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Home My Public Portal About5117 GOLDEN WEST AVE_Plumbing__ 7&A e7 DMS 17 ilio APPLICATION FOR PERMIT DEPARTMENT OFNCS AND SAFETY COIINTY OFF LOS LOS ANGELES WILLIAM J. FOX, OHIEF ENMINEKR PLUMBING 1 FOR APPLCCANT TO FILL IN DISTRICT—KO. GROUP ZONE PERMIT NV PLUNDER READYftM ,� TI 1 ED FIRMT INSP[DTION , i ADDREMM HUILDINO CITY TIL No. ADO= COUNTY 1QLLOCALITY j. N EAR[MT PE MT FEE CRO!!KT. MUMMER vrm Or FU[TURI OR rnrm FII OWN KRLj MAIL WATER OO LMET(TOILET) • CLOD a VD,I,x• HATH TUN • 0.60 , CITY ND. G 97'Od III HOWE R • 0.611 1 14MENY KNOWLEDGE THAT 1 HAVE READ THE■ LAVATORY (WASH MAMIN) • 0.60 APPUCATION AND MTATE THAT THK ABOVE IB CORRECT AND AIMEE TO COMPLY WITH ALL COUNTY CfIDINANOKM KITOHKH ■INK • CLOD AND NATE LAWN REOULATINO PLUMMINO. 1 CERTIFY THAT I FCWHAo THE AMOVE VAUD LOM LAUNDRY TUM OR TRAY • 0.60 ANOKLER COUNTY UOEN■ R I AM THE LEGAL OWNER OF THE XMID DKEORIMED AADVE. m" MYMTKI� nUTLRy • 0.607 \IMMATURE OF WATER HKATKA • 'CLOD P"MITTKII MLOP MINK • 0.60 INSPECTION RECORD FLOOR MINK • D.50 v FLOOR DRAIN • CLOD DIHHWAMHER • CLOD DRINKING FOUNTAIN • 0.n0 URINAL • 0.60 HOUME ■EWKR • CLOD _ MIMOKLLANKOUM O APPROVALS DATE ir+wrsDTDR'S MAH[ ROUGH PLUMMINEI OAS PIPING m" VENT CKMiPOOL • 1.100 CKNUPOOL MEPTIO TANKI SEPTIC TANK DRAIN ( ) PIT ) • 1.00 B41MKR PERMIT 1.011 a" TOTAL FEE UTILITY OO.NOTIFIED •• Q Q UO �� WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT � e eby affirm that I have d certificate of content to wlf 76A667A tnsut'e, gr a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) u or a ceftlfled copy thereof (Sec. 3600, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Pal ty No. TJ8JX Company SL 8119 JYS- Certlfied copy Is hereby furnished. ' FOR APALK.4Nf TO RLL IN(PRINT OR TYPE) BU1LDNO I4_�4J� Certified copy Is filed with the county bulTdADDRESSinq inspec- 5117 ��1�� tion department. NUMBER RKtURE C4R ITEM O FEE LOCALITY 11-17-67 BCU CY�t Cb. WATER CLOSET Date 11-17--87 00 WARM CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST' COMPENSATION INSURANCE OWNER ` (This section need not b6 completed If the work Irrvohr d by 1Q the pormM b for one hundred dollars (=100)or less.) LAVATORY YU pQ AAyADDRfSS 5117 Ci�Tat I ccertlfy that In the performance of the work for which this permit Js Issued, I shall not employ any person In any manner Si NK CIT City TEL NO:818-285-3965 so as to become subject to The Workers'Compensation Laws. DISHWASHER . CONTRACTOR Date Ar llcant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS jg7fin _R_ Chlitn 49 Exemption, you should become subject to the Workers' SM&YANG POOL RECEPTOR �-,�y.��..� TEL Compensation provlslons of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM ii`�" �� -1� with comply with such provisions or this permit shall be STATE UG deerhed revoked. WATER HEATER NO. 425570 CLASS B LICENSED CONTRACTORS DECLARATION INSTRICT,.WY I hereby affirm 0mi I am licensed under provhions of Chapter 9 GAS SYSTEM CxJ1lM O� (commencing with Section 7000) of Division 3 of the Buslness OUTLETS011u L�cx and Professions Code,and my license li in full force and effect. 5 PER SYSTEM FINAL `� v IDAT1oN � Llcense Number 1Ic. Class B DATE & Q Fl Contractor Bacc= Omst- Cb. Date 11-17-67 B ❑ I am exempt under SeG B.3P.C, for this reason Plan check fee 18 5 7.4 A ' Date: Signature PLUMBING PERMIT ISSUING FEE; I� # 000005 z TOTAL FEE o o .( o,0 7 (15 0 Plan check applicant � �� OD. SINGLE FAMILY Plan 0007,0506 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License 12.14-:&87 Law for the following reason (Section 7031.5, Business and rem L� E- �]1IIlEt B� Professlons Code): City FcK1ard Ebights Tel. No.7j 1M ❑ I, as owner of the property, will do the work and the structure Is not Intended or offered for sale (Sectloh , 7044, Butimm and Professions Code). CONST-RUCT10N LENDING AGENCY I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit Is Issued (Set. 3097, Cl Y. C, Lender's Name Lender's Address I certify that I have read this application and stpte that the l� above Information Is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby thorize reprntatWas of this County to enter upon the ve-mentl ed property for Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE auc> 1-1-17-67 Signature of Permittee Date WORKERS'COMPENSATION DECLARATION 76A667A I hereby affirm that I have a, certificate of consent to self CE 617 (2-e0) APPLICATION FOR PLUMBING PERMIT insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C. COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING `` Certified co NUMBER FIXTURE OR ITEM • FEE