HomeMy Public PortalAbout6015 ENCINITA AVE_Plumbing__ DEPARTMENT OFA COUNTY ENGINEER P L U MIM N G I
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING `r
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS /J H ,Yf 7t?
—
T
OR APP IC T FILL IN NEAREST
BUILDING _ CR 01577 N0. OG I p ON
ADORE ROSS 4 / /1
LOCALITY
NEAREST
CROSS SL LVED BV Re.Oy for Inspection DATE ISSUED
�F
I2-1J'S `f
OWNER
DUSTRIAL
MAIL WASTE APPROVAL
ADDRESS _
ary TEL.No. INSPECTION RECORD
PLUMBER
ADORES
GIT EL NO
MATE
LICENSE f{0. ✓ �DiC.zz [-] COUNTY
PERMIT FEES
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�IIMNER TYPE OF FIXTURE OR ITEM FEE E.
WATER CLOSET (TOILET) @ 0.80 5
O
BATH TUB @ 0.80
SHOWER @ 0.80
LAVATORY (WASH BASIN) @ 0.80 p
KITCHEN SINK @ 0.80
LAUNDRY TUB OR TRAY @ ORO v
SLOP SINK @ 0.80
FLOOR SINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @ '0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
GASSYSTEM..............OUTLETS @ 1.00
WATER HEATER @ I.00
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT = 1 00 ROUGH PLUMBING
TOTAL FEE 2 00 GAS PIPING 1 p
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- GASVENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATERHEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF CALIf RNIA OR THAT i AM THE LEGAL OWN
ER OF THE ABOVE SC D RESIDENTIAL PflOPEflTV. UTILITY CO.NOTIFIED
SIGNATURE p� /
OF PERMITTEE _.......W' v. .. ....` ......._. ._......_.
FINAL 1T �S•I
76A067 DBS 17 o b 12-53 �— -
WORKERS'COMPENSATION DECLARATION APPLICATION�I FOR PLUMBING PERMIT �7
I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 C I
insure, or o certificote of Workers' Compensation Insurance, 76A667A lul
or a certified copy thereof (Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
Policy No. 11294689ampany CNA Ins . Co.
Certified copy is hereby furnished. BUILDING `
FOR APPLICANT TO FILL IN(PRINT OR TYPE)® ADDRESS 6015 N. Encinita Ave.
Certified copy is filed with the county building inspec-
tion department. NUMBER FIXTURE OR ITEM ® FEE
LOCALITY Temple City
Dole 6-23-92 Applicont Owen Bros . Plbe. WATER CLOSET
NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST.
COMPENSATION INSURANCE SHOWER OWNER Mr. & Mrs. David Nalick
(This section need not be completed If the work Involved by. MAIL
the permit Is for one hundred dollars ($100)or less.) LAVATORY ADDRESS 6015 N. Enc ini to Ave.
I certify that in the performance of the work for which this
permit is issued, I shell not employ any person in any manner SINK CITY Temple City TEL NO.287-2037
so as to become subject to the Workers'Compensation Laws. DISHWASHER
CONTRACTOR Owen Bros. Plumbing, Inc .
Date Applicant CLOTHES WASHER
NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS 4265 N. Baldwin Ave.
Exem tion, ou should become 'subject to the Workers SWIMMING POOL RECEPTOR
CITY TEL. NO.
Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM Y El Monte 443-0078
with comply with such provisions or this permit shall be STATE LIC,
deemed revoked. WATER HEATER LICENSE NO. 231 741 CLASS C36-20-16
LICENSED CONTRACTORS DECLARATION DISTRICT NO.D PROCESSED BY
1 hereby off irm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS
Iq 5,5-
(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER
and Professions Code, and my license is in full force and effect. 5 PER SYSTEM FINAL >"
DATE VALIDATION d
License Number 231 741 Lk. Class C36-20-16
FINAL , / 0 U
Conaecror Owen Bros. P1bQ.pate 6-23-92 BY IYC�
❑ O,
am exempt under Sec. W
B.6P.C, for this reason Plan check fee U)
Dote: Z
PLUMBING PERMIT ISSUING FEE$
Signature
TOTAL FEE
Plan check applicant =t
SINGLE FAMILY -.
