HomeMy Public PortalAbout9043 GARIBALDI AVE_Plumbing__ ` t '��oMP AT'°" D ATIo" APPLICATION FOR PLUMBING PERMIT
I hereby {)rm that I have a certificate of consent to self 76A667A
Insure, or a certificate of Work"' Compensation Insurance, CC 817(REV. 10/81)
or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company _
Certified copy Is hereby fumisheod.
❑ FOR APPLLCANf TO FRL IN(PRINT OR TYPE) allrLDTNG
Certtfied copy Is filed with the county building Inspec- ADDRESS
tion department. NUMBER FD(TURE OR ITEM 0 FEE A
LOCALITY
Date Applttant WAS CLOSET
UdMFICATE Of EXEMPTION FROM WORKERS' BATH TUB CROSS ST.
COMPENSATION INSURANCE pyy
(This sec►10need nat be completed If the work Involved by 5+►owER �
n
the permtt b for one hundred dollars(=.100)or lees.) LAVATORY MAR
ADDRESS
I certify that In the performance of the work for which this
Permit Is Issued, I shall not employ any pe n In arty manner SINKCITY TEL NO.
to as to become subject to the Worke Mpersation Laws. DISH-(WASHER
GONTRACTOR _
Date IJ-1e- 2 7+ppl'cant CLOTHES WASHER
NOTICE TO APPLICANT: If, after making this to of POOL ADDRESS
Exemption, you should become subject to the,/Workers' CITY TEL NO
Compensation provisions of the Labor Code, you Must forth- LAWN SKINCLER SYMA
with comply with such provisions or this permit shall be STA LIC
deemed revoked. WATHt HEATER NO. aAss
LICENSED CONTRACTORS DECLARATION Dt51RLC7 BY
hereby affirm that I am licensed ander provisions.of Chapter 9 GAS SYSTEM O(FLETs 6—i /�
(�
(commencing with Section 7000) of Dfvhlon 3 of the Bwlneas CNJRFfS OVER
and Professions Code,and my license Is in full force
�and effect. S PER SYSTEM FINAL VALE TION
License Number "1 ��f� Llc. Class_C1-CT4 DATE
FINAL O
Contractor Date -BY
❑ I am exempt under Sec
B.BP.C. for this reason
Plan check fee
Date
signature PLUMBING PERMIT ISSUING FEE$
TOTAL FEE ;10 85 0 A
Plan check applicant # o o a o o 5
SINGLE FAMILY
HOW OWNER-BUILDER DECLARATION Name ( o - 1650
1 hereby affirm that I am exempt from the Contractors Ucense
Law for the fpllowing reason (Section 7031.5, Business and0 0 0 1 6 5 06
Professions Code): City Tel. No. f Q10-84 0j84
I, as owner of the property, will do the work and the
strUOurp Is not Intended or offered for sale (Section
7044, Business and Professions Code
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction lending agency for
the performance of the work for which this permit Is Issued
(Sec. 3097, Cly. C.}
Lenders Name
LencleLes$&dress
I certify that I have read this application and oath that the
above Inforn0lon Is correct. I agree to comply With all County
ordlnances and State laws regulating Plumbing, and hereby
authorize esentatives of this County to enter upon the
above m property for Inspection purposes, SEE TERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date ,
CODUTI' OF LOS ANGELES TEMPLE CITY D508 PLUMING PERMIT
DEPARTME)IT OF PUBLIC WORKS 9701 LAS TL AS PL 0508 0109060015
BUILDINGyAND.SAFETY / LAND DEVELOPMEXT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDI
TR: 5904 LT: 190 UU: .002 9043 GARIBALDI AV
FEE DESCRIPTION: QUANTITY: UOM: AMCLJNT: TEMP CA 917801620
NEAREST CROSS STREET:
5384-008-003 01 PERMIT ISSUlANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALIT'Y: TEMPLE CITY
51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20
TEWT: TOTAL FEES 43.95I99M ON: PROCESSED BY: PLAN BY: EXPIRES .
09/06/01 LIT 03/05/02OWNER: TEL. NO: FINAL DATE FINAL BY: CODE:
.