ADDRESS 51i 111 c"' copy is filed with the unty b ']ding inspection depar en . LOCALITY T WATER CLOSET Date �5� Applicant NEAREST �0•. BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved LAVATORY MAIL ADDRESS by the permit is for one hundred dollars ($100) or less.) a SINK CIT TEL.NOQS5-Sg6 0 I certify that in the performance of the work for which this DISHWASHERV permit is issued, I shall not employ any person in any manner CONTRACTOR fr so as to b co a subject to the r ers' p nsation Laws. CLOTHES WASHER Q .. ADDRESS Date Applicant SWIMMING POOL RECEPTORlaW NOTICE TO APPLICANT: If, after kithis Certificate of CITY , TEL. NO. ng Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM Compensation provisions of the Labor Code, you must forth- STATE + `- LIC. z with comply with such provisions or this permit shall be WATER HEATER (�(� LICENSE NO. I c� ) CLASS lt%a( 11 _ deemed revoked. GAS SYSTEM OUTLETS DISTfitICTr__ NO. PROCESSED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER - $ �— I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL VALIDATION ness and Professions Code, and my license is in full force and DATE effect. License Number Lia Clas FINAL / BY ContractorDate I am exempt om the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ ( 2 1 1.6 A acting in my professional capacity (Section 7051, Bus- iness and Professions Code). '5 # • 5 TOTAL FEE Lic.or Reg.No. Date Plan check applicant ? • • 10,00 HOME OWNER-BUILDER DECLARATION Name eel 0007-, I hereby affirm that I am exempt from the Contractor's Address 1.1,30-81 License Law for the following reason (Section 7031.5, Busi- City Tel. No. ness and Professions Code): ElI, as owner of the property, am exclusively contracting with licensed contractors to construct the project (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,Civ.C.). Lender's Name " Lender's Address Y FOR F�� L k � R� � � I certify that I have read this application and state that the LCT ION above information is correct.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ! V' ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-m Toned r erty for inspection purpo es. Signatur ermittee Date 6- y COUNTY OF LOS ANGELES TEMPLE CITY 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUKAS PL 0508 0010270016 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: 4 LEGAL ID- FEES PAID BUILDING ADDRESS: TR: 15683 LT: 11 5117 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803941 ASS NEAREST CROSS STREET: LA ROSA 8589-010-011 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 10/27/00 UT 04/26/01 LAM• YVONNE (626) 285-2002- 511' GOLDEN WEST AV TEMP 9176039+1 DE 21PTION OF WORK GAS LINE FOR NEW HVAC SYSTEM IW►I COOLING AND HEATING (626) 932-1163- 826 BONITA ST. SPECIAL CONDITIONS: MONROVIA,CA 91016 SP03 F ES Co CONTRACTOR: TEL. Iff-- APPROVALS DATE INSPECTOR -SIGKATORr- IWAI COOLING AND HEATING (626) 932-1163- V� ��y 826 BONITA ST LIC. NO UNDER SLAB WORK MONROVIA CA 91016 778839 C20 ARCHI�ECT OR ENGINEER: TEL. NO: PLASTIC Y/N METAL Y/N LIC. GAS TEST 111111 LID HOT 61ATER HUTMF- �RU`WC WORKS) PLUMBING FIXIUKhN dL.AWN SPRINKLERS UTILITY COMPANY kTIFIED 0 ❑ ' Service REPORT ID: DPR263 ROUTE TO: SS0508 COUNTY OF LOS AN{3EELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC %URK4 9701 LAS TUNAS PL 0508 1002170012 BUILDING AND SAF&T'Y / L.hND DEVELOPMENT TE24PLv' CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDILO ADDRESS: TR: 15683 IT: 11 5117 GOLDEN WZST AV FEE DESCRIPTION: QUANTITY: 00M: AMOUNT: TEMP CA 917803941 ASSFSSOR INFORMATION NUMBER: NFJIL T CROSS STREET: 8589-010-011 01 PERMIT ISSUANCE FEE 27.75 THOMIS PAGE: 597 GRID: A4 LOCALITY: TE0= CITY, C 07 BATHTUBS/SHOWERS 2.00 FII 32.40 TENANT: 25 LAVATORSE,9/SINL9 4.00 PIZ 64.80 ISSUM ON: PROCFi9SED BY: PLAN BY: EXPIRMS ON: 45 WATER CLOSET/UR.INAL 2.00 FII 32.40 02/17/10 SR 02/17/11 TOTAL FEFS 157.35 YVONN: TEL. NO: �D FI2D�L BY: CODE: YVOffi: a•< BEN.TAbU21 - /�/(/�J{L //'D /",1^Ni 5117 GOLDEN WEST AV _ , TE34P 917803941 DESCRIPTION OF WORK PLUMBING FOR KI'TC11EN AND 2 BATHROOMS REMDRL APPLICANT: TEL. NO: JAY M4UTYAFI (818) 266-8978- 6037 SEPULVEIA. BLVD. SPECIAL CONDITIOUS: VAN NUYS, CA 91411 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGHATORE PREFERRED I-OKE BUILDERS, INC. (818) 594-3500- 6271 VAR= AVE. UNIT C LIC. NO UNDER SLAB WORK WOODLAND HILLS CA 91367 773147 B WATER SERVICE PLASTIC YIN METAL YIN ARCHITECT OR ENGINEER: TEL. NO: - ROUGH PL@4HIHG LIC. NO: GAS PIPING GAS VENT HOT WATER SEATS PLUMBING FI%ZVRES LAWN SPR_lbUMXRS GAS 'IFi9T UT L= COMPANY NOTIFIED CNV GRAY WATER SYSTEM au Ly v REPORT ID: DPR263 ROUTE TO: BS0508