HomeMy Public PortalAbout5511 HALLOWELL AVE_Plumbing__ DEPARTMENT OF COUNTY- ENGINEER L � '
NG
DIVISION OF BUILDING AND SAFETY PERMIT .APPLICATION
COUNTY OF LOS ANGELES BUILDING /f
WILLIAM J. FOX, COUNTY EN13INEER ADDRESS _ ��
FOR APPLICA T TO FILL IN LOCALITY NEAREST
BUILDING
ADORE �� �
SS D CROSS ST. v
iI
DISTRICT N0. GROUP ZONE PERMIT NO.
LOCALITY ,� � / .�/ OQ �
NEAREST ^-
CROSS ST: �{�r�y�Qy�_,k RECEI ED BY Ready for Inspection DATEISSUED
/
OWNER �I,.vv. < , �d`l" tr7�
MAIL INDUSTRIAL
ADDRESS WASTE APPROVAL
CITY VAL6€XRGI 11 111ualmr_ rn
INSPECTION RECORD-
PLUMBER 8300 EAST VALLEY 1361A).
ADDRESS AT. 277
CITY 25 TEL.NO. -
0 K 7 [3 STATE
1 P-COU TY
LICENSE N0. .J
PERMIT FEES a
z_
NUMBER TYPE OF FIXTURE OR ITEM FEE 0
WATER CLOSET(TOILET) @ 0.80 $ ;?D 12:
O
BATH TUB @ 0.80
T SHOWER @ 0.80
LAVATORY(WASH BASIN) @ 0.80
KITCHEN SINK @ 0.80
LAUNDRY TUB OR TRAY @ 0.80
SLOP SINK @ 0.80
FLOOR SINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
GAS SYSTEM:.-_.........OUTLETS @ 1.00
WATER HEATER @ 1.00
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $• 1 00 ROUGH PLUMBING �y�
TOTAL-FEE C20 GAS-PIPING (�
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- GAS VENT p
CATION AND STATE THAT THE ABOVEAS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINNCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES � %�J
AND/OR LICE SED CERTIAS REQFY UIREBY PLOS ANGELES (COUNTY GAS TEST 1716 l
AND STATE OF CALIFOR OR THAT 1 M THE LEGAL OWN-
ER OF THE ABOVE DES ED RESID IAYYROPERTY. UTILITY CO.NOTIFIED
SIGNATURE /
OF PERMITTEE__— ......................... .-I............_..—........
76A667 DBS 17 1/53
WORKERS'COMPENSATION DECLARATION e•
; 20=0026DRW4/87' APPL'(CATION,��FOR „P-LUMBING-.PERM'IT '-
1'.hereby;affirm that I have a certificate''of consent'to `self in-': 76A667A' +' r
sure,ora certificate of Workers'Compensation Insurance,or a CE 817(REV 8/86);° Y
certified-copy thereof (Sec. 3800, Lab ",C )
COUNTY OF LOS'ANGELES DEPT. OF-PUBLIC"WORKS•
Policy,No J `Company. - x
Certified copy is hereby furnished..',' - FOR APPLICANT'TO FILL.INy(PRINT OR TYPE) BUILDING,. i ', •
a Certified cop'ygis filed'with.ahe county buil ding inspection ADDRESS” ( L L: l�t✓✓Lri �/�' _ _.�
department. ; NUMBER ;FIXTURE OR ITEM' _ @ FEE ^
r LOCALITY
vl 7 •WATER•CLOSET`(TOILET) �T'► L� :L GA-
Date' Applicarii "" - • NEAREST
- P CROSS"ST' �fT
4 CERTIFICATE OF'EXEMPTION.FROM'WORKERS ': BATH TUB
GOMPENSATIOMINSU RANCE ^. t r, OWNER,` f' i•'•?"
i• ; o °` q ''" 'SHOWER -g
(This section'n4ed'not be corepleted•iif t";w �k involved by; - MAIL.' ',-_ 7._
the pe�mk'is for'one h'undred,dollars''($100)'or less.) •`2, LAVATORY ADDRESS
I certify that it tF e.performancerof th'e work,_fo'which this per; `s r', «» �• _
h4lis issued,�l shall'not-employ any person in.any'manner so SINK f r, CITY TEL' NO`'
as to become suLilect ta.the Workers'—Cornpensation Laws DISHWASHER a'
v .CONTRACTOR. i :Y• ,
^Date 'v"� Applicant� L� "'�� CLOTHES WAS r
NOT( TO PPLICANT If, after making"this Certificate'of Ex- ADDRESS. sb f —7��� �L, A
SWIMMING POOL RECEPTOR
einpt)on,Ayou should become'sutilect to,the+W,orkers'Com pen- CI,T,Y, = TEL 'NO
sahon provi'i6ns`of fhe1L'6bar Code,'you,rriust.forihwith',comp. ''- LAWN SPRINKLER'SYSTEM
ly'with such provisions:or'tFiis'permit sha_Il.be deemed revoK- STATE } /! y LIC n
e`d �t, .. WATER HEATER, LICENSE NO T v ! 7 l I CLASS.
