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Home My Public Portal About6340 GOLDEN WEST AVE_Plumbing__ 76A6617-�fI7 &60 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 6340 Golden West Ave . WILLIAM A. JENSEN, SUP'T OF BUILDING LOCALITY Temple City FOR APPLICANT TO FILL IN NEAREST F�cll SS ST. Lonj7den NUMBER FIXTURE OR ITEM OWNER Dr. Salter 2 WATER CLOSET MAIL 1 BATH TUB ADDRESS 1 SHOWER CITY TEL. NO. 2 LAVATORY CONTRACTOREarl Pat Standlpy, Tne , SINK W/Disp. ADDRESS 201 T\T_ unytj p-n. 4og CITY TEL. NO. GT 4_1559 DISHWASHER l Montp CONTRACTOR S STATE [Z LAUNDRY TUB REGISTRATION' No. 149236 COUNTY [I CLOTHES WASHER DISTRICT GROUP I ZONE I PRO ESSED BY WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD 0 u 0 2 $1.00 PER ITEM OR FIXTURE 11.00 APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT 2 �oo UNDER SLAB WORK TOTAL FEE 1-1 00 ROUGH PLUMBING GAS PIPING A4HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION D STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQU RED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THIAFT I AM T;E LEqAL OWNER OF THE ABOVE GAS TEST DESCRIBED RESIDE A P ry. UTILITY CO.NOTIFIED SIGNATURE OFPERMIT, FINAL VALIDATION ROBERT A. WOOD, CK. M.0. CASH SUPERVISING MECHANICAL F-NG'R 7 2 4 J_ J 1 3 .(` " "ZKERS' T`'°N DK'-WTK)N APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 20-0028 DPW 8/97 Insure, cr a certificate of Workers'Compensation Insurance, 78A84 7A or a certified copy thereof (Sec. 38010, Lab. C.) COUNTY QF LOS ANG ES DEPT. OF PUBLIC WORKS Policy No. Co Certified copy R ed. ❑ FOR ALL IN OR TYPE) BURRING /_ Certified copy Is II the county building Inspec- f� tion department NUMBER FIXTURE OR REM 0 FEE LOCALITY WATER CLOSET Date Appll4ant NEAREST s CERTIFICATE OF D AAPTKDN FROM WOMBS' BAT}i TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This settfen need not be compbfed If the work lmrohred by MAIL the permh is for one hundred donors($100)or kws.) LAVATORY ADDS I certify that In the performance of the work for which this permit Is Issued, I shall not employ any�erson In any manner SINK CrTY TE, NO. to as to become subject to the Workers Compensation Laws. D15}RINASIfR CONTRACTOR Date l Applicant CLOTHES WASHER NOTICE TO APPLICANT: if, after making this Certh9cate of SWIMM1t1G POOL ADDRESS T' Exemption, you should become subject to the Workers' Compensatkon provisions of the Labor Code, you must forth- LAWN SPRIMQER SYSTEM CITY �/ Na with comply with such provisions or this permit shall be STATE LIC deemed revoked. WATER HEATER LKMN!5E NO. CLASS LICENSED CONTRACTORS DEO ARATION DMTRiCi NO. PROCESSED BY I hereby affirm that I am Ikbnsed under provisions of C haptw 9 GAS SYSTEM CUTLETS � D� (commenting with Section 7000)of Division 3 of the Business OUTLETS OVER }�... and Professions Code,and my license is h full force and aeVALIDATIOeffect. 5 PER SYSTEM FINAL p: License Number .32�-�/2 / IIc. Claw L 3tRf DATE �. S: ContKtttor �e &Ido '• Date "� FINAL Y ❑ I am exempt under Sea. B.dP.C_ for this reason Plan check fee Date. PLUMBING PERMIT ISSUING FEE$ $lanahire TOTAL FEE SINGLE FAMILY Plan check applicant OWNER-BUILDER DECLARAT1OfJ Name I hereby am exempt from the Contractors License. Address ACCT.i Law for the oil ti reason (Section 7031.5, Business and o• N Tel. 33D7 20.50 Profewlons Cod y Tl. ❑ I, as owner of TFif will do the work and the 1 ITEM ► structure Is not In offered for sale (Section TOTAL 20 - 50 7041, Business and Pr ? e}. , cPNsTRUCTION LE4 CY �IY •r� I hereby affirm that there is a cons tructl� agency for the pwfomlance of the work for whlci It Is Issued (Sec. 309-/, QIv. C_} �— 1 2/2S/91 Lender's Name 5797 1 Ali 9:4` Lenders Address � I certify that I have read this application and state that the~ ► above Infomxrtlon Is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize repre;entatives of this County to enfer upon the above m tion property for Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date COLRITY OF LOS ANGELES TEMPLE CITE 058E PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TLK&S PL 050E 0209180002 BUILbING AND SAFETY / LAND DEVELOPMDLT , TEMPLE CITY CA 91780 PHONE: (626) 285-048 EXT: LEGAL 10: FM PAID BUUDING ADDRtU.- QN FILE 6340 GOLDEN WeST.AV ` = FEE DESCRIPTION: GLIANTITY: UOM: AMOLMT: TEMP. CA 917801420 ASSESSOR INFORMATION RMER: NEAREST CAOES.STREET: LOKDEN 5383-020-029 01-PEkNIT ISSLMCE FEE 27.73 THOMAS PAGE: 597 GRID: Al LOCALITY",TEMPLE CITY 05 BACKFLOW DEVICE(S) 4.00 DEV 64.80 47 WATER HEATER(S) 1.00 WTH 16.20 19M Old: PROM= BY: PLff BY: EXPIRES TOTAL EES 108,75 Q9/18/02 JK 03/17/03 . Z= FIKA BY: CODE:' SCOTT•DIXIE L (626) 286-7851- 2 6340 i'�I.DEN WEST AV / r (/�� TEMP 917801420 DESCRIPTION OF- WORK REPLACE WATER HEATER, REPAIR i AUTOMATE SPRINKLERS CLARK E GEORGE'S PLLWING (626) 573-2107- 9233 RIO DELL ST ROS EMEADMKTKACTORi : TEL. NO:.: `s�►�S LARK CS AND GEORGE'S PLLKBING (626) 573-2107•, 9233 RIO DELL LIC. NO �' \ sixg WORK ROSEMEAD. CA 91T70 748881 C36 WAT" SERVICE PLASfIC Y/N METAL Y/_N ARCHITECT OR ENGINEER: XTURE; 7y GAS TW I . c Seri Q AO, ' t T ID: DPR263• ROUTE TO: 9S0508