FELD RICHARD J, (626) 287-1961-
9043 GARIBALDI AV
TEMP 917801620 DESCRIPTION OF WORK
GAS LINE FOR HVAC SYSTEM
APPLICANT: TEL. 160:
SHERI (818) 519-7706-
12512 CHANDLER 0301 .
N. HOLLYWOOD 91607 � Cy t,l �y L 1 Vl G kD 1/G4 J 11GG
J OSCONTRACTOR: TEL. NO: \ �' So..�►c: La Ic..�.'a
L A AIR ENERGY SAVERS (818) 780-7807-
22148 SHERMAN WY 0103 LIC. NO � ' S•` UNDER SLAB WURKD 2
CANOGA PARK CA 91303 733534 C20WATER S5ZVICE
,l�� r' �� � \•�
PLASTIC Y/N METAL YIN
ARCHITECT OR ENGINEER: .
l 1 '
LIC. NOd1 I ; 1111111 11,1
`. ~ ` •-' fir- . .
���ervic
I
GAS PIPING
us VaT
CWV
GRAY WATER SYSTEM
i
REPORT ID: DPR263 ROUTE TO: BSD508
I
r
COUNTY OF� .0 LOS ANGRT,RTEMI'.R CITY k 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNA.9 PL 0508 0802050003
13=ING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 ETT:
LEGAL ID: FEF9 PAID BUILDING ADDRESS:
TR: 5904 LT: 190 UN: .002 9043 GARIBALDI AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TE34P CA 917801620
ASSESSOR INFORMATION NUMBER: - NEAREST CROSS STREET:
5384-008_-003 01 PERMIT ISSUANCE FEE 27.75 TI-IOMA.9 PAGE: 596 GRID: H2 LO-A=TY: TEMPLE CITY, C
07 BATHTUBS/SHOWERS 1.00 FII 16.20
Tlap,NT: 25 LAVATORIES/SINES 1.00 FII 16.20 L9SUED ON: pROC&SS9 D BY: PLAN BY: EXPIRES ON:
45 WATER CLOSET/URINAL 1.00 Fa 16.20 02/05/08 SR 08/03/08
47 WATER HEATER(S) 1.00 WTH 16.20
OWNER: TEL. 190: TOTAL FEES 92.55 FP DATE FI Y: CODE:
JI, JIANFEI (626) 226-8864- I,,
9043 GARIBALDI AV '
TEMP 917801620 DESCRIPTION OF WORK
PLUMBING FOR NEW BAT RZOOM
APPLICANT: TEL. :
WIONG (626) 293-1612-
817 N. GARFIEI,D AVE SPECIAL CONDITIONS:
A HAMBRA, CA 91801
CONTRACTOR: TEL. 190: APPROVALS DATE INSPECTOR SIGNATURE
PA LAM CONSTRUCTION, CO. (626) 293-1612-
817 N. GARFISI,D AVENUE LIC. NO UNDER SLAB WORK
ALHAMBRA, CA 91801 809418 B
WATER SERVICE
PLASTIC YIN 1[6'AL YIN
ARCHITECT OR ENGINEER: TEL. NO:
_ ROUGH PLUM®IloG �
LIC. NO:
GAS PIPING
GAS VENT
HOT WATER HRa'I'P.R
PLUMBING FIXTURES
LAWN 9 FRI NKL S
GAS TEST
UTILI'T'Y COMPANY NO'T'LFIED
CNH
GRAY WATER STSTEN
REPORT ID: DPR263 ROUITR TO: BS0508
' QTY OF L09 ANGELES TEMPLE CITY/ # 0508 FINN( PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0806060003
• BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
Pte: (626) 285-0488 ETT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 5904 LT: 190 UH: .002 9043 GARIBAL1I AV
FEE DESCRIPTION: QIIAbr=: UOM: AMOUNT: TEN P CA 917801620
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
5384-008-003 01 PERMIT ISSUANCE FEE 27.75 THOWAS PAGE: 596 GRID: H2 LOCALITY: TEXPLE CITY, C
25 LAVATORIg9/SINKS 1.00 FII 16.20
TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
06/06/08 SR 12/03/08
OWNER: TEL. NO: FIPAL DATE F22ZA Y: CODE:
JI, JIANFEI (626) 226-8864- ,f'� i�
9043 GARIBALDI FAV ���/
TE34P 917801620 61SCTIEPTION OF WORK
BAR SINX
APPLICANT: TEL. NO:
SAME AS 0WNER - S K-� 1p,�,,
SpgcixL ONS:
CONTRACTOR: TEL. NO: _ APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO UNDER BLAB WORK
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TEL. NO:
- ROUGH PLUMBIM
LIC. NO:
GAS PIPING
GAS VENT
HOT MATER HEATER
PLUMBING FIXTURES
LAWN SPFSNFTEZRS
GAS TEST
UTILITY CC14PANY NOTIPIED
CMV
GRAY MATER SYST324
RRPORT ID: DPR263 ROUTE TO: SS0508