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HomeMy Public PortalAbout5555 HALLOWELL AVE_Plumbing__ 76A667A CE 819}RV.6/781 ©S � APPLICATION FO PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ` ADDRESS NUMBER FIXTURE OR ITEM @ FEE LOCALITY r WATER CLOSET NEAREST �•--' BATH TUB CROSS ST. SHOWER OWNERMAIL ! / LAVATORY ADDRESS" r` o SINK CITY e TEL.NO DISHWASHER CONTRACTOR ° C fit.✓0 464 CLOTHES WASHER ADDRESS t:5 00AAM 0 :tl� SWIMMING POOL RECEPTOR JcITY c L ` TEL.NO 2LAWN SPRINKLER SYSTEMTATE } _ _ �q/WATER HEATER ICNSE N08 CASS Com..2 GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING a 0 GAS VENT G' HOT WATER HEATER Qp PLUMBING FIXTURES GAS TEST Plan check fee UTILITY CO.NOTIFIED C� PLUMBING PERMIT ISSUING FEE$ TOTAL FEE FINAL r �� .-- Plan check applicant PLAN CHECK VALIDATION Name Address City Tel. No. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES �J AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION 'j 07 S 0 A I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE (-� Q O O O O LEGAL OWNER OF.AND INTEND TO`RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. j 2 C p qI 0 0 O SIGNATURE OF PERMITTEE / G a a i a o U �I l7 DISTR�O. P CESSE BY 0 1 I INDUSTRIAL WASTE APPROVAL 76A667A� � CE 817(RES.6/781 ©s ' . APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING z­-j , -j % 3 ., NUMBER FIXTURE OR ITEM @ FEE ADDRESS t WATER CLOSET' --? LOCALITY NEAREST r BATH TUB 3 CROSS ST. SHOWER 3 OWNER LAVATORY MAIL 3 �� ADDRESS SINK CITY TEL.NOa _ DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR 214 'r CITY TEL.NO. LAWN SPRINKLER SYSTEM STATE LIC. WATER HEATER LICENSE NO. CLASS GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING v C-.j GAS PIPING �-�--- a GAS VENT HOT WATER HEATER O' PLUMBING FIXTURES GAS TEST a Plan check fee UTILITY.CO.NOTIFIED PLUMBING PERMIT ISSUING FEE$ Q.(� _ TOTAL FEE 9 'c�O FINAL Plan check applicant PLAN CHECK VALIDATION Name Address 41,068A City Tel.No. o a o 0 0 5 1 HEREBYACKNOWLEDGETHAT I HAVE READ THIS APPLICATION AND STATE . THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 2 A 019. 00� AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS O CJ O 1 O0 REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE (� y �p LEGAL OWNER OF,A INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL ' 0•6 I -70 0 PROPERTY. SIGNATURE OF PERMITTEE DISTRICT NO. P OCESSED BY 1.570 " INDUSTRIAL WASTE APPROVAL lo WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT . I h by, affirm that I have a•certificate of consent to self in- �0-0026 PW 4/87 76A667A `sVr a certificate of Workers'Compensation Insurance,or -CE 8)7(REV. 8/86) ce,• ed,copy thereof (Sec. 3800, Lab. C.) = 439 - r COUNTY OF LOS.ANGELES DEPT. OF PUBLIC WORKS Policy No. Company � L Certified copy is hereby furnished: o '' FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ertified copy is filedS.with the county building inspection ADDRESS w L NUMBER - FIXTURE OR ITEM FEE department. @ LOCALITY e WATER,CLOSET(TOILET) �" C Date Applicant q I' NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST: COMPENSATION INSURANCE OWNER SHOWER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS certify that in the performance of the work for which this per- SINK mit is.issued, I shall not employ any person in any manner so CITY � '�' r''S TEL. NO.gg, •:.-_/•'7s as to become subject to the Workers'Compensation Laws. "DISHWASHER ��/. 4� ✓ lYG • - CONTRACTOR TOM /L�`. Date Applicant - CLOTHES WASHER' - .. ADDRESS e NOTICE TO APPLICANT:'If, after making this Certificate of Ex- tion,you should become subject to.the Workers'Com en- SWIMMING POOL RECEPTOR em P Y P CITY {� L. NO. �s7iZ7 sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. a; ed. WATER HEATER LICENSE NO. CLASS 'LICENSED CONTRACTORS,DECLARATION DISTRICT NO. PROCESSED BY I Nereby.affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER d Professions Code, and my license is in full force and ef- 5 PER SYSTEM FIN VALIDATION fe _ O License Number � Lic. Class/® U FINAL 1 'Contfactor Date -Q BY E /o 0 a- I am exempt under Sec. iC®r f Q B.