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HomeMy Public PortalAbout5016 FARAGO AVE_Plumbing__ r 76A667-CE617 6-60 APPLICATION FOR PLUMBING PERMIT � COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER - BUILDING AND SAFETY DMSION Z BUILDING JOHN A LAMBIE COUNTY ENGINEER r ADDRESS WILLIAM A JENSEN SUP T OF BUILDING , n r LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST NUMBER FIXTURE OR ITEM OWNER Cri✓ WATER CLOSET MAIL ADDRESS BATH TUB CITY TEL NO ` SHOWER ' CONTRACTOR Alert P lb a & Htg. LAVATORY - LAVADDRESS 13933 S . Crenshaw Blvd SWK Crnr Hawthorne TEL NO 0S o 93691 DISHWASHER CONTRACTOR LAUNDRY TUB REGISTRATION NO 193617 C-36 COUNTY a � —� CLOTHES WASHER DISTRICT NO GROUP ZONE P CESSED BY _„_WATER HEATER _ c A-1 �- GAS SYSTEM WDUSTRIAL WASTE APPROVAL INSPECTION RECORD a e a V d� . ✓AtI a * ` FO+ s aa` cisF"C.--T W $100 PER ITEM OR FACTURE j APPROVALS L DATE//-- INSPECTORS IGNATURE PERMIT $ 2100 UNDER SLAB WORK 12 TOTAL FEE o ROUGH PLUMBING ;I// &'-A< GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS A PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER 'p� PLUMBING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES .ry ,, n LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE L AL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY + UTILITY CO NOTIFIED SIGNATURE ,�y.� OF PERMITTEE FINAL d 1 1f1 IP9,.�✓ ®r //—��VALIDATION ROBERT A WOOD, / 1/ ■ 0 CASH SUPERVISING MECHANICAL ENG'R L&I.JO 8 9,°1 5 J 0 5 D 900 `� 76-,,A�6 6�- G E 817 7-69 APPLICATION FOR PLUMBING PERMIT7' COUNTY OF LOS ANGELES G LES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION RUILDING JOHN A LAMBIE COUNTY ENGINEER ADDRESS �d J COLEMAN W JENKINS SUP T OF BUILDING LOCALITY4d e FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST ,"l/✓ CROSS ST NUMBER FIXTURE OR ITEM EACH FEE / OWNER O S e WATER CLOSET 1 s0 MAIL BATH TUB 1 50 ADDRESS SHOWER 1 50 CITY /e C1,' TEL NO LAVATORY r 1 50 i .� CONTRACTOR �L,ULyL[�fY SINK 1 50 ADDRESS DISHWASHER 1 50 CITY TEL NO CLOTHES WASHER 1 50 STATE LIC LICENSE NO CLASS SWIMMING POOL RECEPTOR 1 50 DISTRICT NC GRO ZONE PROC S BY LAWN SPRINKLER SYSTEM 2 00 , 0 WATER HEATER 1 50DUSTR !7U WASTE AIPPROVAL O GAS SYSTEM OUTLETS 1 50 INSPECTION RECORD u OUTLETS OVER 5 PER SYSTEM 3071 16"d1i O 688 Oe N z Plan check fee 25% of above See reverse PLUMBING PERMIT ISSUING FEE $ 2 00 TOTAL FEE I APPROVALS QATE INSP CTOR S GNATURE Plan check applicant UNDER SLAB WORK 47Y171 11 Name ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel NO HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT 1 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 1 AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO Of dF RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY FINAL SIGNATUREy • JACK R ALLEN, S PERVISING ECHANICAL ENG R OF PERMITTEE PERMIT VALIDATION cK M O CASH PLAN CHECK ALIDATION CK M o CASH AP, 0 0 1 5APR30 54 D 15.50— a 1—•. WORKERS COMPENSATION DECLARATION APPLICATION FOR-PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers Compensation Insurance CE 817(REV-10/81) or a certified c thereof ((SQ c 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY �y 5/-WIOC3- 7 Pol y NaT��"'"��— Company r (YJ Certified copy is hereby furnished BUILDING ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) i��7'—� Certified copy is filed with the cou ty building inspec ADDRESS tion portment NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET ' '} Date Applicant NEAREST BATH TUB CERTIFICATE OF EXEMPTION