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Home My Public Portal About10545 DAINES DR_Plumbing__ 76A667 Deg 17 11-60 APPLICATION FOR PERMIT RTMENT OF BUILDING AND SAFETY =mtxaft�COIINTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER PLUMBING 1 1 GROUP I ZONE PERMIT NU. FOR APPLICANT TO FILL IN —tics Qm,$ � � PLUMBER 0" NK 5 l 1' REOEIVED BY READY FOR DATE ISSUED / FIRST INSPECTION +�'` �f ADDRESS �P�`G �( P CIA mj BUILDING /Q057 C—ITY—,+ QD V TEL. No ADDRESS 12 COUNTYv p.g� LOCALITY EXPIRES I'M NEAR EHT PERMIT FEES cRosa ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) 0.50 $ ADDRESS BATH TUB @ O.SO CITY -F,L No. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN BINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. i CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROP RTY DESCRIBED ABOVE. GAS SYBTEM OUTLETS @ 0.50 q �A SIGNATURE OF /� . @"� �4_pk _ WATER HEATER @ 0.50 PERMITTEE �4.I �_ 4-R.yj SLOP SINK @ 0.50 INSPECTION RECORD V FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 13.513 �f� - URINAL @ 0.50 V ../� A 1 J Q HOUSE SEWER @ 0.50 � ^� Z MISCELLANEOUS v B 2 /a APPROVALS DATE INBPECTOR'8 NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1,00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 1 SEWER PERMIT . . I 1.00 DAs TEST so UTILITY CO.NOTIFIED TOTAL FEE `B FINAL 76A667 DBS 17 11-513 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF EN13INEER PLUMBING 1. FOR APPLICANT TO FILL IN DI P I Z13NE MIT NO. 7 nil 4�� i i -;3 ?' PLUMBER RIVED BY READY FOR ' DATE 1 UED FIRST INSPECTION / ^l ADDRESS t %� _ BUILDING " • � '�� CITYTEL. No. ADDRESS COUNTY LOCALITY LICENSE NO. EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL 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 KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB 011 TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER GAS SYSTEM OUTLETS @ 0.50 OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. '�'"�" SIGNATURE OF WATER HEATER @ 0.50 PERMITTEE SLOP SINK @ 0.5D INSPECTION RECORD FLOOR SINK @ 0.50 r f -q FLOOR �'- FLOOR DRAIN @ 0.50 _ DISHWASHER @ 0.!Scl DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 .3 `� / •.' • ^:, r 7.,; ,�. V F- J HOUSE SEWER @ 0.50 I J L Z_ MISCELLANEOUS 3 tl a ��'-l1��" �t`C� �I T [7 Q' Top TTo nw c ti vc4gTe.,e ❑ -;-1 T. /xZ I-,-w. APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1:00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 I SEWER PERMIT 1.00 GAS TEST TOTAL FEE ' I UTILITY CO. NOTIFIED � �•. Ir FINAL l WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 f r insure, or a certificate of Workers' Compensation Insurance, 76A667A or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS A Policy Noompony Certified,copy is hereby furnished c FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ❑ Certified copy is filed with the county building inspec- ADDRESS dJC`yJ yTl tion department NUMBER FIXTURE OR ITEM @ FEE f—LOCALITY � f / e Ctf Dae /Q_ AppItgont � /l_177�7b1� WATER CLOSET NEAREST 1-2 BATH TUB CROSS ST I� '� qL`,•ERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER >�G (This section need not be completed If the work Involved by MAIL the permit is for one hundred dollars ($100)or less ) LAVATORY ADDRESS &t(}l f- I certify that in the performance of the work for which this -1 permit is issued, I shall not employ any person in any manner SINK CITY + TEL NO so as to become subject to the Workers'Compensation Laws DISHWASHER ' CONTRACTOR /n7 _fe2ilc CA— Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL NO y LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NOJ� `-f CLASS :1 -+c. LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS � C/ (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Pr�fQ,s}$ns Code,and m license is to full force and effect 5 PER SYSTEM 0> GGJJ�'��/ y FINAL VALIDATION a� ' DATE M, ens Number �C)S 5 L/C{ Lic Class C- U t FINAL � Contractor r,_du Pk 7q Dated - BY fi19, c Q ❑ j am exempt under Sec W B 8P C for this reason I'i Date Plan check fee ® Z Signature _'d'-'-�=F Z PLUMBING PERMIT ISSUING FEE$ - n�' TOTAL FEE 3 �. 