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Home My Public Portal About5723 GOLDEN WEST AVE_Plumbing__ 76A�666.F'EBl/59 i APPLICATION FOR PL MBING PERMI COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGMEER F77 BUILDING ANBD SSP FETY DMSION BUILDING JOHN A. LAM 1 OUNTY ENGINEERWILLIAM A. JENSEN, SUPT OF BUILDING FOR APPLICANT TO FILL IN T ST. NUMBER FIXTURE OR ITEM OWNEB WATER CLOSET MAIL ADDRESS BATH TUB CITY TEL. NO. SHOWER CONTRACTOR LAVATORY ,/ / SINK ADDRESS 6 44 DISHWASHER CITY /lII� TEL NO. CONTRACTOR'SLL STATE LAUNDRY TUB REGISTRATION NO. /tom COUNTY ❑ CLOTHES WASHER DISTRICT NO. GROUP E P ESSED BY WATER HEATER f" V J GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD w O U • P4 F U W _ W UI a $1.00 PER ITEM OR FIXTURE z APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2100 UNDER SLAB WORK r TOTAL FEE ROUGH PLUMBING /J GAS PIPING - 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION / AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT {{ pJ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER 1, /P / .a �• ,'f Q p� I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES _��{ ID P��j ` ✓/�'',,;�� LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST B Y CALIFORNIA OR THAT 1 AM THE LEGAL WNER OF THE ABOVE �-- DESCRIBED RESIDENTIAL ROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTETV (Jy _ rile p FINAL ®F VALIDATION ROBERT A. WOOD, ca. N.O. CASH SUPERVISING MECHANICAL ENG'R 0 4 5,9 55EP20 5 D 5.75~ 76A667-CE817-8-58 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER _ BUMDMG AND SAFETY DMSION fIN UILDING Z 3 Q� e 11 QS JOHN A. LAMBIE, CountF Engineer DDRESS CASSATT D. GRIFFIN.Sup t of Building CALITY FOR APPLICANT TO FILL IN FROSS ST. N N NUMBER FIXTURE OR ITEM OWNER � WATER CLOSET bum t1l BATH TUB ADDRESS S 7 Z /1 Q o Ext e 1 SHOWER CITY _'M t E ;SEL. NO. 1 LAVATORY CONTRACTOR ^L r,, SINS ADDRESS DISHWASHER CITY TEL. NO. LAUNDRY TUB CONTRACTOR'S STATE ❑ REGISTRATION NO. COUNTY ❑ CLOTHES WASHER DISTRICT N:j GRO ZONE P CESSED BY WATER HEATER �1 GAS Mmm INDUSTRIAL WASTE APPROVAL INSPECTION RECORD i Zwgh 60.1f 16/ APPROVALS ORER FIXTURE $ 1 V (/ DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 2 00 ROUGH PLUMBING TOTAL FEE Q GAS PIPING I 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 FIXTURES I HEREBY CERTI I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQ IRED B S ANGELES COUNTY AND STATE OF CALIFORNIA 0 THAT I A HE LEGAL OWNER OF THE ABOVE UTILITYCO NOTIFIED DESCRIBED RE IDENTI P P RTY. �f l SOF PER E FINAL l S ROBERT A.WOOD. OF VALIDATUPERVISING MECHANICAL ENG'R CR. M.0. CASH - E 5 A �.0 Cot3 5, 0 8 tkI"sR � WORKERS'COMPENSATION DECLARATION - APPLICATION' FOR PLUMBING PERMIT I hereby, coff.g,n that-I have a certificate of consent to self in- 76A66�A PW 490 ; sure,'or a cePtificate of Workers'Compensation Insurance,or a certified copy thereof (Sec•3800, Lab C ) COUNTY OF LOS ANGELES DEPT.-OF PUBLIC WORKS 'fl , Policy No Company ❑ Certified copy whereby 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 Dote Applicant WATER CLOSET(TOILET) ,/!i NEAREST '• CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER OWNER ,- (This section need not be completed if the work involved by MAIL J the permit is for one hundred dollars($100)or less.) / LAVATORY ADDRESS $ p� r I certify that in the performance of the work for which this per- SINK f` mit is issued, I shall not employ any person in a y manner so CITY em TEL NO a 3(OV� as to become subiect to the Workers'C mpen ion Laws DISHWASHER V CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT If, after making this C tificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY TEL NO sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATELIC ed WATER HEATER