HomeMy Public PortalAbout10879 GRAND AVE_Plumbing__ �A: a.i, 9/75 TL-/ -� � ,��� C v`
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TY PEI BUILDING
NUMBER FIXTURE OR ITEM • FEE ADDRESS
WATER CLOSET LOCALITYJE
BATH TUB NEARESTCROSS ST. TA T
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY TEL. NO.
DISHWASHER CO
CLOTHES WASHER ��[��
ADD Gi,,1 -,
SWIMMING POOL RECEPTOR M❑f � IN /�
LAWN SPRINKLER SYSTEM CITY MPLE Gl`_A CjA� ,�10. C.l a
STATE LIC
WATER HEATER i LICENSE NO. CLASS o
DISTFJLQT NO ORO PNE R ESSE BY C�
GAS SYSTEM OUTLETS _L o
OUTLETS OVER
6 PER SYSTEM plJ$7RI
WASTE APPROVAL y
INSPECTION RECORD Z
Plan check fee
PLUMBING PERMIT ISSUING FEE $ Q
TOTAL FEE Q
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
AddreS3 ROUGH PLUMBING
City Tel. No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAYS READ THIS APPLICATION GAS VENT
AN STATE THAT THE ABOVE ISCORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUM BrN G.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AHD/OR PLUMBING FIXTURES
LI CE NEED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR TH4&T I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIED R E AL P O ERTY. UTILITY CO. NOTIFIED
SIONATU RE
OF PERMITTEE FINAL
PLAN CHECK VALIDATION ECTCK, IO
RMIT VALIDATION M.0. CASH
6DY
DBS47,10•55 APPLICATION FOR PLUMBING PERMIT
DIVISION OF BUMDING AND SAFETY �,QprG
of
co" of Los Xb Eay�«r
JOHN A. L AMBIE. CouN Y ENWNEER ADDbREE9 ��� lz��
CAGEATT b,GRIFFIN,HUP'T OR BUILDIHa to ��jjy� �
LOCALITY ,Ari�+�,':ti5 i ]�
FOR APPLICA& TO FILL IN N EAR NET
CROOR ST
ER
F=71
DIST ICT NO. ORO P 6 R DT FOR Ix$FlO'f10R
6r
INDUSTRIAL
CI T WANT APPROVA
PLUIIDER D/¢ T / INSPECTION RECORD
ADDR • �/�"� ��✓
c TEL. NO 7—e
UCEN"No. ./.D/A,r�S' N
NU144`VA Trr�9pp FUCruRi oR rrlLw Frr
!r WA CLoarT (Tcm ) ti.00
Tli TUD 1.00
1py
!SHOWER cp gi.6o
LAVATORY (WASH BAYIM) S1. O
KiTC:H-EM PINK 1.b0
DISHWAIHER $1.00
LAUNDRY TUE OR TRAY qi.00 / O
CLOTHES WAiRkER 1.00 .
WATBLR NEATER $1.00 OQ
OAG BYSTICK fl.00
APPROVALS
OATk IHDPECTOR'S SM(ATU
UNDER SLAB WORK
PERMIT • 1 OO RoU uM ING Ae,Y
OAIf PIPI O
TOTAL FEE T47O (3Ao V NT
I HEREBY ACKNOWLEDGE THAT I• HAKE READ THIS APPLJCj4.TION HOT WA R HEAT[R
A3fD STATE THAT THE ABOVE IS CORRECT AMD AGREE TO CoWpLX
WITH ALL COUNTY ORDINANCES AND STATE LAMS REGULATIIIG
PLUMBING. P U BIND FIXTURES
1 HEREBY CERTIFY THAT I AY PROPERLY D Alio R OAa 'T
TB:S
4ICEII SED AS REOUIRE4 BY N E NTY D STATE F
CALIFORNIA OR THAT I OWN OF THE AB YE UTILI CO.NOTIFIED f
DESCRIBm RESIDENTI
S 1 O NATU FIE
OF F'KRMITTR FINAL
JOHN A. LAMBIE,COUNTY ENOIN19KR. VALIDATION ROBERT A.WOOD, CHIEF PLBO. INaPECTOR
bg50N SEP17 3 8.00 In
BCOMPENSATION
DA1O" DPW°/W APPLICATION FOR PLUMBING PERMIT
I hereby nfflrm that I have a certificate oT consent to self Insure,
or a certffloate of Worker's Compenaatlon Insuranoe, or a corttfled
oopy thereof(8eo.3800 Lab.C.)
OUITY OF LOS ANGELES DEPT. OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV.
Policy No. Comparry
❑ Cartlflad oopy is hereby turrrWxKL 40-daE-9
FOR TO FLI IN(PRINT OR TYPE) BUILDING lD��
❑ Certlfhd copy M sled with the county buMN lnsq on /
dal—tri—t— NUIISER FD(TURE OR ITEM • FEE LOCALITY
Deb Appk--d WATER CLOSET NEAF1EBT
CEFIT IFICATE OF EXEMPTION FROM WORKERS BATH TUB COOSS 8T.
