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HomeMy Public PortalAbout9823 HALLWOOD DR_Plumbing__ 76A667A(Cs'B3'713)- 1 1/76 APPLOCAT�ON FOR "PLUM BONG PERM OT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE( ADBUILDING 9823 Ha llwood NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET LOCALITY Temple City NEAREST ' BATH TUB CROSS ST. SHOWER OWNERFrank Mare i' LAVATORY MAILg g 2 3 Hallwood ADDRESS SINK CITY Temple City TEL.NO. 286-7010 r, r DISHWASHER CONTRACTOR Bryant Heat. & Air Cond. Inc CLOTHES WASHER ADDRESS 1350 E. Las Tunas Drive SWIMMING POOL RECEPTOR CITY San Gabriel TEL.NO. 286-1141 r LAWN SPRINKLER SYSTEM STATE LIC. WATER HEATER. LICENSE NO. 221751 C ASS C 2 0 r GAS SYSTEM OUTLETS DISTRICT NO. GROUP O�E SROCESSED BY 1 O PERSYSTTEETS MINDUSTRIAL 3 R OO WASTE APPROVAL INSPECTION RECORD p� IJ @6 Plan check fee PLUMBING PERMIT ISSUING FEE$ TOTAL FEE 10 00 i. Plan check applicant APPROVALS DATE INSPECTOR'S SIGNATURE Name UNDER SLAB WORK Address ROUGH PLUMBING City Tel.No.. GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT 1 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES REQUIRED BY LOS ANGEL - OUNTY AND STATE OF CALIFORNIA OR THAT I AM THE (; GAS TEST �:.c— LEGAL OWNER OF.AND I TED TO RESIDE IN THE ABOVE DE RIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE C)FPERMITT FINAL PERMIT VALIDATION J CK. M.0. CASH PL,AL�`f�EC'K�f�L1D� POLICY6::6 0 AL 14 "� D ©s )II-11C f INUMBERo ` ORKERSCOMPENSATION DECLARATION j ' � '20-0026 DPW 4/87 !r'dU II L�� `�G�1 U ��IIV FOR L�.Vu,GULJ�IIV� II E11�111VU�7 - f hereby, offirmohat I.have a certificate of consent to self in- 76A667A sure,ora certificate-of Workers'Com ensation Insurance,or a (REV. 8/86)' p CE 817 certified•copy thereof (Seca 3800, Lab C ) t COUNTY OF LOS`ANGELES DEPT. OF`PUBLIC'WORKS Policy No.- " Company. r El Certif ed copy.is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING - Gertified copy is filed with the county building inspection ADDRESS _ ��.�j('� +� NUMBER FIXTURE OR ITEM FEE" LOCALITY Z department. @ WATER CLOSET(TOILET) Date Applicant NEAREST a CERTIFICATE OF,EXEMPTION,FROM WORKERS' BATH TUB COMPENSATION INSURANCE' OWNER, I SHOWER (This section need,not be completed if the work involved by MAIL, • the permit is'foF one hundred dollars ($100)'orless.), LAVATORY' ADDRESS (7�� I certify'.that`in the perfi3rmdnce of the work for.which this per- J, i SINK ' it TEL:NO. 1.. Q mit is issued, I 'shall not employ'any person in any ma er so s^ 'as to-become subject to the Workers'-Compensatioa s CITY CONTRACTOR" DISHWASHER Date ;' �d, Applicant `"UOn v CLOTHES WASHER ;. NOTICE TO APPLICANT.=if, after making!hi ertificate,'of Ex-. SWIMMING,POOL RECEPTOR • - � ADDRESS . emption,you should become subject to i Wo ers'Compen- CITY TEL: NO. sation'provisions of the'Lobo r Code, you mesa-fact with comp- LAWN SPRINKLER SYSTEM ly_with such provisions or this permit shall be deemed revok- STATE LIC.' ed. WATER HEATER LICENSE•NO_ CLASS FIX LICENSED CONTRACTORS DECLARATION' DISTRICT NO. P OCESSED BY I hereby'affirm Mthat I am licensed.under provisions.of Chapter GAS SYSTEM OUTLETS 9(commencing.with Section 7000)of Division,3 of the Business OUTLETS OVER G fed Professions Code,:and my license is in full force and ef_. - 5 PER SYSTEM FINAL i VALIDATION. DATE, O License Number Lic, Class - V .i FIN ¢ Contractor Date'-- BY O ❑r I am exempt under Sec LU B BP.0 for this reason D Plan check fee•.; Date. PLUMBING PERMIT ISSUING FEE$ 'v t tSignature TOTAL,FEE - SINGLE FAMILY. HOME OWNER-BUILDER DECLARATION Plgn check'applicant. I hereb 'of that I am exempt from'the Contractor's License Y P `Name' . V,'�t -L•aw for the following:reason (Section 7031.5 Business and t•+. Professions Code):: Address _ � ' I .as owner of the property; will do the work and the City i C : . Tel. Nci,� �� j _ structure.is.not intended or offered for sale(Seclion17.044; Business and Professions.Code): n CONSTRUCTION LENDING AGENCY hereb'ydffirmlthot there'is-a construction lending agency for the performance..of the work for which this permit is issued''. (Sec 3097; Civ. C.). tJ' A. Lender's Lender•'s Name ` _ t+ TJ -Lende'r'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 D ordinances-ond State laws regulating Plumbing, andhereby authorize represent' tives of this County to enter upon the abave-mentioned_pr pe for inspection,purposes. SEE REVERSE FOR EXPLANATORY,LANGUAGE Signatu f'Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 �PL"UMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL-0508-9.7.09040029 BUILDING AND 'SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285 0488 EXT: -LEGAL ID: FEES PAID BUI-L'DI'NG_ADDRESS• TR: 14908 LT: 6 9823 HA[LWOOD DR D FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP-CA-91'7803917 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8589-021-016 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 1.00 FIX 16.35 TENANT: 13 DISHWASHER(S) 1.00 FIX 16.35 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 25 LAVATORIES/SINKS 1.00 FIX 16.35 09/15/97 UT 09/15/98 45 WATER CLOSET/URINAL 1.00 FIX 16.35 OWNER: TEL. NO: 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.35 FINAL DATE FINAL BY: ODE: HO RAYMOND;CHUN C TOTAL FEES 109.50 9823 HALLWOOD DR TEMP 917803917 DESCRIPTION OF WORK PLUMBING FOR NEW BATH ADDITION APPLICANT: TEL. NO: YAM (714) 288-0308- SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: �� O/� APPROVALS DATE INSPECTOR. SIGNATURE WAI TAK CONSTRUCTION (818) 285-7931- \UUv� ((v// 611 E. MISSION DR. LIC. NO UNDER SLAB WORK SAN GABRIEL, CA 91776 586138 B O WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. N0: CREATIVE ARCHITECTURAL AND PLANNING (714) 288-0308- ROUGH PLUMBING P. 0. BOX 4535 LIC. NO: ORANGE, CA 92667 53582 S 0 �'� ` GAS PIPING U FED)O L�C �S GAS VENT HOT WATER HEATER ( pi PLUMBING FIXTURES LAWN SPRINKLERS O GAS TEST 1 UTILITY COMPANY NOTIFIED ` CWV �arwc U °� GRAY WATER SYSTEM i REPORT ID: DPR263 ROUTE TO: BS0508