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Home My Public Portal About10673 HALLWOOD DR_Plumbing__ 76A667 (CE-817)-4/72 APPLICATIill FOR UMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING ADDRESS HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY _^E Fn E- .� �. FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. af{ NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 1.75 OWNER MAIL BATH TUB 1.75 ADDRESS SHOWER 1,75 CITY m ''i- TEL. NO.LA4-I.B-C +.3'j/. LAVATORY 1.75 CONTRACTOR Il r '`nf'A�-t-�p 1 SINK 1.75 ADDRESS Q` DISHWASHER 1.75 Q p CITY TEL. N0. CLOTHES WASHER 1'75 STATE G LICENSE NO. �$ LIC ��j jZJ SWIMMING POOL RECEPTOR 1,75 CLASS G DISTRICT NO. GROUP LZONEK FR CESSE BY LAWN SPRINKLER SYSTEM 1.75 Q -T— WATER WATER HEATER 1.75 INDUSTRIAL(/ I WASTE APPROVAL d / GAS SYSTEM OUTLETS 1.7572 INSPECTION RECORD OUTLETS OVER 5 PER SYSTEM •30 CD v W 6. N Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 s TOTAL FEE 7-5 APPROVALS DATE INSPECTOR 3 SIGNATURE Plan Check applicant UNDER SLAB WORK. Name ROUGH PLUMBING Address GAS PIPING City Tel, No., GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED f �•"'� LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF . CALIFORNIA OR THAT I AM THE LEGAL OWNER 0 ANO INTEND TO RESI OE IN THE ABOVE DES CR D RESIDENTIAL P ,PERTY. FINAL ' d1e>� ��/l•J - SIGNATURE OF PERMITTEE . PERMIT VALIDATION CK. M.0. CASH PLAN CHECK VALIDATION CK. M.0. CASH 14si�NOV 'd 5 u 4.7 5 ,&a COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY I WILLIAM J. FOX, County Engineer I ISTRICT NO. GROUP ZONE PERMIT NO. FOR APPLICANT ��TOFILL IN PLUMBER A F i �_FV1r'�D rLI-i'{?B I il CO. RECEIVED BY DY FOR DATE ISSUED FIRST INSPECTION ADDRESS VALLEY BLVD. r� '7 CITY G SEMEAD TEL. NO. AT. -2/l9 ADDRESS COUNTY 6-30' LOCALITY LICENSE NO. 9JTv1 EXPIRES NEAREST ' PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL / WATER CLOSET(TOILET) @ O. O S _ADDRESS / BATH TUB @ CAP CITY TEL. NO. SHOWER @ 0.5 1 HEREBY ACKNOWLEDGE THAT I HAVE READ T41S LAVATORY (WASH BASIN) 0.5 APPLICATION AND STATE THAT THE ABOVE. IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.5 O AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ O.5 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER /,+ F OF THE RESIDENTIAL ROPERTY DESCRIBED BOVE. GAS SYSTEM--;--OUTLETS @ O.5 G . . o SIGNATURE O WATER HEATER @ O.40 GQ PERMITTEE SLOP SINK @ ❑. ❑ - INSPECTION RECORD FLOOR SINK 0 0.6 FLOOR DRAIN @ O. O DISHWASHER 050 DRINKING FOUNTAIN @ O 50 URINAL @ O. O -J Q HOUSE SEWER @ 13. 0 _ Z_ MISCELLANEOUS - 9 0 APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING /I A. GAS PIPING / 5 GAS VENT i � i / CESSPOOL @1.00 CESSPOOL ,1 / G7 .,1-I L/ SEPTIC TANK: SEPTIC TANK 41 / p S , I DRAIN'( ) PIT ( ) @ 1.00 SEWER t,A B p�GX PERMIT . . . . I 1.00 GAS TEST UTILITY CO.NOTIFIED TOTAL FEE � � I FINAL 76A667 DBS##17 6-52 WORKERS'COMPENSATION DECLARATION c A687; ) L�P rni 11 �/♦tea A T�O V FOR`L II L�lam!/ 11 v U LAY��p mss' II E 11 tl 0 v Y I hereby affirm that I have a certificate of consc;�t to se%f cE ai7 z-so Imo• LLQ �s 1'�1 . insure, or a certificate of Workers'Compensation Insr:.ance,or,. a certified copy thereof(Sec.3800,Lab.C.) COUNTY OF.LOS ANG(LES�� BUILDING AND SAFETY' Policy No. Company I . Certified copy is hereby furnished. FOR'APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ADDRESS CO Certified copy is filed with the county bxz;� NUMBER FIXTURE OR ITEM O FEE rt t LOCALITY Date —t Applicant WATER CLOSET• NEAREST BATH TUB CROSS ST. �Z K/S A CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER LAVATORY MAIL ,�.