HomeMy Public PortalAbout9002 EMPEROR AVE_Plumbing__ 76A667 DBS 17 7-5I " APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAF TY
COUNTY OF LAS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN ISRP I ZONE �PERMIT� �q/�
VALLEY BOULEVARD PLUMBING CO.
PLUMB RECEIVED BY READY FOR DATE ISSUED
8300 EAST VALLEY FIRST INSPECTION
ADDRESS
KU,,3tmtAU A 1. 2-2719 0UILD4N3 /nO
CITY TEL N0. ADDRESS
COUNTY LOCALITY 1.
LICENSE NO. EXPIRES
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET(TOILET) O.SO S ADDRESS
BATH TUB (a 0.50 CITY TEL. NO.
SHOWER 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASHBASIN) 0.60 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
D
AND AGREE TCOMPLY 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 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OW ER
G+4B SYSTEM OUTLETS 0.50 Qf' THE RESIDENTIA ROPERTY DESCRIBED ABOV
610NATURE OF�
WATER HEATER 0 0.50 PERf"IITTE
SLOP SINK N K a 0.50 INSPECTION RECORD
FLOOR BINK 0.60
FLOOR DRAIN 0.50
DISHWASHER 0.50
DRINKING FOUNTAIN 0.60 '-/A - )- /C- /J17-1Z 01
URINAL t /0.60 /A/ ,16 7— !/,'fl7k1
n Q
HOUSE HEWER 0.50
MISCELLANEOUS
9,45 Ws rt?
H0 s 6 IS SOLD . 0
APPROVALS
DATE /INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING K.0 V v/ ��
GAS VENT "OIC I/"�,l/J ll-J
CESSPOOL 1;00 CESSPOOL Y
SEPTIO TANKC SEPTIC TANK
DRAIN ( ) PIT ( ) t.OD SEWER
PERMIT 1.00 GAB TEST F/Annp��9 /,L_ 'may—
UTILITY CO.NOTIFIED
TOTAL FEE
FINAL -//_61, Li
i
WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING- PERMIT
_4 20-0026 DPW 4/87
I hereby, affirm°thea I have a certificate'of cor sent to self m- 76A667A , .
,sure, or a certificate of Workers'Com ensation Insurance,or 6 ' -'•
P :CE 817(REV 8%86)
certified copy thereof.(Sec 3800, Lab.0 )
_, „ ` . "COUNTY OF LOS ANGELES =' DEPT. OF PUBLIC-WORKS' - -
Policy No ' Company,
Certified copy is,hereby furnished .BUILDING Q A ., •• '"
FOR APPLICANT TO FILL IN (PRINT OR TYPE) _ ! /`40 a, G 'I,C
"Certified copy is filed with the county building,inspection ADDRESS v V
department ; " NUMBER FIXTURE OR ITEM �a FEE
LOCALITY-
WATER CLOSET(TOILET)
.Date "*`' -Apphcani NEAREST ,0 ;
_ , BATH TUB CROSS,ST
CERTIFICATE OF,EXE/MPTION FROM'WORKERS" ]
'
'COMPENSATION INSURANCE : = SHOWER, ' 3 OWNER. �'1—
. . -�
'(This section need not be completed if the`wor'involved by MAIL
"the permit is for one hundred dollars ($100) or less.) LAVATORY ;y ADDRESS Q �Ct!(. F ' s4 r T aOoZ
I:certify`iFat in ithe'performanc.of the work'for which this"per- A - E u
init is'issued, I shall- m
not employ any person in arty manner so SINK CITY S� yb, TEL NO
tds to becom``e`sublect to.the Workers' Copensdtion Laws
DISHWASHER CONTRACTOR, co
Date-• �Applicantj - CLOTHES'WASHER'
ADDRESS, - •
NOTICE TO'APPLICANT If_after making this Certificate of Ex- Q
e_n ' on,"you should become'sublect to the Workers'Compen- SWIMMING'PO6L RECEPTOR
CITY, TEL NO,•
•'satin provisions of the Labor Code,--you must forthwith'compd" Lo WN`SPRINKLER:SYSTEM ` ��� e C`_ r
ovisions'or this permit shall be dee STATE LIC
ly with such pr
ed b° a WATER HEATER. . LICENSE NO / CLASS-,.
92 9
'LICENSED CONTRACTORS DECLARATION DISTRICT NO / P E ED BY .
GAS SYSTEM OUTLETS
I hereby affirm that5l-am licensed under provisions of Chapter.' (/ D
9(commencing wiih Section 7000)'of Division 3 of the Business` OUTLETS OVER
and,Professions Code,'and my,license,is in full force and'ef-• 5 P,ER'SYSTEM -FINAL`
feet VALID TION
. DATE — „ f�
i �/ O
License.Number ,3 f �` Lic Class' V
Q FIN
Contractor`-'• S-¢ Date-2
v (
a' I am exempt under Sec- .46 / 33.� ���J V
LU
B &P'C for this reason, Plan check fee' N
t�. , . ' date �) 8 3 3.1 A x
PLUMBING-PERMIT ISSUING FEE $ S v ;
# o o e,s:o5.
Signature
NOTAL FEE
SINGLE FAMILY 5' i o' o l 656,
H E OWNER-BUILDER,DECLARATION Plan check applicant
t
I hereby affirm ih'at I am exempt from the Contractor's License Name o oyo; 6-5,10
daw for the following reason (Section-7031 5, Business and
S" w ' -• =J' "
ProfessionsCode) Address (, �;;� +8
`I, s owner of the^property,will,dothe,work and the City
Tel No _
structure is not intended or offered:for sale(Sectwn 7044,-
Business and'Piofessions Code) '
'- CONSTRUCTION LENDING AGENCY'
y
I hereby affirm that there,is a construction.,lending agency for
the performance'of'the work for,which'this:permit'is issued
(Sec 3097, Gv -C )
- Lender's Name
Lender%,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, an&heieby = _
authorize representatives of this.County to enter upon the'
above-mentioned property for inspection purposes ,•
1 'f SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee -Date a
• COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0210160013
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: ES PAID BUILDINGADDRESS:
ON FILE 9002 EMPEROR AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SGAB CA 917752017
ASSESSOR 0 NEAREST CROSS STREET: ROSEMEAD
5382-021-001 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H1 LOCALITY: TEMPLE CITY
07 BATHTUBS/SHOWERS 1.00 FIX 16.20
11 CLOTHESWASHER(S) 1.00 FIX 16.20 ISSUEDPROCESSED A XP .
25 LAVATORIES/SINKS 1.00 FIX 16.20 10/16/02 JK 04/14/03
45 WATER CLOSET/URINAL 1.00 FIX 16.20
OWNER: TEL. N • 47 WATER HEATER(S) 1.00 WTH 16.20 FINAL DATEF1N AL BY- CODE:
LOU PING FAN (626) 285-1269- 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20
9002 EMPEROR AV TOTAL FEES 124.95 L3
SGAB 917752017 DESCRIPTION OFIWORK
PLUMBING FOR ADDITION/CONVERSION
APPLICANT: L. 07
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. N0: �/,�;% ���� APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NO �lfllr�`
ryez� �.� SLA R
/ WATER SERVICE
11 v yly p�✓� r� ��, PLASTIC Y/N METAL Y/N
ARCHITECT OR ER: TEL. NO: ' 1
�,j �`__ ����� ROUGHPLUMBING
LIC. NO:/ �___ I _� '� s---
L�
GAS VENT
-� --,� 7,
HOT WATERE
- - - -- -- — - - - - B NFIXTURES
LAWN SPRINKLERS
GAS TEST
L OMNOTIFIED
cWV
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508