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Home My Public Portal About10533 DAINES DR_Plumbing__ WORKERS'COMPENSATION DECLAIR44TION I' APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of corisent to self 76A667A 1 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 Certified copy'is hereby furnished copy g BUILDING ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS �6.3rS �• Q4 ' Certified cois filed with the county building inspec- tion department NUMBER FIXTURE OR ITEM @ FEE LOCALITY �— Date Applicant WATER CLOSET NEAREST nn CERTIFICATE OF EXEMPTION FROM WORKERS' - l BATH TUB CROSS ST �4 ASL COMPENSATION INSURANCE SHOWER OWNER � 4S fr0 H h (This section need not be completed if the work involved by MAILf 'j� the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS �J 3 flA+t-r�9 I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY ✓ TEL NO so as to become subject to the Workers'Compensation Laws DISHWASHERT7T CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL NO Compensation provisions'of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO SS LICENSED CONTRACTORS DECLARATION DISTRICT NO OCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS s 15 (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect 5 PER SYSTEM FINAL f CL DATE 11-4; VALIDATION 4 License Number Lic Class OC FINAL fi O Contractor Date BY _I V ❑ ua I am exempt under Sec a H B&P C for this reason Plan check fee ► Date PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLE FAMILY Plan check applicant :P2'7 6.2 A • HOME OWNER-BUILDER DECLARATION Name ;i o 0 o o,o'5 I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031 5, Business and 2 0 0 4 0, 5 0 Professions Code) City Tel No ❑ j, as owner of the property, will do the work and the 0 o 0 4 0 5 0=0 structure is not intended or offered for sale (Section loop. 0'611'4 7044, Business and Professions Code) -&3 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 e roperty for inspection purposes ' `,. SEE REVERSE FOR EXPLANATORY LANGUAGE to Signature of Permittee Dater WORKERS'COMPENSATION cafeDECLARATION se APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of'fansent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV 10/81) a- or a certified copy thereof (Sec 3800, Lob C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company ❑ Certified copy is hereby furnished = ❑ FOR APPLICANT TO FILL INPRINT OR TYPE BUILDING \ Certified copy is filed with the county building inspec- ( i ADDRESS ��'S33 �. 4l1tA2_s tion department NUMBER FIXTURE OR ITEM @ FEE �7- LOCALITY Date Applicant WATER CLOSET NEAREST - CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST -a l 1YW COMPENSATION INSURANCE SHOWER OWNERAskliA naxn (This section need not be completed if the work involved by A,heel the permit is for one hundred dollars ($100)or less.) MAIL LAVATORY ADDRESS ��J 3� ""�'•' I certify that in the performance of the work for which this � permit is issued, I shall not employ any person in any manner SINK CITY l B� TEL NO ^.. 32 f so as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR Dote /applicant CLOTHES WASHER NOTICE TO APPLICANT If, after making this' Certificate of ADDRESS Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions,of the Labor Code, you must forth- CITY TEL NO LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO C LICENSED CONTRACTORS DECLARATION DISTRICT NO P ESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS �r-r (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER c-7 >_ and Professions Code, and my license is in full force and effect 5 PER SYSTEM FINAL 9L - DATE �� VALIDATION u License-Number Lic Class IF FINAL ad Contractor Date BY "' 0 ❑ V U, I am exempt under Sec � B&P C for this reason r» Plan check fee Z Date PLUMBING PERMIT ISSUING FEE$ -'j� ► Si nature g - � (� �� Plan check applicant TOTAL FEE a 1 6 5 Q SINGLE FAMILY O O V 1 6,50Q HOME OWNER-BUILDER DECLARATION Name j hereby affirm that I am exempt from the Contractor's License Address Q 1 — v Law for the following reason (Section 7031 5, Business and Professions Code) City Tel No ❑ j, 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 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 jaws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above- ention property for inspection purposes _ � SEE REVERSE FOR EXPLANATORY LANGUAGE Z/0 P,-, Signature of Permittee Drate t ` COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9608220036 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE:, (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 8822 LT: 1 10533 DAINES DR ASSESSOR INFORMATION NUMBER: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802813 NEAREST CROSS STREET: EL MONTE 8586-011-017 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 1.00 FIX 16.35 TENANT: 25 LAVATORIES/SINKS 2.00 FIX 32.70 TSSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 45 WATER CLOSET/URINAL 1.00 FIX 16.35 08/22/96 TC 08/22/97 TOTAL FEES 93.15 OWNER: TEL. NO: FINAL D TE FINAL BY: CO KAO DAVID �� f6 6832 MUSCATEL AV 7 17 SGAB 917751226 DESCRIPTION PLUMBING FIXTURES REPLACEMENT DUE TO FIRE DAMAGE APPLICANT: 0• THE CHENGTON_ENT_ERPRISE, INC. (818) 446-2068- - • SPECIAL CONDITIONS: - CONTRAC OR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE THE CHENGTON ENTERPRISE, INC. (818) 446-2068' 735 W. DUARTE RD. #438 LIC. NO UNDER SLAB WORK ARACDIA, CA 91007 721149 B WAR SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR NGINEER- - ROUGH PLUMBING LIC. NO:, tilt GAS PIPING PU�L�C p /,� p0��S GAS VENT � �1� HOT WATER HEATER 'g- LAWN SPRINKLERS GAS TESTJ2�6-R UTILITY COMPANY NOTIFIED CwV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9612120006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 8822 LT: 1 10533 DAINES DR 1 FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802813 ASSESSOR INFORMATION ER: NEAREST CROSS STREET: 8586-011-017 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.35 TOTAL FEES 44.10 ISSUED ON: PROCESS BY: PLA E . 12/12/96 TC 12/12/97 OWNER: TEL. N0: FINAL DATE FINAL Y• CODE: KAO 6832DAVID MUSCATEL AV SGAB 917751226 DESCRIPTIORK GAS SYSTEM FOR NEW HEATING AND A/C UNITS APPLICANT: TEL. NO: ATLANTIC AIR (818) 330-6676 `� �° SPECIAL CONDITIONS: oO CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ATLANTIC AIRE (818) 330-6676- 15865-B GALE AVENUE #808 LIC. NO � \ UNDER SLAB WORK INDUSTRY, CA 91745 613226 C20 WATER SERVICE RCHITECT OR ENGINEER: TEL. N � CI �O PLASTIC Y/N METAL Y/N ROUGH LIC. NO: ( — uun LGAS PIPING `( HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV WATERGRAY SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508