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Home My Public Portal About5738 GOLDEN WEST AVE_Plumbing__ C.B. 17 23M SETS 12-43 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING 1 COUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE '7q26" 7 �1PERMIT /./y ROUGH FIXTURES COMPLETE ® / q 2 6" / HEATER CESSPOOL SEREADY FOR PTIC TANK RECEIVED BY FIRST IN PECTION ` DAT/E ISSUED AS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY NAMEl �r `/j±a"D'L/'V�' ADDRESS 4 W 'A �. J_ • L ^. _ / ADDRESS (/ �� f(I.QJ�,� �i. LOCALITYNEAREST C!/,6�� /�d /�y1 J CITY �q TEL.No. CROSS ST. vk 6[ !f'-Jt" , f Nf tt--o COUNTY CERT.No. ` EXPIRES W NAME (� LOCATION OF SEPTIC TANK, OR CESSPOOL = MAIL I ADDRESS . NORTH O CITY -�--�"t�Q 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. a fG OWNER i CORRECTIONS$ SOUTH J DESCRIPTION OF WORK z_ BATH TUB FURNACE IZr SHOWER DISHWASHER C3 LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP GLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAMB WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I I METER GAS SODA FOUNTAIN I OUTL GAS PIPING IJ GAS VENT 1 CESSPOOL I I TOTAL NUMBELOFFIXTURES SEPTIC TANK-CESSPOOLTIC TANK ® SEWER $ ,� ® � UTILITY CO.NOTIFIED I n TOTAL FEE FINAL 76A667 OBB 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES ' WILLIAM J. FOX, CHIEF ENGINEER PLUMBING 1 PERMIT FOR /A�P"PECCANT TO FILL IN DISTRICT GROUP � q L/ 9 / . PLUMBER / .,@�LYNf Q' RECEI ED BY READY FOR O FIRST INS /�� Ej•9 ADDRE99 ted- BUILDING CITY TEL NO. (,I,t �( j ADDRESS 6 COUNTY' LOCALITY LICENSE NO. C ',,. EXPIRES NEAREST PERMIT FEES' 1 cRoas ST. NUMBER TYPE OF FIXTURE OR ITEM FEE A OWNER ,4 .1, X�IIJ� 1 MAIL WATER CLOSET(TOILET) @ 0.50 0 I �i1 ADDRESS 3 E L7u / BATHTUB @ 0.50 ; CITY TE NO. SHOWER @ 0.50 1 HERE84 ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE_OR I AM THE LEGAL OWNER OF THE REBIDENTI ;mvpDESCRIBE ABOVE. GAS BYBTEM OUTLETS @ 0.50 ��lG ff SIGNATURE OF �� 4�'•�yF i/�C/ WATER HEATER @ 0.50 Q(j PERMITTE BLOW BINK @ O.so INSPECTION RECORD ; FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL @ 0.50 J Q HOUSE SEWER @ 0.50 Z MISCELLANEOUS 0 O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT I 1.00 GAB TEST UTILITY CO.NOTIFIED TOTAL FEE D D FINAL � S�! 76A667-CE81712/59 TEMPLE C4TY 4- APPLICATION FOR PLUMBING PERMIT � COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING L.AND,$tFETY RIVISION BUILDING JOHN A. AMBI OUNTY NGINEER ADDRESS 5- U WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY ' FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM OWNER ' WATER CLOSET MAIL BATH TUB " ADDRESS CITY TEL. NO. SHOWER LAVATORY CONTRACTOR SINK ADDRESS DISHWASHER CITY y�� TEL. 140. CONTRACTOR'S �y j STATE ❑ LAUNDRY TUB REGISTRATION NO. % COUNTY ❑ CLOTHES WASHER DISTRICT NO. I GROUPA ' /N I P CESSED BY WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL � 1riSPECTION RECORD a O U U W tn a $1.00 PER ITEM I / OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ ( 2 00 UNDER SLAB WORK TOTAL FEE ROUGH PLUMBING GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND,STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL .PROPERTY. UTILITY CO.NOTIFIED SOF PERMETTEF �(/JT-�• FINAL �y ®. 0VALIDATION ROBERT A. WOOD, 0 M.O. CASH SUPERVISING MECHANICAL ENG'R ( 3 .C� U `•:;�4 2 7 1 !L;R ? 2 5 D Y 76A667-CE#817 f9-67 - - APPL,ICATION ' FOR PLUMBING PERM `..COUNTY OF LOS ANGELES - DEP RTMENT OF COUNTY ENGINEER B ILDING -AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W,,JENKINS. SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN (PR NT 0R TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 1.50 MAIL ' BATH TUB 1.50 ADDRESS SHOWER 1.50 C17Y TEL. NO. J LAVATORY 1.50 CONTRACTO SINK 1 50 ADDRESS{(j/.Z, AIO. DISHWA HE� 1.50 CITY �J/ TEL. NO. CLOTHES WASHER 1.50 STATE LIC LICENSE NO . ��._ CLASS SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE PROCESSED BY LAWN SPRINKLER SYSTEM 2.00 � If--1 o U WATER HEATER 1 50 INDUSTRIALWASTE APPROVAL - O GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD U OUTLETS OVER W 5 PER SYSTEM .30 D_ _ Z Plan check fee 25% of above. See reverse PLUMBING PERMIT ISSUING FEE S 2 00 TOTAL FEE APPROVALS DATE INSPECTOR S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel. No. HOT WATER HEATER LANDSTATE BY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBINGFIXTURES LL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST GEBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED D AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF NIA OR