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HomeMy Public PortalAbout9115 DUFFY ST_Plumbing__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0306170008 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL S PAID BUILUNG ADDRESS: TR: 16134 LT: 9 9115 DUFFY ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802449 ASSESSOR INFORMATIONBER: NEAREST CROSS STREET: NOEL 5387-022-021 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY 47 WATER HEATER(S) 1.00 WTH 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: P OCES AN BY: EXPIRE ON: 06/17/03 JK 12/14/03 OWNER: TEL. NO: FINAL DATE FINAL Y: CODE: PARKER THOMAS P;NANCY (626) 287-5626- —7 03 9115 DUFFY ST TEMP 917802449 UNFRIPTIO 0 WO K C/O WATER HEATER APPLICANT: NO: ACTION CONTRACTORS (310) 515-1311- 17111 S BROADWAY ST SPECIAL CONDITIONS: GARDENA 90248 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ACTION CONTRACTORS (310) 515-1311- 17111 SOUTH BROADWAY LIC. NO UNDER SLAB WORK GARDENA CA 90248 B/L 27953 WATER SERVICE PLASTIC Y/N METAL Y/N T CENGINEER: TEL. NO: - ROUGH PLUMBING LIC. NO: GAS PIPING GAS VENT HOT WATER HEATER I PLUMBING FIXTURES III LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED cWV GRAY WATER SYSTEM • ADDITIONAL DATA ON FILE REPORT ID: OPR263 ROUTE TO: BS0508 76A667 OBS17 I,-6O APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER �Im..I­I-ZEINE PERMIT !' FOR APPLICANT TO FILL IN 3 y' _/ q 1' PLUMBER yAL�EY R !llFVAR i)I N ro RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION ADDRESS 8300 EAST VAT ) FY gi V BUILDING 'fl"ROSEMEAD TEL No. _271 ADDRESS LICENSE No. 93M EXPIRES 630• LOCALITY ` •� _ NEAREST PERMIT FEES CROSS BT. L NUMBER TYPE or IIXTIIRE OR ITEM FEE OWNER MAIL - WATER CL08ET(TOILET) 0 0.50 B ADDRESS BATH TUB @ 0.50 CITY TEL No. — SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS —LAVATORY (WASH BAS(M) 0.50 APPLICATION AND STATE THAT THE ABOVE I9 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES --KITCHEN SINK @ 0.50 AND 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 RESIDENTIAL PROPERTY DESCRIBED ABOVE. OAS SYSTEM OUTLETS @ 0.50 SIGNATURE OF . WATER HEATER @ 0.50 PERMITTEE SLOP SINK - ® 0.50 INSPECTION RECORD FLOOR BINK - @ 0.50 FLOOR DRAIN @ O.SO DISHWASHER - @ 0.50 ,• DRINKING FOUNTAIN Q D.SO URINAL ~ ® 0.50 _ Q HOUSE SEWER @ 0.50 Z M19C ELLANEOU9 63 o APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING OAS PIPING OAS VENT CESSPOOL ® 1:00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ I.DO SEWER / .¢ PERMIT 1.00 GAS TEST I�/.s.'EYE C��/L'42• —� 4!-0 UTILITY CO. NOTIFIED _ TOTAL FEE B 1 / FINAL V _ WORKERS'COM ION DECLARATION raeeeow - APPLICATION FOR PLUMBING PERMIT I hereby affirm that I.have have x a certificate of concept to self ce an I Iz-ea) insure, or a certificate of Workers'Compensation Insurance,or a certified copy.thereof(Sec. 3800,Lab.C.) COUNTY OF LOS ANGELES 7 ' - BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished: FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Certified copyis filed with the county building inspection NUMBERI FIXTURE OR ITEM © FEE ADDRESS- 4e artment. LOCALITY D WATER CLOSET Dale - Applicant NEAREST i BATH TUB CROSS ST. CERTIFICATE EXEMPTION FROM WORKERS' —' COMPENSATION INSURANCE SHOWER OWNER MAIL (This section need not be completed if the work involved LAVATORY o1• ADDRESS by the permit is for one hundred dollars ($100) or less.) SINK `� / CITY TEL. NO��� J��b � 1 certify that in the performance of the work for which this DISHWASHER permit is issued, I shall not employ any person in any an no CONTRACTOR so as toeco a subject.to t e Workers'Comp ns ion laws. CLOTHES WASHER Q t • - F �Date� Applicant ADDRESS SWIMMING POOL RECEPTOR U NOTI E T APPLICANT: if, after mak ng this Certificate of CITY TEL. NO. C Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATELIQ to Compensation provisions of the Labor Code, you must forth- LICENSE NO. CLASS z with 'comply with such provisions or this permit shall be WATER HEATER deemed revoked. DISTRICT NO. PFV5CESSED 8 GAS SYSTEM OUTLETS LICENSED CONTRACTORS DECLARATION OUTLETS OVER S/QU I hereby affirm that I am licensed under provisions of Chapter '5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL ,O ` VALIDATION " ness and Professions Code, and my license is in full force and DATE ! yl effect. FINAL License Number Lia Class- BY Contractor Date _2L V I am exempt from the licensing requirements as I am a plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section.7031.5, Busi- City Tel. No. 1 9 5 6 A ness and Professions Code): 13 1, as owner of the property, am exclusively,contracting # o o e o - 5 with licensed contractors to construct the project 2e o 2800 (Section 7044, Business and Professions Code). _. CONSTRUCTION LENDING AGENCY e oo2 a Q 0v 1 hereby affirm that there is a construction lending agency ' for the performance of the work for which this permit is I,1. 1 .3—8 1 issued 'Sec. 3CiY:C.). (� �-, �.S r W 0(�� Lender's Namee nnle /—n Y!J Lender's Address —1 ( 1 D ! �. M I certify that I have read this application and state that the above information is correct.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby - authorize representatives of this County to enter upon t e - above-mentioned prof try f insp tion purposes. %. "A o— � Boa„ ;1 " �,a �f Signature o Apermittee Date