LICENSE CLASS LICENSED CONTRACTORS DECLARATION / GAS SYSTEM OUTLETS DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter O 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect HOSE BIB DATE l��Z 6 License Number Lic. Class a FINAL O U Contractor Date BY O` ❑ - O I am exempt under Sec � F' I�r� U B 8P C for this reason Plan check fee pop. d Vf Date PLUMBING PERMIT ISSUING FEE$ d 3303 91.70 ? Signature TOTAL FEE 7a 1 ITEMS SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant TOTAL f91 -70 I hereby affirm that I am exempt from•the Contractor's License Name CHECK 91.70 Law for the following reason (Section 7031 5,-Business and e G�A��E OQ Professions Code) Address I, as owner of the property, will do the,work and the City Tel No structure is not intended or offered for sale(Section 7044, 0000-0001 1�23�9b Business and Professions Code) CONSTRUCTION LENDING AGENCY ' 4394 1 PM 608 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 1 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 laws regulating Plumbing, and hereby authorize repr entatives of this County to,enter upon the INtio property for inspection purposes - ' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of mittee Date --- COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0304140070 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL PAID BUILDING ADDRESS: TR: 6561 LT: 462 5723 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802504 INFORMATIONASSESSOR UM NEAREST CROSS STREET: LIVE OAK 8587-023-006 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 2.00 FIX 32.40 11 CLOTHESWASHER(S) 1.00 FIX 16.20 ISSUED C A EXP ON: 21 HOSE BIBB(S) 2.00 FIX 32.40 04/16/03 JK 10/13/03 25 LAVATORIES/SINKS 2.00 FIX 32.40 OWNER: TEL. NO: 45 WATER CLOSET/URINAL 2.00 FIX 32.40 FINAL DATE FICODE: ZOVAK PETER;JOANNE - 47 WATER HEATER(S) 1.00 WTH 16.20 (� � - 5723 GOLDEN WEST AV 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 / TEMP 917802504 TOTAL FEES 205.95 DESCRIPTION OF WORK PLUMBING FOR ADDITION APPLICANT: TEL. O'LEARY; TOM (626) 287-0927- 5823 AGNES AVENUE SPECIAL 0 DITI TEMPLE CITY CONTRACTOR: TEL. N0: ;� APPROVALS DATE INSPECTOR SIGNATURE TOM OILEARY CONSTRUCTION (626) 287-0927- 5823 AGNES AVENUE LIC. NO U � O�FbWV TEMPLE CITY, CA 91780 489354 B-1 �' ✓•r�l rY _= " 6 IL U �✓ WATER SERVICE PLASTIC Y/N METAL Y/N a' ARCHITE CT OR ENGINEER: LIC.- /N0:� JF I _ t �`�„ GH P UMB G vU'^� GAS VENT - — -— - - - PLUMBING FIXTUR S LAWN SPRINKL-ERS GAS TEST UTILITY comPT97 5T= CWV GRAY WATER REPORT ID: DPR263 ROUTE TO: BS0508 C ' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0411120003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL D: FEES PAID BUILDING-ADDRESS: TR: 6561 LT: 462 5723 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802504 ASSESSOR A 0 NEAREST CROSS STREET: LIVE OAK 8587-023-006 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY 13 DISHWASHERS) 1.00 FIX 16.20 TENANT: 25 LAVATORIES/SINKS 1.00 FIX 16.20 ISSUED ON: PROtESSEDY: PLAN BY: EXPIRES 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 11/12/04 JK 05/11/05 TOTAL FEES' 76.35 OWNER: TEE N0: FINAL DATE FINAL CODE: ZOVAK PETER;JOANNE 5723 GOLDEN WEST AV [� TEMP 917802504 DESCRIPTION Of PLUMBING FOR KITCHEN REMODEL APPLICANT: L. O'LEARY; TOM (626) 287-0927- 5823 AGNES AVENUE SPECIAL CONDITIONS: TEMPLE CITY CONTRACTOR: T APPROVALS DATE INSPECTOR SIGNATUR TOM O'LEARY CONSTRUCTION (626) 287-0927- 5823 AGNES AVENUE LIC. NO UNDER SLAB WORK TEMPLE CITY, CA 91780 489354 B-1 WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECTOR ENGINEER: TEL. 0: LIC. N0: ROUGH PLUMBING GAS NG 7- GAS VENT HEATERHOT WATER PLUMBING R S LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIEU CWV GRAY WATERSYSTEM REPORT ID: OPR263 ROUTE TO: BS0508