HomeMy Public PortalAbout9019 GARIBALDI AVE_Plumbing__ D.B.S.17 25M SETS 2-47 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY PLUMBING
COUNTY OF LOS ANGELES
WM.J. FOX. CHIEF ENGINEER
NATURE OF INSTALLATION DISTSR!PT440. GROUP ZONE-- PERMIT NO.
ROUGH FIXTURES COMPLETE 1
HEATER CESSPOOL -I SEPTIC TANK 9Y READY FOR
RECEIY
FIRST INSPECTDA ISSUE
ION �^
GAS- MISCELLANEOUS
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY'
T. AAI CO. JOB �r ,
NAME ADDRESSr
® ADDRESS 123 No. Goverly Ave. LOCALITY,
2
iL
CITY TEMPLE CITXj,.QALIF. NEAREST. `
COUNTY
CERT.NO. EXPIRES m NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL a MAIL
3 ADDRESS
NORTH O
CITY TEL.No.
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF-QUALIFICATION.
PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
>
3 OWNER
CORRECTIONS
SOUTH
J
DESCRIPTION OF WORD i
BATH TUB FURNACE
R'
SHOWER DISHWASHER O
LAVATORY REFRIGERATOR
i
KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
SLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN
DATE INSPECTOR'S NAM[
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I
METER GAS SODA FOUNTAIN GAS PIPING
OUTL
GAS VENT
CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC TANK
1 I _
-CESSPOOL-------SEPTIC TANK , SEWER ( '
j /s UTILITY CO.NOTIFIED
TOTAL FEE
111' FINAL I 1 Jl
L
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer PLUMBING 1
DIVISION OF BUILDING & SAFETY
WILLIAM J. FOX, County Engineer
FOR APPLICANT TO FILL DISTRICT NO. GROUP ONE / PERMIT N .
PLUMBERREADY FOR
REC ED BY DATE ISSUED
FIRST INSPECTION
ADDRESS
BUILDING ,.
CITY TEL NO. ADDRESS
COUNTY LOCALITY
LICENS NEI. EXPIRES
NEAREST �/+) 11 -
PERMIT FEES CROSS ST.
f
Tn Q s rAd _
tee+ p `
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER _���(_�% 'H A ___
MAIL 9 • o
WATER CLOSET(TOILET) 0.50 y{ ADDRESS
BATH
BATH TUB O.SO _CITY / '_ _ TEL. NO.f•7 - _
SHOWER 0.50 1 HERESY ACKNOWLEDGE THAT i HAVE READ THIS
v LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE AE30VE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK 0.50 AND STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY 0.50 AN13ELEB COUNTY LICENSE, OR , AM THE LEGAL OWNER
GAS SYSTEM�"�OUTLETS � 0.50 OF THE RESIDENTIAL $OPERTY D SCRIBED ABOVE.
f� - / - >
BIONATURE OF
WATER HEATER 0 0.50 PERMITTE T �-
SLOP SINK 0 0.50 _ INSPECTION CORD
FLOOR SINK Q 0.50
FLOOR DRAIN @ 0.50
DISHWASHER 0.30 p
DRINKING FOUNTAIN O.SO
URINAL i)Q 0.50 PLex rAIL Q
HOUSE SEWER 0 0.50 J ��n 4,
HOUSE Z
MISCELLANEOUS _ / �,.. - �? Lo
O
J
-13
v! e.
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING Z/-
GAS
GAS PIPING
GAS VENT
CESSPOOL 0 1.00 CESSPOOL
8EPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) 1.00 SEWER
PERMIT 1,00 GAS TEST
TOTAL FEE
UTILITY CO.NOTIFIED
S
FINAL
76A667 DBS#17 6-52
WOMUP COM TtoN DECI"TION 20-0626 DPW?leo
I hereby■Mrm that I hevpwl Oats of consent to self Insure, '°"°�'^ APPLICATION FOR PLUMBING PERMIT
or a certtflcate of Worker's Compensatict Insurance, or a certlfled
Dopy thereof(8ec.3800 Lab.C.) -
�y � y k COUNTY OF LOS ANGELES DEPT.OF PUBL IG WORKS DEPT.OF PUBLIC WORKS DIV.
Certtfled copy 4 Forhrrristred
FOR APPLICANT TO M-L IN FRW OR TYPE) /1>
Certified copy Is flied with the county bu 6*V
/ I�IJLBEfa F0714RE OR Q9d FEE
Data Applsoarrt WATER CLOBEr NEAREST
cumFtCATE of E7cEmpT10N FROM WORKER& CIST,
CCOMPENSATION INSLRANCF BATI I TUB S
(This sectibp need not be oompUned tf Ura work Invotwd PY tM SHOWER ^r W PAGE, PAF CE
permtt Is for one hundred do0ata(11100)or kme,)
I certtfy that In the performance of the work for which this permit LAVATORY
Is.Issued, I shall not employ any person Irvany manner sv as to 8fyt
become subject to the Wprkert'Cbmpeneatlon laws_
DISWASHEA CITY TEL NO.�
Date ApPkarrt CLOTFIE8 WASHER
NOTICE TO APPLICANT; If, after making tbls CerTlfJcate of
ESow4Xion,you-ah-Id become-*ct to the Works%'Compensation SWDAMD1G POOL RECEPTOR
provlalons of the Labor Code,you must forthwith compty_wtth ouch jAr%)MFFjA
provt"or this permit shall be deemed revoked. . LAWK 6"iKLE R SYS"I'a MY TEL No. 3 '
I hereby affirmghaSED �T
t liccehsedunder provisions nsJof Chapter 8 WATER HEATER J
(commencing with Section 7000) of Dlvlsioh 3 of the Business and �L �' C Z�
Profsse.16m Cods,and my Itoenas{s In full force end etteoL GA$SYSTEM OUTLETS
=NO, rQLASS
PER Fi0 BY
6fi 338YS� 'f'91
IJ ^cense Number L�l Llo.Class G"Y4•�. .