HOME OWNER-BUILDER DECLARATION Name fi%7�i.v
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and Address �_^
Professions Code): City Tel. No.
r iw'I�
I, as owner of the property, will do the work and the S
structure is not intended or offered for sale (Section D ICITAL 63 . 4 0
7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY CHECK -r" tl
I hereby affirm that there is a construction lending agency for to JHM_r ,I1!
the performance of the work for which this permit is issued
(Sec. 3097, Civ. C.).
Lender's Name [iiTl[I—[itis;i {J'.icj Lj_'
7,
Lender's Address I Ail
I certify that I have read this application and state that the D
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 eater upon the
-m boned propert for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
-23-92
Si Lure of Permittee Dote
COUNTY OF LOS ANGELES TEMPLE CITY # 0506 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9610240006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 5904 LT: 380 6015 ENCINITA AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801935
ASSESSOR INFORMATION NUMB R: NEAREST CROSS STREET:
5384-013-024 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY
51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.35
TENANT: TOTAL FEES 44.10 ISSUE ON: PROCESSED BY: PLAN Y: EXPIRES ON:
10/24/96 TC 10/24/97
OWNER: TEL. NO: FINAL DATE // FINAL BY: CODE.
NALI60150 ENCINIDABAVNIE lc) —M 6
TEMP 917801935 DESCRIPTION OF WORK
NEW HEATING AND A/C SYSTEM
APPLICANT: EL. NO:
HUNTINGTON AIR COND. (818) 285-5049-
450 AGOSTINO RD. SPECIAL CONDITIONS:
SAN GABRIEL, CA rl
CONTRACTOR: TEL. N0: .�P,�,--qT' U ? APPROVALS DATE INSPECTO SIGNATURE
HUNTINGTON AIR CONDITIONING, INC. (818) 285-5049-
440-450 AGOSTINO ROAD LIC. NO 0 ( UNDE SLAB WORK
SAN GABRIEL, CA 91776 644769 020 "ry�--pq ply - yrs-1
ARCHITECT OR ENGINE : TEL. N0:
�G'] I ) �JUV Il �JW-'J PLASTIC
CEYVNCEMETAL Y/N
- -- ------ -------�-_-- ROUGH PLUMBING
LIC. NO:
'li Ut GAS PIPING
X GAS VENT
o�y HOT WATER HEATER
C
PLUMBING FIXTURES
® �JT,1,/�,`� a� LAWN SPRINKLERS
�
STI J�� 11♦ GAS EST
a.J' UTILITY COMPANY NOTIFIED
CWV
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0205070010
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDR SS:
TR: 5904 LT: 380 6015 ENCINITA AV
- FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801935
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: WOODRUFF
5384-013-024 011PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY
11.. CLOTHESWASHER(S) 1.00 FIX 16.20
TENANT: 7-14ATER-HEATEHCS7 � 1.DO.WTH 16.20 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
511LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 05/07/02 JK 11/03/02
TOTAL FEES 76.35
OWNER: TEL. NO: FINAL DATE FINAL BY: CODE:
VAN LEER;SRIAN & TERRY (626) 285-2031- 77/T_-� _
6015 ENCINITA AV
TEMP 917801935 DESCRIPTION 0 WORK
RELOCATE WATERHEATER AND LAUNDRY
APPLICANT: TEL. NO:
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. NO: i APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NOUNDER SLAB WORK
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT 0 ENG E N0: - \ ROUGH PLUMBING
LIC. NO:
r
S PIPING
_ 12 i
txs--VTNT-
HOT
- -
PLUMBING FIXTURES
WN SPRINKLERS
S TEST
UTILITY COMPANY NOTIF1 D
C V
WATERGRAY SYSTEM
REPORT ID: DPR263 ROUTE TO: RS0508