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HomeMy Public PortalAbout9071 EMPEROR AVE_Plumbing__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1205210012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT (LEGAL ID I FEES PAID BUILDING ADDRESS I ON FILE 1 9071 EMPEROR AV I I IFEE DESCRIPTION QUANTITY UOM AMOUNT I SGAB CA 917752016 I ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET ROSEMEAD I 15382-011-018 101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY, Cl I 125 LAVATORIES/SINKS 1 00 FIX 16 20 TENANT I TOTAL FEES 44 00 11SSUED ON PROCESSED BY PLAN BY I 105/21/12 SR 1 (OWNER TEL NO I IFINAL ATE FINA BY CODE I IGHABOUR WAGDY R,ANAAM S (626) 482-2433- I IJ ._ 19071 EMPEROR AV 1 I ISGAB 917752016 I 1DEJCCR ' ON OF WORK 1 I I I IREPLACE LAVATORIE FOR BATHROOM REMODEL I (APPLICANT TEL NO I I 1 ISAME AS OWNER I I ISPECIAL CONDITIONS I I I I I I I I I (CONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE 1 ISAME AS OWNER - I I I I LIC NO I (UNDER SLAB WORK I I 1 I I I I I I I IWATER SERVICE I I I 1PLASTIC YIN METAL YIN I I 1 (ARCHITECT OR ENGINEER TEL NO I I I I 1 - I IROUGH PLUMBING I 1 1 LIC NO I 1 1 I IGAS PIPING I I I I I I 1 -1 IGAS VENT I I 1 I I I_ I I I I I 1140T WATER HEATER I I I I I I I I I I IPLUMBING FIXTURES I I I I I I I ILAWN SPRINKLERS I I 1 I I I I I I IGAS TEST I I I I I 1 1 I I (UTILITY COMPANY NOTIFIEDI I I I I 1 1-1 1 I I ICWV I I I I I I I I I IGRAY WATER SYSTEM I I I I I I I I I I I1 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 I I I I I I I IREPORT ID DPR263 ROUTE TO BS0508 I I I 1 I I D B S 17 25M BETS 10-47 APPLICATION FOR PERMT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING Wm.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION, DISTRICT NO. GROUPI ZONE PERMIT o. ROUGH FIXTURCS COMPLETE i HEATER CESSPOOL SEPTIC TANK R EI jjjrrM 13Y READY FOR DATB i88UEEEppp/Y �% FIRST INSPECTION f- 'yl AS MIS ELLANEOUS i. APPLICANT FILL IN HEAVILY UTLINED PORTION ONLY JOB l� - E NAME ADDRESS l J m `1 ADDRESS J n�"` � LOCALITY I A � NEAREST y CITY No CROSS ST. etas COUNTY CERT.NO EXPIRES K NAME / LOCATION OF EPTIC TANK, OR CESSPOOL 3 MAILADDRESS / ? S1 1C' NORTH CITY IAM THS LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIPICAT6 OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. 0W HER CORRECTIONS SOUTH J DESCRIPTION OF �Ii z_ HATH TUB -�—FURNACE D Q' AV ROWER DISHWASHER l] LAVATORY REFRIGERATOR -KITCHEN SINK WATER SOFTENER FLOOR SINK SANDTRAP LOP SINK FLOOR DRAIN 1 WASH TRAY URINAL APPROVALS k� WATER CLOSET DRINKING FOUNTAIN DATE INaPE R'6 NAME _L1_WATER HEATER DENTAL LAVATORY ROUGH PLUMBING —(X—METER-=L-GAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT I �[ CESSPOOL TOTAL NUMBER OF FIXTURES �J' SEPTIC TANK _ LCESSPOOL-----SEPTIC TANK —(— SEWER I I S UTILITY CO NOTIFIffD I I TOTAL FEE 5 1>0 — FINAL rte' URKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT; T1 0rpbygef�� that I'have`a certificate of consent tc self in- �6A�66�A PW 4/87 ''sure, or a rerfi i6ate of0Workers'Compensation Insurance„or a CE 817(REV 8/86) r certified copy fh'areof (Sec 3800, Lab C ) ° COUNTY OF LOS ANGELES - DEPT. OF PUBLIC-WORKS Policy No Company " ti Certified copy is hereby furnished FOR APPLICANT TO FILL IN (PRINT OR TYPE) FADDRESS NG Certified copy is filed with the county building inspection ' 90� department NUMBER ` ' FIXTURE OR ITEM @a FEE , ITY3 WATER CLOSET(TOILET)Date Applicant CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB `1 ST F�_D�a'�. � ��.A. ` k ' COMPENSATION INSURANCE - SHOWER C/ OWNER (This section need not be completed if the work involved by _ the'permiMAID t is for,one hundred dollars,($100)or less ) 3 ` LAVATORY - ADDRESS I certify that in,the performance'of the work for which this per- mit is issued, I shall not employ any person in SINK any manner so CITY r_ _ TEL N I�i �� �] ` 'as to become sulilect to the Workers'Compensation-L ws DISHWASHER _ I _I� 1 e N + D _ CONTRACTOR Date Applicant I I CLOTHES WASHER r NOTICE TO APPLICANT 'If, after making this C"71ertificate of Ex- - ADDRESS 5" emption, you should become�sublect to the Workers'Compen- SWIMMING POOL RECEPTOR CITY TEL NO sation provisions of the Labor Code, you must forthwith comp-, � LAWN SPRINKLER SYSTEM° ' ly,with'such provisions or this permit shall be deemed revok- STATE LIC ed - r ( WATER;HEATER 6 eV LICENSE NO CLASS ' K LICENSED CONTRACTORS DECLARATION_, DISTRICT NO e PROC ED BY I hereby affirm that I am licensed under provisions of Chapter -GAS SYSTEM 3 OUTLETS 9_(commenung with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,'and my license is in full force and ef- 5 PER SYSTEM FINAL fect -_ - DATE CL 6' VAL TION ' License Number Lic Class ~©I O " -r, - - FINAL IxV Contractor Date BY I am exempt urider Sec y r W- B 8P C for this reason` CL Plan check fee Z Date PLUMBING PERMIT ISSUING FEE$ SignatureTOTAL FEE U' SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor s License Name Law for the following reason (Section 7031 5, Business and - o ';2 0 3 IL 6 A, Professions Code) I Address (� 1, as owner of the property, will do the work and the City Tel No' .�` structure isnot intended or offered for sale(Section 7044, _ �) '0 10 0510 ' Business and Professions Code) - I r Vo,o.1 0 0,5 0 CONSTRUCTION LENDING AGENCY ' � r I hereby affirm that there is a construction lending agency for � - ' - • Q a03: 8 8, the performance of-the work for which this permit is issued (Sec 3097, Civ_C ) r Leriderrs Name Lender's Address I certify that I have read this application and state that the F above information is correct I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives this County to enter upon the above me boned proper or inspection,purposes SEE REVERSE FOR EXPLANATORY LANGUAGE _Signature 6t Permittee Date