HomeMy Public PortalAbout20134 GRAND AVE_Plumbing__ APPLICATION FOIA PLUMBING PERMIT -
Goun" OF LOS ARS
DEPAETMENI' OF COIINT7 ENG MM
sUnXOG AND SAFETY DIVISION � �-�
��.
LOCALMY
FOR APPLICANT TO MI. IN XFJ
NUIitER P'I]CRJRE OR ITISY olvim w
]IiT]<R CL OB= Jim
RAM'POE
ADDHEM
BKOWER CrrT 7m. NO.
LRVMORT CC /W./
sm ADDH�
D>�pA� C1TT TEL !(O. .�
LAUNDRY TUB HEQLETHATION LSO. Y 3� cou. .
CLOTMIS:WA = P - CT Imo. ORO ZONE} P BY
VIAM HEAffi Vf' 4 1
MA ftBr K D IDUVRIAL
r►AM
bMPECnON
i Fra
APPAovAL9 Dwra MPecroa•a a,aruru>:fi
PERMFT $ 2100 UNDIM BL J3 WORK
TOTAL.FEE ROUGH PLUMBING
OAS PIPING `
I HIRIaT ACCIUIOTLIDGI THAT I KM CLAD TWIT APPUCATIOA
AND STATE UTAT THE ASOYS If ODMUCT AAD ARCA TU COAPLT GAS VT2IT
VITH ALL COUNTY ORDU ICII AID ITATI LAWS IEGDLATIaG HOT WATER HEATER
L
AS.
IM CECTiFTsjm As �T I F@LY $rrRKD .AND/OR PLUMBING FUCTURES '
rg OF
RAIA OR THAT THA 7�7 I[ GAS TEST JA
am RIAID � CLl LfTILITY CO.NtjT`thEp
-UMX
ERMS
F I NAL
m. ' VALIDATION RO®ERT a WOOD.
aI N.0. cm $UPXflMDINO MZCHAMCAL:EmCrR
0 5 5 5 2 AN 1 17 5 D 3 .00
WQRKERS'CQMPIiNSATION DE{LARATION APPLICATION FOR PLUMBING PERMIT
I hereby affirm th rt I have a certificate of consent to self 76,s667A
Insure,.or a certLflcat , of Workers' Compensation Insurance, C 817(REV, 10/81)
or a certified copy thereof (Sec. 3800, Lab..C.) COUNTY OF LOS ANGELES BUILDING AND.SAFETY
Policy No._Compatly
Certified copy Is herby fumlihed.
FOR APKJC Nr TO FILL iN(PRINT OR TYPE) BUILDING
Certified copy Is filed withthe un ull q I
tion dereni. NUMBER FIXTURE OR FFEM 4 FEE
LOG4IITY
date ' 114ant NEAREST
WATER CLOSET
CERTIEICAn OF EXU-:M SROM WORKERS' BATkrIUB ST.
COMPEN$ATI INSURANCE
(Tbl*secibn need not be completed tF tits work Irnrofved by
MAJL
SHOWER'
the pewnft'Is for one hundred dollgm($M)or less.) LAVATORY ADDRESS f
1 certify.that in the perforrhapce of the waric far which this
permltlslssued,I thoq not employ dry Paon In any monner SINk CITY l _P9-_P9- No.
to as 16 become subject to the Worker! Compensation taws. QLc+IWASHER• CONTRACTOR
Date ATp l l ca n t CLOTHES WAST ER ARE
NOTICIt TO APPLICANT: if, after maklnq this Certlfictite of SWIMMING POOL RECEPTOR
ExOmptlbn, you should become subject to the Workers'
Compenscrtloq provillons of the-Labor Code, you must forth- CITY TEL NO'
with comply with such provisions or this permit shall bo 4sWN�PRINI¢St5Y5T5H ST TE LC
deemed revoked. WATER HEAIER -NO.