ROM WO ERS' CROSS ST COMPENSATION INSURANCE SHOWER OWNER c (This section need not be completed if the work involved by MAIL - s the permit is for one hundred dollars ($100)or less ) LAVATORY ADDRESS I certify that,+n the performance of the work for which this permit is issued I shall not employ any person in any manner SINK CITY r— ti TEL N06 + so as to become subject to the Workers Compensation Laws DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER " ADDRESS0LAJ /V NOTICE TO APPLICANT If after making this Certificate of " SWIMMING POOL RECEPTOR � j Exemption you should become 'subject to the Workers , Compensation provisions of the Labor Code you must fortes- LAWN SPRINKLER SYSTEM CITY //1 TEL NO'provisions -71 with comply with such provisions or this permit shall be STATE ,C/S% LIC ry / deemed revoked r WATER HEATER j LICENSE NO C/3� CLASS, LICENSED CONTRACTORS DECLARATION � DISTRICT NO ROCESSED BY o I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER a CL and Professions Code and my license is in full force and effect` 5 PER SYSTEM FINAL0 DATE V (DATION O License Number `��T 35Z� Lic Class S�Sr�,n t 6 � 1 FIN 1"' O ContractorBYUJ ❑ I am exempt under Sec d p + B &P C forthis reason � � Plan check fee ® �2`912 5 A' Date PLUMBING PERMIT ISSUING FEE$ # 5 o`o'o e 0 ' Signature _ � TOTAL FEE N 'I, 3-0.50 Plan check applicant SINGLE FAMILY I , HOME OWNER-BUILDER DECLARATION Name o 0 0 3 a 5 Q= , U I hereby affirm that I am exempt from the Contractor's License l Law for the following reason (Section 7031 5 Business and Address a p 91 6 —_-8 5 ' Professions Code) City Tel No s ❑ - z I, as owner of the property, will do the work and the �J structure is not intended or offered for sale (Section 7044 Business and Professions Code) ' CONSTRUCTION LENDING AGENCY = 4 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ C ) t Lender s Name ar Lender s Address r 4 r I certify that I have read this application and state that the i above information is correct I agree to comply with all County ' ordinances and State jaws regulating Plumbing ,and hereby _ authorize represe tatives of this County 10 enter upon the above- nti ne property for inspection p ores SEE REVERSE FOR EXPLANATORY LANGUAGE Signatellf Permitte date i v WORKERS COMPENSATION DECLAR ION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certifitcitezof consent to self 20 0026 DPW 6/87 insure or a certificate of Workers Compensation Insurance, 76A667A City 6f- Temple City or a jertified copy thereof (Sec 3800 lob C ) COUNTY OF LOS ANGELES „ DEPT'OF PUBLIC WORKS ` PolicPt Y y No 6969-00 pony NMIC z R&A 94744 Certified copy is hereby'furnished I L L FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING © Certified copy is filed with the county building inspec ADDRESS 5016 No. Farago Ave, NUMBER FIXTURE OR ITEM Tem le -Cit a tion department A @ SFEE LOCALITY WATER CLOSET Date4/I Zq1 ApplicaGPn _Y3 Inst:;0_fit. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST L&ye Oak A COMPENSATION INSURANCE SHOWER OWNER �,rankC. ontreras (This section need not be completed if the'work Involved by MAIL the permit4s for_one'hundred dollars ($100)or less ) LAVATORY ADDRESS" 5 16 N Farago A I certify that in the performance of the work for which this r permit is issued I shall not employ any person in any manner SINK CITY �1t�-579-482 so as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR General Installation Co Date Applicant CLOTHES WASHER ADDRESS NOTICE 'TO APPLICANT If after making this Certificate of 6558 West Blvd. Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL NO LAWN SPRINKLER SYSTEMLas Angeles 753 4 with comply with such provisions or this permit;shall be STATE LIC _ deemed revoked I WATER HEATER LICENSE NO 151839 CLASS C3 6 . LICENSED CONTRACTORS DECLARATION DISTRICT NO OCESSED BY P l I hereby affirm SYSTEM OUTLETS r �m that I'am licensed under provisions of Chapter 9 � � (f ?/ , (commencing with Section 7000) of Division 3 of;he Business OUTLETS OVER and Professions Code,and m license is in full force and effect 5 PER SYSTEMFINAL y DATE VALIDATION 0.1 License Number 151839 L,c Class C36 A/ -� U W. 0. Prov in 4/91 BY AL -yv fr �i Contractor Date - }�, ( O, ❑ I am,exempt under Sec � ti ' tUB 8P C for this reasonfl Plan check fee �.� Date ` PLUMBING PERMIT ISSUING FEE$ 13,100 - .v A u L^ Q Signature TOTAL FEE 1 201-5- 0 Plan check applicant i c SINGLE FAMILY t HOME OWNER-BUILDER DECLARATION Name - i A__1va I hereby affirm that I am exempt from the Contractor's License i Address Add Law for the following reason (Section 7031 5„Business and _ I�f =1 i, Il_I Professions Code) I City Tel No — - i TIT ErlD ❑ 1, as owner of the property, will do the work and the 'A j yi 20 - 50 structure is not intended or offered for sale (Section 7044, Business and Professions Code) ' CHECK 20.50 CONSTRUCTION LENDING AGENCY e 1-HANE 1 hereby affirm that there;s a construction lending agency for l the performance of the work for which this permit ;s issued > (Sec 3097 Civ C ) L i 1100—[IAl,l 1 9/11/90 l Lender s Name 1 X K i4 10, nock r 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 jaws regulating Plumbing and hereby e authorize representatives of this County to enter upon the above-me tiMerty for inspection purposes { L _ SEE REVERSE FOR EXPLANATORY LANGUAGE 9/7/90 , Signature of a tt a Date ' • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1101060007 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT ILEGAL ID I FEES PAID BUILDING ADDRESS 1 ITR 11497 LT 14 BL B I 1 5016 FARAGO AV 1 I IFEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917803525 1 (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 18574-009-049 101 PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE 597 GRID D4 LOCALITY- TEMPLE CITY, Cl 1 107 BATHTUBS/SHOWERS 1 00 FIX 16 30 I 1 ITENANT I11 CLOTHESWASHER(S) 1 00 FIX 16 30 11SSUED ON PROCESSED BY PLAN BY 1 I 125 LAVATORIES/SINKS 3 00 FIX 48 80 101/06/11 SR I I 145 WATER CLOSET/URINAL 2 00 FIX 32 50 1 1 (OWNER TEL NO I TOTAL FEES 141 70 I INAL DATE F�Iy CODE 1 ITONG AMANDA (626) 616-1719- 1 1 1 1620 RAMONA ST #B I I 1SAN GABRIEL CA 91776 1 1 CRIPTI N OF WORK 1 IPLUMBING FOR KITCHEN BATH OM REMODEL, LAUNDRY AND POWDER 1 I 1 IROOM 1APPLICANT TEL NO 1TONG, AMANDA (626) 616-1719- 1 1 I 1620 RAMONA ST #B 1 1SPECIAL CONDITIONS 1SAN GABRIEL CA 91776 1 1 1 1CONTRACTOR TEL NO I 1APPROVALS DATE INSPECTOR SIGNATURE 1 IFUN ON CO (323) 842-8306- 1 1 1 11948 LANSDOWNE AVE LIC NO 1 1UNDER SLAB WORK I 1 I ILOS ANGELES CA 90032 685987 1 1 1 1 1 I I IWATER SERVICE I I IPLASTIC Y/N METAL Y/N 1 1 1 (ARCHITECT OR ENGINEER TEL NO I I I 1 1 1 - I IROUGH PLUMBING 1 1 I 1 LIC NO IGAS PIPING 1 1 IGAS VENT 1 I I I I I IHOT WATER HEATER I 1 1 _ 1 I 1 1 1 1PLUMBING FIXTURES I I I I I ILAWN SPRINKLERS 1 I 1 I I I 1 1 IGAS TEST I 1 I I I I I 1UTILITY COMPANY NOTIFIEDI I I I 1CWV I I I 1 1 IGRAY WATER SYSTEM 1 I I I I I I I I I 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 12EPORT ID DPR263 ROUTE TO BSO508 1 1 1 1 I I I I I I