number �/C© �Z� Lic. Class FIN99 Contractor Dote_ B O 17 I am exempt under Sec. U B.&P.C. for this reason Poo. �883.3A Plan check feeZZ Date: /0 � # 0:0 0 0 0 5 PLUMBING PERMIT ISSUING FEE$ Signature I ° - 40.50 TOTAL FEE SINGLE FAMILY 0 0 0 4 Q,5 0 c=i HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name 0 1.2 5 8 8 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. Cl.).* 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 oboe tioned pro erty for inspection purposes. <Z Z �L SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Da COUNTY OF LOS ANGELES r TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0912150018 BUILDING AND SAFETY_ / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) '285-0488 EXT LEGAL ID 1 FEES PAID I BUILDING ADDRESS ITR 15862 LT 2 1 10206 DAINES DR 1 IFEE DESCRIPTION. QUANTITY UOM AMOUNT TEMP CA 917802707 I ASSESSOR INFORMATION NUMBER- I I NEAREST CROSS STREET 18586-027-002 101 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID B3 LOCALITY TEMPLE CITY, CI 1 111 CLOTHESWASHER(S) 1 00 FIX 16 20 I 1 TENANT 113 DISHWASHER(S) 1 00 FIX 16 20 (ISSUED ON PROCESSED BY. PLAN BY- EXPIRES ON- 1 125 LAVATORIES/SINKS 1 00 FIX 16 20 112/15/09 SR 12/15/10 1 I 151 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20 1 I (OWNER TEL NO I TOTAL FEES 92 55 1F NAL UTE FINAL BX CODE I (WANG, WANJIE (626) 448-8908- 1 1I 110206 DAINES DR 1 1 ITEMP 917802707 1 I,D SCRIPTION-'OF WORK I I I (PLUMBING FOR KITCHEN AND LAUNDRY ROOM REMODEL I (APPLICANT TEL. NO ISAME AS OWNER I I ISPECIAL CONDITIONS I I I I I ICONTRACTOR. TEL. NO I (APPROVALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER - I I 1 I LIC NO I (UNDER SLAB WORK I 1 I IWATER SERVICE I I I I IPLASTIC Y/N METAL Y/N I 1 I 1ARCHITECT OR ENGINEER- TEL NO- 1 I= I I I I - 1 IROUGH PLUMBING 1 1 1 LIC. NO I 1 i (GAS PIPING I I IGAS VENT I I I I HOT WATER HEATER I I I I I I 1 IPLUMBING FIXTURES I I 1 _ I I I I I ILAWN SPRINKLERS I _ I 1 I I 7 IGAS TEST I 1 I I I •(UTILITY COMPANY NOTIFIEDI I I I ICwV I I I I (GRAY WATER SYSTEM I I I I I I I I I I I p� fl I I I I I R E D a 1 IREPORT ID DPR263 ROUTE TO BS0508 I I I 1 I I I I I I