COMPENSATION INSURANCE ASSES
(ThM seotion need not be corepMted if five fork Involved by ti» SHOWER NAP BOOK PAGE PARCEL
Permit to for one hundred dolMrs($100)or Fess.)
LAVATORY
I certify that In the performance of the work for which this permit
to Issued, I shell not employ any person In any manner eo as to Spm ACQE88 /c /l 6.,,become subject to ter
he Work 'Comperuaflon Laws. Q �/p
DISWASHER Ct1Y 71� TEL-
Date
ELDate Awn CLOTH E8 WASHERr
NOTICE TO APPLICANT: If, after making this Certificate of COKfRACTOR �(� 0.3 OaOE
Exemption,you should become subject to the Workers'Compenaaiion 8WWAING POOL RECEPTOR
provisions of the Labor Code, you must forthwith oomply with such ADDRESS
provislons or this permit shall be deemed revoked. LAWN SPPoNXLEFI 8YSlE11
LICENSED CONTRACTORS DECLARATION CITY TEL NO. }
I hereby affirm that I am licensed under provisions of Chapter ° WATER HEATER Q8
(commencing with Seotfon 7000) of Division 3 of the Business and STATE
Profeasiona Code, and my Iloense h In full force and effect CART L� OUTLETS LIC�7i8> CLASS
�
(XJTIFfS OVER DISTRICT NO. PF10CE88E0 BY
5 PER SYSTEM
Lk; n Number uc.Claes �J v
DATE ,R�.� VALIDATION W
Convector DateFKAL
7
❑ 1 am exempt under Seo. BY
B.aP.C.for this reason
DELL: Plan check fee 0110.
PLUMBING PERMIT[SWING FEE 3
F-1TOTAL FEE
c
Plan check applicant "
SINGLE FAMILY "I• 1
HOME OWNER-BUIIDFA DECLARATION Name
I hereby affirm that I am exempt from the Contractor's Lloense Law if reg.
for the following reason (Sectdd
ion 7031.5, Business and Professions Aresa r
code): Tel.No. 1 ITRE
��
ply
❑ t,as owner of the property,will do the work and the ptruoWrer T c33 35
Is not Intended or offered (for sale Sectlon 7044, Business
I l�r1 r -J� -
and Profseetons Code). ' CCY� hd•25
I CONSTRUCTfON LENDING AGENCY C
I hereby affirm that there Is a construction lending agency for the
performance of the work for wHbh this permit Is Issued (Sec. 30°7,
CN.C.) 3/24f13-5
Lenders Name ?61'7
Lenders Address
I oertify that I have reed 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
repreeentattvee of this County to enter upon the above-mentloned
property for Inapegp6n pu SEE FEVERSE FOR EXPLANATORY LANGUAGE
8t1Flature of F*Mdee Date
I
• COUNTY OF LOS ANGELES TEMPLE CITY A 0508 PLUMBING PERMIT
DEPARTM[NT OF PUBLIC FORKS 9701 LAS TUNAS PL 0508 1005050003
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PUONE: (626) 285-0488 ETT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 14020 LT: 19 10879 GRAND AV
FEE DF6SCRIPTION: QUANTITY: DOM: AMOUNT: TEMP CA 917803550
ASSESSOR INFORMATION NUMBER: NFJULEST CROSS STREET:
8574-007-019 01 PERM= ISSUANCE FEE 27.75 TEKtiQ PALE: 597 GRTD: D4 LOCALITY: TEMPLE CITY, C
07 BATHTUBS/SHOWERS 1.00 FII 16.20
T827ANT: 25 LAVATORIES/S= 1.00 FII 16.20 I-SSUED ON: PROCESSED BY: PLAN BY:
45 WATER CLOSET/URINAL 1.00 FIS 16.20 05/05/10 SR
TCrIAL FEES 76.35
Ole[EHUHI N: 6) NO: Fri. DAT�� FN
: CODE:
HUEI CHEM LIN (626) 215-3286- k'Y,/TL
10879 GRAND AV
TE!{P 917803550 ION OF WORK
PLUMBING FOR NEW BATHROOM
APPLICANT: TEL. NO:
YU, ANDY (626) 458-8111-
11946 FAIRVIEW ST. SPECIAL CONDITIONS:
EL MONTE CA 91732
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
HUEI CHEM LIF (626) 215-3286-
10879 GRAND AVENUE LIC. NO UNDER SLAB WORK
TEMPLE CITY, CA 91780 NONE
IQITER. SERVICE '
PLASTIC YIN METAI, YIN
ARCHITECT OR E WEER: TEL. NO:
- ROUGH PLUM131OG
LIC. NO:
GAS PIPING
GAS VENT
HOT MATER BEATER
PLUMBING FIZZURE.9
LATIN SPR401LEa.9
GAS TEST
UTILITY COMPANY NOTS}i7SCJ
CWV
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: RS0508