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Home My Public Portal About5806 GOLDEN WEST AVE_Plumbing__ r WORKERS'COMPENSATION DECLARATION 76A667A I hereby gffjrrn-that I have a certificate of consent to self ce e17 (2-80) APPLICATION FOR PLUMBING PERMIT insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec 3800,Lab COUNTY OF LOS ANGELI�S BUILDING AND SAFETY Policy No Company �� Certified copy is hereby fl nished. / FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING y ADDRESS Certified copy,is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE de t nt LOCALITY WATER CLOSET Date Applicant NEAREST BATH TUB CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER LAVATORY MAIL (This section need not be completed if the work involved ADDRESS >_ by the permit is for one hundred dollars ($100) or less.) SINK CITY 0 a J� TEL NO I certify that in the performance of the work for which this DISHWASHER U CONTRACTOR permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER ADDRESS 0 Date Applicant SWIMMING POOL RECEPTOR U NOTICE TO APPLICANT- If, after making this Certificate of CITY `� TEL NO.�y� f UJ CL Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC., to Compensation provisions of the Labor•Code, you must forth- LICENSE NO (o Q CLASS ? with comply.with such provisions or this permit shall be r deemed revoked I I GAS SYSTEM OUTLETS Q DIST /NO SED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL ® �/ VALIDATION ness and Professions Code, and my license is in full force and DATE f effect. F 1 N AL i nse Nupil;er Lie Class BY o , n actor `. Date "/77k� I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code) TOTAL FEE Lie.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section 7031 5, Busi- City Tel No0 2 4 1 A ness and Professions Code). I, as owner of the property, am exclusively contracting o'o 0 o o5 with licensed contractors to construct the project (Section 7044,Business and Professions Code) 2 0 0 1 0 0 CONSTRUCTION LENDING AGENCY o 0 0 1 600'. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is 1 ]—8 1 issued(Sec 3097,Civ C.) Lender's Name Lender's Address I certify that,I have read this application and state that the above information is correct I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby author representative f this County to enter pon the i abov -men coned pro t for inspection/purp es n ure of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0102020007 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEG I S PAID BUILDING ADDRESS: TR: 6561 LT: 452 5806 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802203 ASSESSOR INFORMATION NUMB . NEAREST CROSS STREET: LAS TUNAS 8587-027-024 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 1.00 FIX 16.20 TENANT: 25 LAVATORIES/SINKS 1.00 FIX 16.20 ISSUED ON: PROCESSED PLAN B XP . 45 WATER CLOSET/URINAL 1.00 FIX 16.20 02/02/01 UT 08/01/01 TOTAL FEES 76.35 OWNER: TEL. NO: FINAL DAT Y: CODE: MACHMULLER FRED;WILHELMINA H 5806 GOLDEN WEST AV - TEMP 917802203 DESCRIPTION OF WORK,- PLUMBING FOR BATHROOM EMOD EL. L & W KITCHENS & BATHS (626) 287-1131- 8812 LAS TUNAS DR SPECIAL CONDITIONS: SAN GABRIEL, CA p- CONTRACTOR: TEL. NO: _ �� APPROVALS DATE INSPECTOR SIGNATURE L AND W KITCHENS AND BATHS (626) 287-1131- 8812 LAS TUNAS DR. LIC. NO UNDER SLAUVORK SAN GABRIEL, CA 91776 2053448 WATER. SERVICE ARCHITECT ENGINE PLASTIC Y/N METAL Y/N TE j � �� LIC. NO:/ _ 11,111 \ ROUGH PLUMBING 21 GAS PIPING LAJ I� GAS VENT HOT WATER HEATER -- PLUMBING FIXTURES AWN SPRINKLERS GAS TEST nUTILITY COMPANY NOTIFIED LJ $ 9d / CQv GRAY WATER REPORT ID: DPR263 ROUTE TO: SS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0204110010 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING TR: 6561 LT: 452 - - - 5806 GOLDEN WEST AV's FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802203 ASSESSOR I OR ._ ' - ' - - NEAREST-CROSS STREET:LAS"TUNAS 8587-027-024 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY 13 DISHWASHER(S) 1.00 FIX 16.20 TENANT: 25 LAVATORIES/SINKS 1.00 FIX 16.20 N: TOTAL FEES 60.15 04/11/02 JK 10/08/02 OWNER: TEL. N0: FINAL— � FINAL BY: CODE: MACHMULLER fRED;WILHELMINA H (626) 285-8219- !�J 5806 GOLDEN WEST AV TEMP 917802203 DEQ RIP PLUMBING FOR KITCHEN REMODEL TEL. L & W KITCHEN & BATH - 8812 LAS TUNAS SPECIAL CONDITIONS: SAN GABRIEL � -GEL.ES Cp CONTRACTOR: TEL. NO: OS �/��, APPROVALS DATE INSPECTOR GN T R L AND W KITCHENS AND BATHS (626) 287-1131- ' 8812 LAS TUNAS DR. LIC. NO WER SLAB0 SAN GABRIEL, CA 91776 _ 205344B WATER SERVICE PLASTIC Y/N METAL Y/N ENGINEER:ARCHITECT OR . LIC. NO: GAS PIPING 1111111 P 1281 LC V V 0lu(-7-'alK3 RO-T-QWM HEATER FIXTURES �Y "0 O17WN SPRINKLERS A Q ® ®y UTILITY CWTU NOTIFIED ervi e Th GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: SS0508 _ 411 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0102220046 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING TR: 6561 LT: 452 5806 GOLDEN WEST AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802203 ASSESSOR INFORMATION NUM NEAREST CROSS STREET: WOODRUF 8587-027-024 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TOTAL FEES 43.95 ISSUED ON: PROCESSED A B RES ON: 02/22/01 UT 08/21/01 OWNER: TEL. NO: FINAL DATE FINA CODE: MACHMULLER H 5806G0LDENWESTAyj2 2 00 TEMP 917802203 DESCRIPTION 0 INSTALLATION OF CENTRAL HEATING AND AC APPLICA L. CAL WEST HTG AND AC (626) 574-9300- 9737 VAL ST SPECIAL CONDITIONS: TEMPLE CITY CAL ONTRACTOHEATING AND AIR COND. TEL. N574 9300 APPROVALS ATE INSPECTOR SIGNATURE 9737 VAL ST. LIC. NO \\ UNDER SLAB WORK TEMPLE CITY 505986 C20 I WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGI L. NO: ROUGH PLUMBING LIC. NO;I GAS PIPING - -- - ---- - __ - - --- - ----! GAS VENT HOT WATER HEATER - - --- - -- - - - ---- --=rPLUMBING FIXTURES LAWN SPRINKLERS GAS TEST TILITY COMPA 0 C GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508