&P.C.-for'this reason Plan check fee V C! ► g Date: PLUMBING PERMIT ISSUING FEE$ ? Signature TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant T W- Gyl I hereby affirm that.l am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, 'Business and Professions Code): Address Ai_ 1 as l; as owner of the property, will do the work and the City457Iry 1y Tel. Na. structure is not intended or offered for sale(Section7044, Business and Professions Code).' CONSTRUCTION LENDING AGENCY s 3 Na3 I hereby affirm that there is a construction lending agency for »t -- the performance-of the work for which this permit'is issued ` ' (Sec. 3097, Civ. C.). '_Hi-1NGE Lender's Name Lender's Address I.I>_i1J I I certify.that I have read this application and state that the pop. '53,9 1 J.U.1•7 above information is correct. I agree to comply with,'all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the ab rrnonecI1p;4%e6 for inspection purposes. ¢�_Z_,GT_ SEE REVERSE FOR EXPLANATORY LANGUAGE Sig ature of Permittee Date COUNTY OF LOS ANGELES y 05sLu-"�BING PERMIT ;"--PAf'-',McNT OF PUBLIC WORKS 970 As T N A S 0508 04101400:;'-- BUIL-Dfllx�-:; AND SAFETY LAND DEVELOPMENT 1-'fflvlLE 11 .CITY CIA 91780 ni-)WE: os26) 285-0488 EXT: (LEGAL ID: —FEES TR: 30308 9 555-HLIOWELL AV FEE DESCR I PT T QUANTITY: LF. AMOUNT: ARC- r'ri f-mc78418 ASSESSOR INFOUT11-1—CA NUMBER: N E!%R EST CRC�S'S STREET: LIVE O!,< 8586-015-032 01 PERMIT ISSUf-,N--E FEE 27.75 THO�'�'A- AGE-. 597 GRID: B3 k---,CAi.'TY: TEMPLE CITY, Cl 51 LOW FPS GAS' 5 CUTLET 1.00 SYS 16.20 TENANT: TOTAL FEES 43.95 ISSUEDON: -TREnSED BY: PLAN By. 10/14/04 i :/12/45 OWNER: TEL.-NO: FINAL DA';,.: 'Ai BY 'QDF: GAMBOA JON C;jUDY 5-555 HALLOWELL AV ARCD 910078418 TE S C—RI P T 1 jp.'-TU F GAS LINE REPLACE A/C & FAU APPLICANT: TEL. NO: GLOVER (626) 347-5311- 1 SPECIAL PR ------- !CONTRACTOR: TTRib I �TiGUTGRE 1� , . 1 ;2-TRO INC- 626,, 357-5'"1- 1630 57-57 1-16-710 S. MYRTLE AVE. LIC. NO UrARITCR—SJEZ--� XK------- II r ,MONROVIA, CA 91016 ;n-822SCIO WATER SERVCE PLASTIL YIN METAL '/N 1AP.CHITECT ROUGH PLUMN: LIC. NU: GAS PIPING HOT WATER PLUMTi—NG F'5-75'-K'i= LAWN :7 UTILITY CONPANY NOTIFIED CWV GRAY WATER SYSIEM ADDITIONAL DATA ON FILE REPORT !D: D'"263 ROUTE TO: SS0503 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0809150017 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: FEES PAID I BUILDING ADDRESS: 1 ITR: 30308 LT: 9 1 5555 HALLOWELL AV 1 I (FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( ARCD CA 910078418 (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: DAINES 18586-015-032 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY, Cl 1 107 BATHTUBS/SHOWERS 2.00 FIX 32.40 1 ITENANT: 125 LAVATORIES/SINKS 2.00 FIX 32.40 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I 1 145 WATER CLOSET/URINAL 1.00 FIX 16.20 109/15/08 SR 03/14/09 1 1 TOTAL FEES 108.75 1 1 (OWNER: TEL. NO: (FINAL DA FINAL BY: CODE: 1 IGAMBOA, MR/MRS. JOHN - I ' 15555 HALLOWELL AV I ) V (ARCD 910078418 IDESCRfPTIC OF WORK 1 1 (PLUMBING F R MASTER BATHROO REMODEL 1 (APPLICANT: TEL. NO: I IO'LEARY 15827 AGNES AVENUE (SPECIAL CONDITIONS: (TEMPLE CITY CA 91780 I (CONTRACTOR: TEL. NO: 1APPROVALS DATE INSPECTOR SIGNATURE ITOM O'LEARY CONSTRUCTION (626) 287-0927- 1 15823 AGNES AVENUE LIC. NO (UNDER SLAB WORK ITEMPLE CITY, CA 91780 489354 B-1 1 WATER SERVICE 91 IPLASTIC YIN METAL YIN 1 1 1ARCHITECT OR ENGINEER: TEL. NO: 1- 1 - IROUGH PLUMBING 1 1 LIC. No: 1 I I I 1 IGAS PIPING I IGAS VENT I I 1 IHOT WATER HEATER 1 (PLUMBING FIXTURES 1 1 (LAWN SPRINKLERS 1 1 IGAS TEST I 1 (UTILITY COMPANY NOTIFIED( I 1 ICWV I 1GRAY WATER SYSTEM I I I I I I I I I I I I I I II I I I I I I I I I IREPORT ID: DPR263 ROUTE TO: BSO508 I I I I I I