5 Plan check applicant I l i SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name l i" t F� m `" - I hereby affirm that I am exempt from the Coritractor's License Address `' � �' °-�J Law for the following reason (Section 7031 5,,Business and Professions Code) City Tel No rt"tf 'i='- ❑ 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 r ordinances and State laws regulating Plumbing, and hereby l authorize representatives of this County to enter upon the - above-mentipne pr erty fo inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE i ture of FermiF; Date evORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 insure, or a certificate of Workers' Compensation Insurance, 76A667A or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS 1. Policy NoJ2r��mpony Replsill e lid. ❑ Certified copy is hereby furnished ❑ _ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building pec NUMBER FIXTURE OR ITEM Q FEE ADDRESS 1 0545 D4i:nes Dr. tion department LOCALITY Temple Cit Date_8/24/94 - —Appl.c ` WATER CLOSET NEAREST CERTIFIICCATE OF EXEMPTION FRO ORKERS' BATH TUB CROSS ST Pal Mal COMPENSATION INSURANCE SHOWER OWNER Lowe (This section need not be completed if the work Involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY 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 CITYTemple TEL NO 442-71 50 so as to become subject to the Workers Compensation Laws DISHWASHER CONTRACTOR Br ant Jitq Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT If, after making this Certificate of 13 5 0 E. Las Tunas Dr.. Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY Tempel City TEL NO _ LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO CLASSr—on LICENSED CONTRACTORS DECLARATION DISTRICT NO�� PROCESSED BY I 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 FINAL VALIDATION p Z CI�� License Number�3751 Lic Class C;-2() DATE U FINAL VControctor ate $= 24r—/_=r= /� BY Y Q ❑ f-1 I am exempt under Sec () 141 B 8P C for this reason Plan check fee ® t Date PLUMBING PERMIT ISSUING FEE$ Signature � r"'1'" TOTAL FEE — Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 'L I hereby affirm that I am exempt from the Contractor's Licenser_.('��t�'GE .=l1' 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 t I=1f 7044, Business and Professions Code) t�+at � fi�'ix_ 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 pop- ordinances and State jaws regulating Plumbing, and hereby authorize representatives of this County to enter upon the ve-mntioned property inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE X�S,gnaturi4�rm,tte Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS T- NAS PL 0508 0007100018 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: EGA FEES PAID BUILDING ADDRESS: TR: 8822 LT: 80 BL: .001 10545 DAINES DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802813 ASSESSOR NFOR A ON NUMBER: NEAREST CROSS STREET: HALIFAX 8586-011-015 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY 47 WATER HEATER(S) 1.00 WTH 16.20 EN TOTAL FEES 43.95 ISSUED N: PRO-S-SED BY: PLAN EXPIRES . 07/10/00 UT 01/07/01 OWNER: TEL. NO: FINAL DAT FINAL BY-: CODE: LOWE R GARY;BEVERLY S (818) 442-7150- 10545 DAINES DR I TEMP 917802813 DESCRIPTION OF WORK WATER HEATER CHANGE OUT IN SAME LOCATION APPLICANT: TEL. NO: GOOD DAY PLUMBING INC (626) 285-8080- 9729 E. LIVE OAK AVE SPECIAL CONDITIONS: TEMPLE CITY, CA 13EAES co CONTRACTOR: TEL. NO: ®� APPROVALS DATE INSPECTOR SIGNATURE GOOD DAY PLUMBING (626) 285-8080- 9729 E LIVE OAK LIC. NO UNDER L WORK TEMPLE CITY CA 91780 565485 WATER SERVICE ARCHITECT 0 EN IN ER: TEL. PLASTIC Y/N METAL Y/N LIC. N0: OUGH11PLUMBING 1111111 GAS PIPING GAS ENT U E L W(0 OT WATER HEAT �� `/ PLUMBING FIXTURES O I LAWN SPRINKLERS O ❑ �� GAS TEST A 0 yUTILITY CO TIFIED �e�'vece Vh�'� oe V GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508