��I w (This section need not be completed if the work involved ADDRESS W CL by the permit is for one hundred dollars ($100) or less.) SINK0 CITY TEL. NO. U I certify that in the performance of the work for which this DISHWASHER permit is issued, I shall not employ any person in anymanner CONTRACTOR 0 so as t b, come subject to the W rkers'.Compen t' CLOTHES WASHER ADDRESS !�� U �DatW��IApplicant E SWIMMING POOL RECEPTOR /[ � d NOTICE TO APPLICANT:•If, after aking this Certificate of CITY L-eJ►J TEL.NO.g(�® ��67 .tA Exemption, you should become ubject to the Workers' LAWN SPRINKLER SYSTEM 2 Compensation provisions of the Labor Code, you must forth- STATE LIC.. 52 with comply with such provisions;,or.this permit shall be WATER HEATER LICENSE NO�� CLASS deemed revoked. GAS SYSTEM OUTLETS C%f G1/'1DIST�.I.G-T NO, P OCESSED BY • 0(/ LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL VALIDATION ness and Professions Code, and my license is in full force and ! DATE .Lam# effect. � l FINAL ^ VV I License Number Z� Lic.Class / BY p Contract o ate , I am exempt from.the licensing requirements as I am a Plan Check fee b� f licensed architect' or a registered professional engineer 20 4 _S acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lie.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section.7031.5, Busi- City Tel.No. ness and Professions Code): •4 8 1,5 A I, as owner of the property, am exclusively contracting with licensed contractors to construct the project o o'o o o 5 (Section 7044;Business and Professions Code). 2 1 300 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency o o.0 1 3 0.0 czi for the performance of the work for which this permit is issued(Sec. 3097,Civ.C.). Q .6—•8 1 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize resentatives of this unty t enter upon the men on`p perty for' ction rposes. gnature of Permittee Date I �� COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0909010018 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: I FEES PAID BUILDING ADDRESS: 1 ITR: 19189 LT: 82 1 1 10673 HALLWOOD DR 1 I IFEE DESCRIPTION:. - QUANTITY: UOM: AMOUNT: ( TEMP CA 917804125 (ASSESSOR INFORMATION NUMBER: 1 ~ NEAREST CROSS STREET: PAL MAL 1 18585-029-009 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, Cl 1 125 LAVATORIES/SINKS 1.00 FIX 1.6.20 1 I (TENANT: I _TOTAL FEES . 43.95 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1 I I 109/01/09 SR 09/01/10 1 I I I I IOWNER: TEL. NO: i F .AL DATE FIAL BY: CODE: ICAMPOS, JOHN (626) 443-4376- 1 ,/•{,Knn[ 110673 HALLWOOD DR I I 1 ITEMP 917804125 I (DESCRIPTION OF WORK 1 I I (REPLACE KITCHEN SINK 1 I I I I 1APPLICANT: TEL. NO: (ARCHITECTURAL CREATIONS (310) 505-4255- I I 1 1917 N. BAYVIEW AVE. 1 ISPECIAL CONDITIONS: 1 (WILMINGTON CA 90744 I I I I I I I I I I (CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1 (ARCHITECTURAL CREATIONS (310) 505-4255- 1 11 1917 N. BAY VIEW AVENUE LIC. NO I (UNDER SLAB WORK I 1. 1 (WILMINGTON, CA 90744 759571 B I I I I I . 1 I (WATER SERVICE I 1 I 1 1 (PLASTIC Y/N METAL'Y/N (ARCHITECT OR ENGINEER:- TEL. NO: I I I I I - I (ROUGH PLUMBING I I I LIC. NO: I I I I IGAS PIPING I I I I I I I I I I IGAS `TENT I I I I I 1 1-1 1 I I IHOT WATER HEATER I I I I I I I I I I 1PLUMBING FIXTURES 1 1 1 I I I I I I I I (LAWN SPRINKLERS I I I I I I I I I I IGAS TEST I I I I I 1 1-1 1 1 I 1UTILITY COMPANY NOTIFIED( I I _IcWV I I 1 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 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 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 I I 1 I I I I I I