•
LICENSED•CONTRACTORS'DECLARPTION ''-k'"_• ` ` ' w DISTRICT Iyjy PRO ED BY
" GAS'SYSTEM OUTLETS CJ
1-hereby'dffirm that I am'licensed under provisioris of_Chapter C�r
r ' 9'(commencing.with Section 7,000)of Division 3'of the Business OUTLETS OVER
acid Piofessions'Code, 6nd'my licenselis m-full force-and efr_.- 5:PER,SYSTEM . - VEINAL -VALID ON'
fect = r DATE' tL
rLic;`. mberenseNu /��AA. i ` a r• _ �'- V
'FINAL-"'
(font rdcI 'joe/�i ��i' Lam/ bate d' BY iti'_ O
I,am'exempt
'under-Sec' x.• yVj:
`B&P C' for,this,reas`on 5' Plan cheek fee „ H
Date PLUMBING'PERMIT'ISSUING FEE$ S
•Signature. TOTAL FEE " �•,9 8.S 3 A.
i•SINGLE FAMILY:' ai ., - •~ y # o aro=o e 5 ,
HOMEOWNER-BUILDER DECLARATION Plan"check•applicant
•I hereby affirm'that I am exempt fiom the Contractor',sLicenseName • ` e� "�wo °:3 4,5
Law•for'the following•reason'(Section„7031:5j BuIsiness and- , ` ' ' y ;
Professions Code) Address i 0�e 0'3h'4 Jr Q=
I,, as!,owner,of the property,,,will'do-the'work•and•the City;,' , Tel 'No - v U ,
s••
0`!� 1
`structure is not'�int'ended'or offered for sale(Section 7044;
Busin'es's cind,•Professions Code)
• '' ''CCNSTRUCTION;LENDING•AGENCY
I
her affirm that th-efe is-a construction lending agency for
tle.performance,of the•work'forv,whicF this.,perm.it i's`issued
(Sec. 3007,Civ..0 ):r k' irk.', ,•
,Lender's Name' • - �',
' Lende'r's Address. - ,” •
I�cert)fy that I,have read'ihis.dpphcaiior arid'state that the
'above infbrmation•Is correct-, I agree-to comply'with'all County'
ordinances,and State'laws regulating Plumbing, and'here'by -
authonze'••representatives.of this-County,{o,enter upon the
a6--' " entioned propeity for:in`speciion purposes.
SEErREVERSE•FOR EXPLANATORY LANGUAGE' -
na`tu're of Permittee, d•fe
r' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0205130016
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: - FEES PAID BUILDING ADDRESS:
TR: 30308 LT: 3 5511 HALLOWELL AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ARCD CA 910078418
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: DAINES
8586-015-026 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY
49 WATER TREATING EQUIP 1.00 SYS 16.20
TENANT: TOTAL FEES 43.95 ISSUED PROCESSED : PAN ON:
05/13102 JK 11/09/02
OWNER: TEL. NO: FINAL DATE
FIN Y: CODE:
SYIP;ANN (626) 579-1525- �-
5511 HALLOWELL AV
ARCD 910078418 DESCRIPTION OF WORK
INSTALL WATER SOFTENER
APPLICANT: TEL. NO:
ALAP ASSOC (818) 407-1247-
7229 VARNA ST _ P�ECIAL CONDITIONS:
N HOLLYWOOD - -
CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE
ALAP ASSOCIATES (818) 407-1247-
7229 VARNA ST LIC. NO i, �`/= .�d'1 OR
N. HOLLYWOOD CA 91605 771905C36
=' `y AT R SERVICE
of �' PLASTIC Y/N METAL Y/N
ARCHITECT TEL. N0:
LIC. N0:
— J_I I _ PLUMBING
GAS PIPING
�_ i �---' M i `; —,;�
- GAS VENT
Ffb� i%TER HEATER
PLUMBING FIXTURES Z
.� LAWN SPRINKLEFS
GAS TESTa
.• .� 7: Si," UTILITY COMPANY NOTIFIED
CW
_
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508