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Home My Public Portal About9915 DUFFY ST_Plumbing__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1306190012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: 1 FEES PAID I BUILDING ADDRESS: ITR: 18155 LT: 5 I 9915 DUFFY ST I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917802608 I (ASSESSOR INFORMATION NUMBER: I - I NEAREST CROSS STREET: LIVE OAK 1 18588-013-012 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY CAI 1 147 WATER HEATER(S) 1.00 WTH 16.20 (TENANT: I TOTAL FEES 44.00 (ISSUED ON: PROCESSED BY: PLAN BY: I 106/19/13 SR I (OWNER: TEL. NO: - I IFI , D TE, FINAL BY: CODE: I IPEARSON MICHAEL G 19915 DUFFY ST I I n/ ITEMP 917802608 I ID PTION OF WORK IWATER HEATER CHANGEOUT I I I (APPLICANT: TEL. NO: I I (DOBBINS, KEVIN (310) 838-0408- I 1 13801 LENAWEE AVE 1 ISPECIAL CONDITIONS: ICULVER CITY 1 I I I I I I I i I 1 (CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE I IMIKE DIAMOND PLUMBING (310) 838-0408- 1 I 13801 LENAWEE AVE. LIC. NO I IUNDEI2 SLAB WORK ICULVER CITY CA 90232 399170 I 1 1 I IWATER SERVICE 1 I I _I IPLASTIC Y/N METAL Y/N I i (ARCHITECT OR ENGINEER: TEL. NO: I I (ROUGH PLUMBING I I I LIC. NO: I I .1 I I I I (GAS PIPING 1 I IGAS VENT I I I I I I ' (HOT WATER HEATER Irl I (PLUMBING FIXTURES I 1 1 I I I I I I ILAWN SPRINKLERS I I I I I 1 IGAS TEST I I (UTILITY COMPANY NOTIFIEDI I I I I I I ICWV I I I I I I 11 1 I IGRAY WATER SYSTEM I I I I I I I 1 I I I I I I I I I I I I I I I I I I I I I I I i I I I I I I I I I I I I I I I I I i I I I I I I I I I I I IREPORT ID: DPR263 ROUTE TO: BS0508 I I I I I I I 76 A 667—CE 817 468 \!'mss"-' APPLICATiON FOR MBI G PIERM;�� COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING Thi ff! JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS991 COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY no FOR APPLICANT TO FILL IN (PR NT oR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER T. Sent WATER CLOSET -1.50 WAIL BATH TUB I.50 ADDRESS -�� SHOWER 1.50 CITYTempleC TEL. NO. LAVATORY 1.50 CONTRACTOR _ _ SINK 1.50 ADDRESS 16920 Grand A DISHWASHER 1.50 CITY TEL. NO. 44Zm -7070 CLOTHES WASHER 1.S0 STATE LIC LICENSE NO. 2898 CLASS C-20 SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GRO P ZONE BY LAWN SPRINKLER SYSTEM 2.00 e � 0 P r0 WATER HEATER 1.50 1L<O INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.50 INSPECTION REC A OUTLETS OVER 5 PER SYSTEM •30 •/ - I LU N z a Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE 3.50 APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK ]dame ROUGH PLUMBING Address GAS PIPING GASVENT City. Tel. No. HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COU TY AND STATE OF " CALIFORNIA OR THAT I AM TME LrAOWVNE F AND INTEND O RESIDE IN.THE ABOVE DESCRI D TIA PERTY. - FINAL SIGNATURE JACK R. ALLEN, SUP RVISIN CH ANICAL ENG'R, G PERMITTEE PERMIT VALIDATION C K. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH ` 742 F 17 5 D 3.5G .. ler e': 7n,a-so APPLICATION FOR PERMIT D&ZARTMEATT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER p� FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT'NO. PLUMBEf�ON 1 f•NA PLUMBING CONTRACTOR=' 'f•�/n Ci RECEIVED BY READY FOR DATE ISSUED e� W, Lo S:5 ADDRESS344 , GarVey = Monterey Park, ttu1, FIRST INSPECTION A•�•�¢� 54 - �1d Gl -'u BUILDING � CITY 4®S �/ TEL. NO. ADDRESS 9F IS COUNTY 94 / f P g LOCALITY. LICENSE Nb. �p — EXPIRES 1O l?0 V.�..5 y 4 NEAREST PERMIT FEES CRcss ST. '} d'S NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER 1, 1-41 MAIL WATER CLOSET (TOILET) @ 0.50 5ADDRESS BATH TUB @ 0.501 4- CITY TEL. NO. SHOWER @ 0.501 -5-6 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS �7�/I LAVATORY (WASH BASIN) @ O.SO ^� APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND O I_KITCHEN SINK @ 0.50 STATE LAWS REGULATING PLUMBING. a I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 �� - ANGELES COUNTY LICENSE, O E LEGAL OWNER OF THE RESIDENTIAL PROPERTY ESCRIBEdIN VE. ® I GAS SYSTEM---3—OUTLETS @ 0.50 I 115'b�A SIGNATURE OF WATER HEATER @ 0.50 I y 4! PERMITTEE SLOP SINK @ 0.501 INSPECTION RECORD FLOOR SINK @ 0.50 IFLOOR DRAIN @ 0.501 IDISHWASHER @ 0.5011 DRINKING FOUNTAIN @ 0.5011 IURINAL @ 0.501 I .J IHOUSE SEWER @ 0.501 I Q MISCELLANEOUS 0 I APPROVALS DATE INSPECTOR'S NAME en ROUGH PLUMBING GAS PIPING GAS VENT 1 CESSPOOL @ 1.00 I CESSPOOL �I SEPTIC TANK: I SEPTIC TANK I 'DRAIN ( ) PIT ( ) @ 1.001 I SEWER PERMIT . I 1.00 GAS TEST (� I UTILITY CO. NOTIFIED TOTAL FEE $ p FINAL WOR55'COMPENSATION DECLARATION /p� PPMC n��ON FOR PLU p NG j�j?ji]Fl T I hereby!,Uffifm that I hove a certificate of consent to self 76A667A D=� ll lry ll V u�1 ll U1/ll ll V ll L5 WfIVU insure, ora certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) W certifiieQed�co/jyam�thereof (Sec..3800, L b/�C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY 01 No. ompany2e-Aq oo, ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS tion department. a- NUMBER FIXTURE OR ITEM @ FEE nn�, Date /— ✓ Applicant NOEAREST CALITY ��/v( /e fe WATER CLOSET CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER' OWNER (This section need not be completed if the work involved by . the permit is for one hundred dollars $100 or less. MAIL P ( ) ) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER e, CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers: SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY• Tmq (� �!J`�qC TEL. NO.Lr(/z'�Cr� LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE �7 LIC. Q� deemed revoked. WATER HEATER LICENSE NO. O 37 J 5 CLASS C S LICENSED CONTRACTORS DECLARATION DISTRIC O. R ESSED BY I hereby affirm that I am licensed under provGAS' SYSTEM OUTLETS visions of Chapter 9 ( � � (commencing'with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM. A �f °� DATE �,TION License Number,/UJ 73� Lic. Class 03 Contractor D (� /!/N04 Date� BY 0 ❑ • LU I am exempt under Sec. 3J 8 0..1 'A IL B.BP.C. for this reason }y H Plan check fee D tt 0 o 0 0 0 5 Date: PLUMBING PERMIT ISSUING FEE$ Signature ,I o.a 1 650 TOTAL FEE Plan check applicant 9 0 0 1 6 5 051: SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 0 1. 1 5=86 I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and 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 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby.offirm 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-mentioned property for inspection purposes. �ry - � SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date