HomeMy Public PortalAbout5124 FARAGO AVE_Plumbing__ EIS 17 10 B9
DAPPLICATION FOR PLUMBING PERMIT
BS 17
DIVISION OF BUILDING AND SAFETY
Deportment of County Engmeer
County of Los Angeles BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
CASSATT D GRIFFIN SUP T OF BUILDING
LOCALITY /t6e
FO PLI ANT TO FILL IN NEAREST
CROSS ST
OWNE .LIQ DISTRICT NO GROUP ZONE READY FOR INSPECTION
MAIL e1 T 7 I -,—/- C)
C)
ADDRESS .!� A
O ,,c INDUSTRIAL
CITY EL N � ®/6( (F' WASTE APPROVAL
J
PLUMBER INSPECTION RECORD
,-r
ADDRESS I ^ (�{
CI ga&W11TEL
LICENSE NO (Q S
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $100 $
BATH TUB @ $100
SHOWER @ $100
LAVATORY (WASH BASIN) @ $100
KITCHEN SINK @ $1 00
DISHWASHER @ $1 00
LAUNDRY TUB OR TRAY @ $1 00
CLOTHES WASHER @ $100
WATER HEATER @ $1 00
GAS SYSTEM @ $100
APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
21 GAS PIPING
TOTAL FEE GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANG S COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE GA OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RAL PRO /
SIGNATUR
OF PERMI EE FINAL ��'
JOHN A LAM UNTY ENGIN ER` VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR
CK m 0 CASH
��2867� FEB15 3 200 t)
t
76A667 CU17 8 58
APPLICATION FOR PLUMBING PERMIT
II
DEPARTMENT OF COUNTY ENGINEER
BIIII.DING AND SAFETY DIVISION �INc _
OHN A LAMBIE CountF Eag�aeer
C SATT D GRIFFIN Supt of Building LOCALITY ,� L
FOR APPLICANT TO FILL IN NEARESTdoe
�-�
CROSS ST
NUMBER FIXTURE OR ITEM J
OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS J
SHOWER CITY7-1 J TEL NO _
LAVATORY CONTRACTOR ��—
SINK ADDRESS IT
DISHWASHER CITY TEL NO
CONTRACTOR S STATE ❑
LAUNDRY TUB REGISTRATION NO COUNTY ❑
CLOTHES WASHER DISTRICT NO GROUP NEESSED BY
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
VAPPROVALS
OR PER ITEM
FD[TUR $ /
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2100 ROUGH PLUMBING
TOTAL FEE GAS PIPING 12 '
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURESr
I HEREBY CERTIFY THAT AM PRO LY REGIS RED AND/OR GAS TEST
LICENSED AS REQUIRED L S�IKN LE COU Y AND STATE OF
CALIFORNIA OR THAT A HE LEGAL OWNE 0 THE ABOVE UTILITYCO NOTIFIED {
DESCRIBED REST TI OP Y
SIGNATURE FINAL
OF PERM ITTE
ROBERT A WOOD
Or VALIDATION SUPERVISING MECHANICAL ENG R
L�l CK m O CASH
LAL�5820.5". A°R ?8 5 R 300 r
i
Vj(Cr-tha c'have a ATION DECLARATION APPLICATION FOR PLUMBING PERMIT
I h0.ej$p'by?-#firm that I have a certificate of consent to self in- 76A��A DPW 4/87
sore,or a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86)
certified copy thereof (Sec. 3800, Lab. C.) LJ
Policy No. Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
Certified copy is hereby furnished:
❑ FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
Certified copy is filed with the county building inspection ADDRESS
department. NUMBER FIXTURE OR ITEM @ ],FEE LOCALITY
Date Applicant WATER CLOSET(TOILET NEAREST
BATH TUB CROSS ST.
CERTIFICATE OF EXEMPTION FROM WORKERS' V
COMPENSATION INSURANCE It OWNER
( SHOWER �5.
(This section need not be completed if the work involved by MAIL` •� /� �//�
the permit is for one hundred dollars ($100)or.less.) ( LAVATORY ADDRESS• V /pV liFO-�
I certify that in the performance of the work for which this per-
mit is issued, I shall not:employ any per in on a ner so SINK CITY �Q p / TEL. NO.
as to become subject to the Workers' o en ows. DISHWASHER ` L
CONTRACTOR
Date CC d Applicant t CLOTHES WASHER ADDRESS
NOTICE TO APPLICANT: If, after making this Certificate f x- SWIMMING POOL"RECEPTOR c
emptiopn, you should become subject to the Workers'Co p- CITY .A TEL. NO. 7
cation rovisions of the Labor Code, you must forthwith co LAWN SPRINKLER SYSTEM .�/Vl
ly with such provisions or this permit shall be deemed revok- STATE ����j LIC.
ed. WATER HEATER LICENSE 15Z;
CLASS 4" -7_3
` ^ '
LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY
I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS
9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER v
and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL
fect. VALIDATION
DATE
�j '
License Num Lic. Class 36 f/ V
Fl
Contractor Date
h-
I am exempt"under Se U
141
B.BP.C. for this reason Plan check fee ►
Date: PLUMBING PERMIT ISSUING FEE$ tJ
Signature
TOTAL FEE
` SINGLE FAMILY ! Plan check applicant
HOME OWNER-BUILDER DECLA ON PP
I hereby affirm that I am exempt from the Contractor's License Name
Law for the following reason (Section 7031..5, Business and
Professions Code): Address
;2943.3A
I, as owner of the property, will do the work and the City Tel. No. # a o 0 0 0 5
structure is not intended or offered for sale(Section 7044,
Business and Professions Code).