LICENSE4 CONTRACTORS dECt.ARATION
r hereby affirm that I am Iicented under provlsrpns of meter 9 SYS7fM OUTLETS BY
(commencing with Section 7000) of Division 3 of the Qusiness A;,-, �
and Profewions Code,and my license is In full force and effect. RR DIS VALIDATION
License NUm ic. Class^
FINAL Cf
Contractor Date BY �0
IIi exempt under$ec.T. W
B:sP.C. for this reason Pldn check fee
bate: 'PLUMBING PERMIT ISSUING FEE$ _
Slgnatuvp_
TOTAL FEE
Plan check applrcant
SINGLE'FAMILY
HOME OWN ER-6UIL.DLIZDECLARATION Name
I hereby affirm that I am exemptfrom the Cpntractor;License 3,
Address
3 9 ,5 A
Law for the following reason (Section 7031.5, Businets'and . # a o 0 0 0 5
ElCode).- city Tel. No. k
ElI,as &wren of the property, will do the work End the 2 o 6 5 Q
structure Is not Intended or offered for sale (Section
7044,. Business and Professlons Oode). R o 0 0 6 5 Q
CONSTRUCTION LENDING AGENCY 0.7.26-83
I hereby affirm that there Is-a construction lending agency for
the performanoe of the work for which this permit Is Issued
(Sec. 3097, Civ. C_).
tender's Name r
Lender's Address
I certify that I have read this applltatlon and state thqt the ,
above Information it cornett. I agree to comply with air County
ordinances and State IbwK rNulatinp Numbing,and hereby
quthorizd pr es of this County to enter upon the
a on p for Inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
naturo of Permittee
COUNTY OF LOS ANGELES TEMPLE CITY 0508 PLUMING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0106260003
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
ON FILE ! 10234 GREEN ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUKT: TEMP CA 917803336
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GLICKMAN
8585-006-022 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: 94 LOCALITY: TEMPLE CITY
07 aATHTUBS/SHOWERS" 1.00 FIX 16.20
25 LAVATORIES/SINKS 1.00 FIX 16.20BY,- EXPIRES .
45 WATER CLOSET/UIRINAL 1.DO FIX 16.20 06/26/01 UT 12/23/01OWNER: TEL. 100: .
TOTAL FEES 76.35 flWALD4TE CODE:
SWARTZ NICHOLAS J (626) 448-1185- Qi -71x1
10732 GREEN ST v 1
TEMP 917803336
PLUMBING FOR BATHRM LOCATED INSIDE GARAGE
APPLICANT: TEL. NO:
SAME AS OWNERSPECIAL CONDITIONS:
CONTRACTM, -
/ SOS P�(,ELES CO APPROVALS DATE INSPECTOR SIGkATURE
SAME AS OWER
. LIC. NO % UNDER SLA13 WORK
PLASTIC YIN KETAL Y/N
ARCHITECT OR ENGINEER: . NO: R09� PLUMBING
LIC. NO. GAS kPING
1 1
GAS YEN T
U CL, MV 00 F�
U
PLU GING F XTU[ES
LAWN' SPR I N KL MW-
GAS TEST
/7
UTILITY UNTKU-Wr=
t
\\ SCWV
@rvice_/ GRAY WATER SYSTEMi
i
i
REPORT ID: DPR263 ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY 0 0508 PLUMBING PERMIT
DEPARTMENT OF PLBLIC WORKS 9701 LAS TLNAS PL 0508 0101310001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
ON FILE 10234 GREEN ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803336
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GLICKMAN
8585-006-022 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY
07 BATHTUBS/SHOWERS 1.00 FIX 16.20
25 LAVATORIES/SINKS 2.00 FIX 32.40 .
45 WATER CLOSET/URINAL 1.00 FIX 16.20 01/31/01 UT 07/30/01
TOTAL FEES 92.55
OWNER: TEL. NO: FINAL DATE F I NAIL B
SW RTZ, NICHOLAS J
10232 GREEN ST 1p
TEMP 917803336
PLUMBING FOR BATHROOM ADDITION
SAME AS OWNER -
+�ySPECIAL CONDITIONS:
CONTRACTOR: TEL. NO:
APPROVALS DATE INSPECTOR SIGRATURE
SAME AS OWNER . � \i,
LIC. NO UNDER SLAB WO"
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARC HITECT OR ENGINEER: TEL. . � ROUGH PLUMBING
LIC. NoGAS PIPING
VENT
,��' ^lll 111 �11i
Ll
;
c r<< i ,t ;,�
�r ->>
REPORT ID: DPR263 ROUTE TO: BS0508