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Home My Public Portal About5616 HALLOWELL AVE_Plumbing__ D.B.S.-17 252 SETS 12-45 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBINGWM. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUPI ZONE PERMIT NO. ROUGH FIXTURES COMPLETE _ HEATER _! CESSPOOL SEPTIC TANK RECEIVED BY FIRST INSPECTION REDY FOR DATE ISSUED GAS I MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB C NAME _ ADDRESS W M ADDRESS LOCALITY f - NEAREST "I CITY TEL.No. CROSS ST. COUNTY CERT.No. EXPIRES M NAME W LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL.No. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. 1 OWNER CORRECTIONS SOUTH d DESCRIPTION OF WORK — - BATH TUB FURNACE ~ a ----- o SHOWER DISHWASHER LAVATORY REFRIGERATOR KITCHEN SINK _.-WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INBPHCTOR'6 NAME WATER HEATER _.__DENTAL LAVATORY ROUGH PLUMBING __ METER GAS SODA FOUNTAIN GAS PIPING OUTL GAS VENT I 11 CESSPOOL 1-5 __--TOTAL NUMBER OF FIXTURESI SEPTIC TANK I I _CESSPOOL SEPTIC TANK ISEWER II y UTILITY CO.NOTIFIED + I ]_ ,TOTAL FEE FINAL D.B:S.-i, 25M SETS 12-45 APPLICATION FOR. PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WM. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE DATE ISSUED R'Ee IVSD BY READY FOR HEATER CESSPOOL —I SEPTIC TANK {gip FIRST INSPECTION GAS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB a i9 0: NAME .••`• a.• ADDRESS ADDRESS �� ,��" �,Q LOCALITY "• „� - D J _ NEAREST II. CITY TEL.No.( �%�( �v.�fyC� CROSS ST. COUNTY / /�,G.' __ CERT.NO. - c� 7,11 EXPIRES &;�,A _7I ¢ NAME LOCATION OF SEPTIC TANK, OR C SPOOL z MAIL 3 ADDRESS NORTH O -- CITY - TEL.No. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICIATE OF QUALIFICATION. wN®kR I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. A D ' W OWNER CORRECTIONS SOUTH DESCRIPTION OF FORK DBATH TUB FURNACE W' SHOWER DISHWASHER O LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP ' SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS __,WATER CLOSET DRINKING FOUNTAIN DAYS INSPECTOR-8 NAME /—WATER HEATER DENTAL LAVATORY ROUGH PLUMBING -.Z 4-I( - i METER—S(_GAS ---------SODA FOUNTAIN GAS PIPING OUTL GAS VENT CESSPOOL ZQ TOTAL NUMBER OF FIXTURES C ® SEPTIC TANK CESSPOOI aEPTIC TANK - SEWER UTILITY O..NOTIFIED I TOTAL FEE FINAL r� '�f•_... -,WORKER'S I have a certiIONficate DECLARATof consent to 76A666DPWg/89 APPLICATION FOR PLUMBING PERMIT I hereby 76A667A ,3ffi�rm that I have a certificate of consent to self insure, or,a ces ltjcate of Worker's Compensation Insurance, or a certified copy th4rreof JSec.3800 Lab. C.) Policy No. 994965 Company Republic Indemn i tCpUNTY.OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV. ❑ Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ADDRESS 5 616 Hallowell Certified copy is filed with the ounty building inspection department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY A r c a d i a Date 6/2 4/91 Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE ASSESSOR MAP BOOK j PAGE PARCEL (This section need not be completed if the work involved by the SHOWER "' , permit is for one hundred dollars($100)or less.) OWNER I certify that in the performance of the work for which this permit LAVATORY jJf Ben Marrone is issued, I shall not employ any person in any manner so as to / SINKMAIL 5 616 Hallowell become subject to the Workers' Compensation Laws. / ADDRESS DISWASHER /� CITY Arcadia TEL.No-5 79-3061 Date Applicant ! CLOTHES WASHER {/ CONTRACTOR NOTICE TO APPLICANT: If, after making this Certificate of Frank Marrone and Sons Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such IIADDRESS 9860 bower Azusa Rd . provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM -. LICENSED CONTRACTORS DECLARATION / / CITY E1 Monte TEL.NO. 444-254 >_I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER a. (commencing with Section 7000) of Division 3 of the Business and STATE LIC. Q Professions Code,and my license is in full force and effect. GAS SYSTEM OUTLETS �O LICENSE NO. CLASS 6 U OUTLETS OVER DISTRICT NO. PROCESSED BY Q 5 PER SYSTEM Q License Number 397884 Lia Class C/3 6 C/1 P O X17 /�� I— U FINAL VALIDATION � Marrone 12/31/90 DATE d Contractor Date _ ' U) 2Z ❑ FZ I am exempt under Sec. BY AL B.&P.C.for this season Lt Date: Plan check fee , Signature PLUMBING PERMIT ISSUING FEE$ �3 ❑ TOTAL FEE r � Plan check applicant SINGLE FAMILY , HOME OWNER-BUILDER DECLARATION Name , I hereby affirm that I am exempt from the Contractor's License Law _ for the following reason (Section 7031.5, Business and Professions Address ;'.. ,< Code): ❑ City Tel. No. I, as owner of the property,will do the work and the structure is not intended or offered for sale Section 7044, Business and Professions Code). 00 CONSTRUCTION LENDING AGENCYCH I hereby affirm that there is a construction lending agency for the =' k t- `• _=:'a performance of the work for which this permit is issued (Sec. 3097, Civ. CJ JU Lender's Name _ f i;jf iI i...f n tF f� .L 1..�• �. .; Lender's Address _ I certify that I have read this application and state that the 'above '•` information is correct. 1 agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize rep esentatives of this County to enter upon the above-mentioned pr sp rposes. SEE REVERSE FOR EXPLANATORY LANGUAGE //- �D —Signature of Permittee Date WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 insure, or a certificate of Workers' Compensation Insurance, 76A667A or a certified copy thereof (Sec. 3800, Lab. C. COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished.❑ BUILDING //JJ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Slj`lj r/LOG✓GGA Certified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET NEAREST �— CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER �� /2�2�Gt (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS 1 certify that in the performance of the work for which this 7/�� permit is issued, I shall not employ any person in any manner SINK CITY ` CIY/ .��Q77 TEL. NO. %�I so as to become subject to the Workers'Compensation Laws. DISHWASHERCONTRACTOR �^,� Date Applicant lg�`—�MA,2Aq'/� CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS --a Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY TEL. NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. _ deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS ��V — (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM 0- FINAL VALIDATION �� DATE License Number Lic. Class �. FINAL Contractor Date BY 0 O I am exempt under Sec. ELI bl. 8.8P.C. for this reason Plan check fee ® N Z Date: PLUMBING PERMIT ISSUING FEE$ /�/ Mz_ SignatureTOTAL FEEff Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name +;•y I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and ;'_ij _t? Professions Code): City Tel. No. I, as owner of the property, will do the work and the `"•`'` structure is not intended or offered for sale (Sectionr' , 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name _-••- `-'�'1 Lender's Address !` >i y I certify that I have read 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 representatives of this County to enter upon the above-mentionedp operty for ' ection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Ad S' r of ermitte o Date WORkERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that 1 have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. Pd✓Ods ❑ FOR APP ICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS Ce tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE v OWNER (This section need not be completed if the work involved by SHOWER MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS I certify tha in Jhe performance of the work for which this permit is J sh I not employ any person in any manner SINK CITY so as tall ct to the W ers'Com ensation Laws. ` !! DISHWASHER CONTRACTOR Date pplica CLOTHES WASHER ADDRESS NOTICE A LI ANT: If, .Xter this.Certificate of SWIMMING POOL RECEPTOR Exemption, ou should become subject to the Workers' CITY �y T Compensation provisions of the Labor Code, you must forth- /.a 441 f LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. ESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER V o and Professions Code,and my license is in full force and effect. 15 PER SYSTEM FINAL VALID N (� 3� DATE�_5 —�v License NumberLic. Class t% i RZ FIN �L Contractor Date / B J 20 9 S 2 A ❑ I am exempt under Sec. G7/t24/ #Eo'00005 B.&P.C. for this rea Plan check fee o 1 6.50 t _ PLUMBING PERMIT ISSUING FEE$ a a a 1 fa 5 0 CE Signature 6 TOTAL FEE ( Q24-84 Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address I certify that I have read 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 outhorize resentati sof this County to e ter upon the above- i n p r y f r inspection pu oses Ff !VERSE FOR EXPLANATORY LANGUAGE Rq q I FOR � p= AL �polcn, — . Signature of Permittee �-' _�� •�' . t-Git " COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1110200002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: I FEES PAID BUILDING ADDRESS: I ITR: 12392 IT: 18 BL: .001 I 5616 HALLOWELL AV I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( ARCD CA 910078419 I (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LIVE OAK 18586-013-024 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY, Cl 1 107 BATHTUBS/SHOWERS 5.00 FIX 81.30 I (TENANT: I11 CLOTHESWASHER(S) 1.00 FIX 16.30 (ISSUED ON: PROCESSED BY: PLAN BY: I I 113 DISHWASHER(S) 1.00 FIX 16.30 110/20/11 SR I 121 HOSE BIBB(S) 2.00 FIX 32.50 1 I (OWNER: TEL. NO: 125 LAVATORIES/SINKS 5.00 FIX 81.30 IP- JARCD DATE FINAL Y: CODE: I 1KASUBUCHI, GREGG (626) 215-5438- 145 WATER CLOSET/URINAL 3.00 FIX 48.80 1 1 15616 HALLOWELL AV 147 WATER HEATER(S) 1.00 WTH 16.30 I 910078419 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.30 ID CR PTION OF WORK I I TOTAL FEES 336.90 (PLUMBING FOR KITCHEN, BATHROOMS, LAUNDRY, WATER HEATER, GAS I I (LINE (APPLICANT: TEL. NO: 1 I 1 IQUAN, ALBERT (626) 202-8328- 1 13139 HEMPSTEAD AVE ISPECT_AL CONDITIONS: IARCADIA, CA 91006 1 1 I I I I I (CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE IKASUBUCHI, GREGG K (626) 215-5438- 1 I 15616 HALLOWELL AVENUE LIC. NO (UNDER SLAB WORK IARCADIA, CA 91007-8419 NONE I 1 1 (WATER SERVICE 1 1 I I 1 (PLASTIC Y/N METAL Y/N 1 1 1 1ARCHITECT OR ENGINEER: TEL. NO: I I 1 1 IPOLYTECH DESIGN BUILD INC. (626) 321-2127- I (ROUGH PLUMBING 12025 SO. 4TH STREET LIC. NO: 1 1 I ( 1 ALHAMBRA, CA 91803 NONE i (GAS PIPING 1 1 IGAS VENT I I 1 1 IHOT WATER HEATER 1 I 1 I I I 1 1 (PLUMBING FIXTURES I I 1 I I I 1 1 ILAWN SPRINKLERS 1 1 1 1 IGAS TEST I 1 I 1 (UTILITY COMPANY NOTIFIEDI I 1 I I 1CWV 1 I I I (GRAY WATER SYSTEM I I I I I I I I I I I I I I I I I I I I (REPORT ID: DPR263 ROUTE TO: BS0508 1 1 1 I