CONSTRUCTION LENDING AGENCY r it o - 31L50
I hereby affirm that there is a construction lending agency for o'o 6 3 iL 5 0
the performance of the work for which this permit is issued
(Sec. 3097, Civ. C.).
pU 21 -=88
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 oil.ordinance d Stat regulating Plumbing, and hereby
author' e r res s of this County;to enter upon the
abo -m property for inspection purposes.
lt � SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature o ermittee / Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1104060011
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS 1
1TR 11497 LT 8 BL B I 5124 FARAGO AV
I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803527 1
(ASSESSOR INFORMATION NUMBER INEAREST CROSS STREET
18574 009 042 101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID D4 LOCALITY TEMPLE CITY CI
I 107 BATHTUBS/SHOWERS 2 00 FIX 32 50 1
ITENANT Ill CLOTHESWASHER(S) 1 00 FIX 16 30 JISSUED ON PROCESSED BY PLAN BY 1
113 DISHWASHER(S) 1 00 FIX 16 30 104/06/11 SR 1
125 LAVATORIES/SINKS 4 00 FIX 65 10 1
OWNER TEL NO 145 WATER CLOSET/URINAL 1 00 FIX 16 30 IFINAL DATE FINAL BY CODE 1
IREYES VIRGINIA 147 WATER HEATER(S) 1 00 WTH 16 30
15124 FARAGO AV 151 LOW PRS GAS 5 OUTLET 1 00 SYS 16 30 1 �I +
TEMP 917603527 TOTAL FEES 206 90 IDEISCRTPTibN OF WORK 1
IPLUMBING FOR NEW BATHROOM LAUNDRY ROOM KITCHEN WATER
THEATER AND GAS LINE
(APPLICANT TEL NO 1
ISYAL ABERGEL (818) 594 3500 1
119562 VENTURA BLVD 1 (SPECIAL CONDITIONS
ITARZANA CA 91367 1
1CONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE 1
1PREFERRED HOME BUILDERS INC (818) 594-3500 1 1
fl-
16271 VARIEL ST #C LIC NO (UNDER SLAB WORK
(WOODLAND HILLS CA 91367 773147 B 1
I IWATER SERVICE
IPLASTIC Y/N METAL Y/N I I 1
(ARCHITECT OR ENGINEER TEL NO 1
ID DESIGN INC (818) 594 3500 1 TROUGH PLUMBING 1
119562 VENTURALVD LIC NO
CA 9
ITARZANA CA 91367 NONE IGAS PIPING
1 I I
1 IGAS VENT
1 I I I
1 IHOT WATER HEATER 1
I I I I
PLUMBING FIXTURES 1
I
LAWN SPRINKLERS
I _
1 j IGAS TEST
I
UTILITY COMPANY NOTIFIEDI I I
I I 1 GW' I I I
1 1 IGRAY WATER SYSTEM 1
1 I I I I
I
1 I I I I I
1 I I I I
I f I I
I
I I I I
IREPORT ID DPR263 ROUTE TO BS0508 I 1
I I I I I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0212050019
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
LEGAL ID FEES PAID BUILDIWG ADDRESS
TR 11497 LT 8 BL B 5124 FARAGO AV
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803527
AS ORMA UM NEAREST CROSS STREET FREER
8574 009 042 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID D4 LOCALITY TEMPLE CITY
51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20
TENANT TOTAL FEES 43 95 ISSUED ON PROCESSEDBY PLAN BY EXPIRES ON
12/05/02 JK 06/03/03
OWNER TEL NO FINAL E FINAL BY CODE
REYES RUBEN A,VIRGINIA C (626) 442 8822 //2
5124 FARAGO AV
TEMP 917803527 DESCRIPTION F WORK
C/O FURNACE
APPLICANT L NO
GLOVER (909) 279 0604
5030 VICEROY AVENUE SPECIAL CONDITIONS
NORCO 92860
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
AIR TRO INC (626) 357 5311
1630 S MYRTLE AVE LIC NO UNDER SLAB WOR
MONROVIA CA 91016 258228 C20
WATER SERVICE
- PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER TEL NO
i I ROUGH PLUMBING
LIC NO '
GAS PIPING
GAS VENT
WATERHOT HEATER
PLUMBING FIXTURES
LAWN SPRINKLERS
UTILITYGAS TEST
COMPANY NOTIFI
W
GRAY WATER SYSTEM
REPORT ID DPR263 ROUTE TO BS0508