THAT I AM T LEGAL OWNS OF,AND INTEND TON, THE ABOVE DEGC D RE (DENTIA PROPS Y FINALURE JACK R. ALLEN, SUPER VISIN CH ANICALEN G'R RMITTEE PERMIT VALIDATION cK M O CASH PLAN CHECK VALIDA N CK M O CASH L 5 0 4 3 JUN 13 5 D 5.00- WORKER'S COMPENSATION DECLARATION 76A667A 6DPW 9/69 APPLICATION FOR PLUMBING PERMIT 76A66 I hereby affirm that I have a certificate of consent to self insure, , I or a r ertificate of Worker's Compensation Insurance, or a certified ^ copy tnereof(Sec 3800 Lab C)' COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV. Policy No Company Certified copy is hereby furnished / FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING dmg'mspection ADDRESS Certified copy is filed with the county buil pa ment I NUMBER FIXTURE OR ITEM @ FEE LOCALITY, Date •� Applica(�,Ji'�/.,1�'/tea�sG� WATER CLOSET �-- NEAREST -CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST BATH TUB- COMPENSATION INSURANCE ASSESSOR ' (This section need not be completedSHOWER MAP BOOK PAGE PARCEL if the work Involved by the permit is for one hundred dollars($100)or less.) LAVATORY OWNER I certify that in-the performance of the work for which this permit is issued, I shall-not employ any person in any manner so as to SINK- MAIL ADDRESS become subject to the Workers Compensation Laws DISWASHER CITY TEL NO Date Applicant CLOTHES WASHER CONTRACTOR NOTICE TO APPLICANT If, after making this Certificate of G' Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR = provisions of the Labor Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked j LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATIONCITY EL NO I hereby.affirm that I am licensed under provisions of Chapter 9 WATER HEATER ✓ / d (commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS /�' L CET SE NO CLASS C LIC 4� 60M V Professions Code,and my license is in full force and effect / - OUTLETS OVER DISTRICT NO P CESSED BY lZ c� /(,�/ /,/ /7 r y� 5 PER SYSTEM , License Numb / / 7'`� ' Lic Class � zy O FINAL 4 VALIDATION W DATE 7-I Z��Q ILCD MoFIN Date I am exempt un er Sec BY AL B&P C for this reason r Date Plan check fee Signature PLUMBING PERMIT ISSUING FEE$ (0 r , ❑ TOTAL FEE 4' r, SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and Professions Address Code) / City Tel No , t � D ❑ I,as owner of the property,will do the work and the structure 1 1 f EN& is not intended or offered for sale (Section 7044, Business and Professions Code) I j � ; - 5 CONSTRUCTION LENDING AGENCY NED, it 1.tS.j I hereby affirm that there is a construction lending agency for the performance of the work for which this-permit is issued (Sec 3097,- - I off t31_ o 00 Cni C) / s� Lender's Name 1 (_IS]i I.{-- if)U S i r/31.x-+.4. Lender's Address ` =`�-�I=5 J 1 AN ::26 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• r representatives of this County to enter upon the above-mentioned property for pection purposes -SEE REVERSE FOR EXPLANATORY LANGUAGE r 7-11 Signa ure & Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508LIUMBING IPIER�MQWT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS P 0508 0003100002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: --F—Eff PAID BUI •NG-PPESS: TR: 11131 LT: 18 BL: .001 5'6.8 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: �IEMP CQ 9�1p780252�—� ASSESSO INFORMATION NUMB NEAREST–(ROSS-:-ST-REET.:--LI•dE OAK 8588-012-029 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 2.00 FIX 32.40 TENANT: 11 CLOTHESWASHER(S) 1.00 FIX 16.20 ISSUED PROCESSED BY: PAN BY: EXPIR . 13 DISHWASHERS) 1.00 FIX 16.20 03/10/00 UT09 6/00 21 HOSE BIBB(S) 2.00 FIX 32.40 OWNER: TEL. NO: 25 LAVATORIES/SINKS 4.00 FIX 64.80 FINAL DATE FINAL BY: CODE: KU; 45 WATER CLOSET/URINAL 3.00 FIX 48.60 5638 GOLDEN WEST AV 47 WATER HEATER(S) 1.00 WTH 16.20 TEMP 917802520 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 DESCRIPTIN Of WORC TOTAL FEES 270.75 PLUMBING FOR ADDITION AND REMODELrNG APPLICANT: TEL. NO: KWOK (323) 728-7833- 109 E. FLORAL DRIVE SPECIAL CONDITIONS: MONTEREY PARK, CA ZED,S c® IONTRACTOR: CONTROL TEL. NO: 1125 APPROVALS DATE INSPE OR IGNATUREION –— 16026 DOUBLE GROVE ST LIC. NO UNDER SLAB WORK VALINDA, CA 91744 590485C-36 * 60 WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT 0 ENGINEER: 0: ROUGH PLUMBING LIC. N0: 1 11 1111Vi"L IY�fl1� GAS PIPING GAS VENT RUFOUC \1//111/O�,-=�S N � ATE HEATER V V l�J Uu LJ v PLUMBING FIXTURES O E) l� LAWN SPRINKLERS Q El GAS TEST El �g UTILI 0 El CWV ��ryTh�� GRAY WATER SYSTEM * ADDITIONAL DATA ON FILE REPORT 1D: DPR263 ROUTE TO: BS0508