L D�
DATE : VALIDATION
0 I am wwrrQt under Seo. {' UYg.
I
r � r
B.AP.C,ter&M reason t Plan cheek fee -
PLUMBING PERMF ISSUING FEE S
❑ TOTAL FFF
804OLE FAMILY Plan cheL<}c rt nn5
�3
HOME OWNER-WILDDECLARATION Name ANT.I hereby a"dull I aryl exempt from the C x tractors License Law
Ir-
for the following reason (8ectIon 7031.6, %tslneq end Professlops Address
Cods): 7 [MC 20.50
❑ J,as owner of the property,will do.the work and the struoture � Tet hid. �5 V1 ITEMS
Is not Intended or offered for sal 4(Section 7044, Business DECK
20 . 50
50
and Profeeslaft Code). 1 4iL�i `?Q■�)
CONSTRUCTION LENDING AGENCY -
I hereby&Mrm that there Is a construction lending agency for the
perfo{mpnoe of the work for whbh this permit Is Issued (Seo. 3007-,
Cty.C.)
Iafrdees Name 000&-W01 7/ 5/90
-1669 1 AM 9:18-
' Conches Addrom
I oerlHy that I have read this appllcatlon and state that the above '
Information Is correct, I agree to comply wRh all County ordlnanoes
and State laws regulating Plumbing, and hereby authorize ,
repreeentetivse of this County to eater-upon the above-mentioned
propbrty for Inspection purpoens. SEE REVERSE FOR EXPLANATORY LANGUAGE
COtrNT'Y OF LOS APQELE.9 TE4PLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0804300006
.BUI TNG AND-SAFE'T'Y / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 ETT:
LE3AL ID: FEES PAID BUILDING ADDRESS:
TR: 5904 LT: 189 UN: .002 9019 GARIBALDI AV
FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: TEMP CA 917801546
ASSESSOR INFORMATION NUMBER: xRncF6aT CROSS STREET: MYDA
5384-006-030 01 PERMIT ISSUANCE FEE 27.75 Tf-O A.9 PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, C
07 BATHTUBS/SHOWERS 7.00 FII 113.40
TE37ANT: 11 CZOT4119WA.9HER(9) 1.00 FII 16.20 ISSUED ON: PROCFSSED BY: PLAN BY: EMPIRES ON:
13 DI9HFASHER(S) 1.00 FIS 16.20 04/30/08 BR 10/27/08
17 FLOOR DRAIN(S) 3.00 FII 48.60
OWNER: TEL. NO: 21 HOSE BIBB(9) 3.00 FIS 48.60 FINAj, DATE FINAL BY: CODE:
FANO, JAMES Q (626) 215-9510- 25 LAVATtJRIE9/SINKS 4.00 = 64.80
9019 GARIBALDI AV 27 PRESS REG DEVICE(9) X3.00 DEV 48.60
TEMP 917801546 45 WATER CLOSET/URINAL 3)00 FII 48.60 ..._.J`CStIPTIOti OF'WORK
47 WATER HEATER(S) '1.00 NPH 16.20 PLUMBING FOR ADDITION AND REMODEL
51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20
APPLICANT: TEL. 190: TOTAL FRFi9 465.15
Stu (626) 524-3164-
4205 E. LIVE OAR AVESPECIAL CONDITIONS:
ARCADIA, CA , -5 91001 - � (('�v `;'q -2 r-
CONTRACTOR: TEL. NO: Z7 APPROVALS DATE INSPECTOR SIGNATURE
NA LII AND SHENG WANG (626) 286-3328-
5012 WALNUT GROVE AVE #201 LSC. NO UNDER SLAB WORK
SAN GABRffi,, CA 91776 865781 B
WATER SERVICE
PLASTIC YIN METAL YIN
ARCHITECT OR ENGINEER: TEL. NO:
42 JR. (626) LIC. NO: ROUGH PLS®I PG
4205 E. LEVE OAK AVE. LSC. N0:
ARCADIA, CA 91006 021951 GAS PIPING
GAS VENT
HOT HATER BEATER
PLUMBING FIXTVRFS
LAWN SPRINKLERS
GAS TEST
UTILITY COMPANY NOTIFIED
cWV
GRAY PLATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508