HomeMy Public PortalAbout8810 HERMOSA DR_Plumbing__ 76.667 OBS IT 11-50 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
BING
COUNTY F LOS ANGELES
WILLIAM J.. FOX, CHIEF ENGINEER PLUM1
TR T O. ROUP O
F13R//APPLICANT TO FILL IN � ;r
PLUMBER RECEIVED BY READY FOR DATE ISSUED
r � FIRST INSPECTION
ADDRESSNO
1 rvW./`6�J prJ �1 ,/
6�,�. y''� ADDRESS r,
CITY y�OH/W TEL No. 'p
COUNTY LOCALITY
LICENSE NO. EXPIRES
NEAREST
PERMIT FEES CROSSST (J'1t P1J7Ca �)/
NUMBER TYPE OF FI%TORE OR ITEM FEE OWNER `• \`�p A\ KJLX
MAIL
WATER CLOSET(TOILET) a O.SD S ADDRESS
BATH TUB 0 0.50 CITY TEL No.
SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) ® 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK 0.50 AND STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY 0 0.50 ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER
GA9 SYSTEM-OUTLETS ® 0.50 OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
SIGNATURE OF
WATER HEATER O.SO PERMITTE ll 0
SLOP SINK Q 0.50 INSPECTION RECORD
FLDDR BINK 0.50
FLOOR DRAIN 0.50
DISHWASHER Q 0.50
DRINKING FOUNTAIN 0.50
URINAL 0.50 J
Q
HOUSE SEWER @ 0.50 -6-0 Z
MISCELLANEOUS O
0
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL @ 1:00 Q CESSPOOL \
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT 1.00 SEWER
PERMIT 1.00 GAS TEST
TOTAL FEE
UTILITY CO.NOTIFIED /
S IJ
FINAL
ranase Tr 940 0 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ,
COUNTY OF LOS ANGELES . PLUNABIgm
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICTNO. GROUP I ZONE PERMIT NO.
FONTANA PLUMBING CONTRACTOR V/ 7
Oe/o 0
PLUMBER RECEIVED BY READYFOR DATEISSUED
.344 W. Hv
arvey - Monterey Park, Calif i ,t FIRST INSPECTION '7
ADDRESS
ATlantic 2.4654 merxn BUILDING fD d
CITY TEL. NO. ADDRESS
COUNTY .w // �f
LICENSE NO. , B M EXPIRES (P/3 S� LOCALITY -C./yll�T
^T NEAREST
PERMIT FEES cRosssT.
NUMBERI TYPEOF flXTV 0.E OR 11.14 FEE OWNER
WATER CLOSET (TOILET) @ 0.501S hJJ1L MAIL
ADDRESS
/ BATHTUB @ O.SOILS C7 CITY TEL. NO.
SHOWER @ 0.50 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
/ LAVATORY IWASH BASINI @ 1 S J Q APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
1 KITCHEN SINK @ 0.50 re3 STATE LAWS REGULATING PLUMBING,
1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
/ I LAUNDRY TUB OR TRAY @ 0.50 _ X75)_ ANGELES COUNTY LI1. OR I AM THE LEGAL OWNER
OO 0.500_ OF THE RE OF NTIAL PCENGl RTR" -SCRIBED ABOVE.
GAS SYSTEM�OUTLETS
SIGNATURE OF
_�_ WATER HEATER @ 0.50 PERMITTEE �
SLOPSINK @ o.sOl INSPECTION RECORD
FLOOR SINK @ O.50
r FLOOR DRAIN @ 0.50IT�
DISHWASHER @ 0.501
DRINKING FOUNTAIN @ 0.50
URINAL @ O 50 J
HOUSESEWER @ 0.50 _ Q
MISCELLANEOUS
O
I I
1
APPROVALS
' DATEINSP
E
C
T
OR'S NAME
II ROUGH PLUMBING J N /
_ - GAS PIPING
GAS VENT
CESSPOOL @ 1.00 CESSPOOL '
SEPTIC TANK: SEPTIC TANK I
DRAIN ( ) PIT ( I @ I.00 I SEWER
PERMIT . 1.00 GAS TEST
'I UTILITY CO. NOTIFIED
TOTAL FEE
I S !1 So -�+ vl r•�
FINAL
RKERS'COMPENSATION DECLARATION -002
APPLICATION .FOR PLUMBING PERMIT
9 hereby, firm tItat I have a certificate,of consent to self in- 26A667 DPW 4/87 n
]6n6mn _ '7lLlll
sure,or'o certificate of Workers'Compensation Insurance,or a CE 817 (REV. 6/86)
osrtified.copy thereof (Sec. 3800, Lab. C.). -
Polley Na. r� Company: '- COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
.Certified copy is hereby furnished.. �{ ,
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING �p_�d 1 e F,fttoSo,_
Certified'copy is filed with the county building inspectiori ADDRESS O
NUMBER FIXTURE OR ITEM LOCALITY 1 -
deparime t. .-. @ FEE (/
Do to VISR] "V Applic'eif I 'WATER CLOSET(TOILET) D NEAREST,
CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB pj Q' CROSS ST. S
COMPENSATION INSURANCE OWNERC U�/0 Ow TN AJ
SHOWER -
(This section need not be completed-if the work involved bya. MAIL Q� I a j,
BT
'he permit is for one hundred dollars($100) or less.) LAVATORY ADDRESS O e U
I certify that I.the performance of the work for which this per-
mit
er mit is issued,1 shopSINK CITY
not employ any person in any manner so pnrt)V{m�
as to become subject to the Workers' Compensation Laws. DISHWASHER -
,�y. CONTRACTOR
Date "J Applicant CLOTHES WASHER - -
NOTICE AP LICANT: If, after making this ertificate of Ex- SWIMMING POOL RECEPTOR ADDRESS
emption, you should became subject to the Workers'Compen- CITY , _ - - TEL NO.
sell on provisions of the Labor Code,you must forthwith Comp- LAWN.SPRINKLER SYSTEM '
ly with such provisions or this permit shall be deemed revok- STATE LIC.
WATER HEATER LICENSE NO. CLASS
LICENSED CONTRACTORS DECLARATION - DISTRICT NO. PROCESSED BY
I hereby affirm that I am licensed under provisions of Chapter �. GAS SYSTEM OUTLETS
9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER
and Professions Code, and my license is'in full forceandef- S PER SYSTEM FINAL VAU TION >.
fect. DATE /` d
License Number. Lis.. Class O
v
FI R
Contractor Dote O
f
I am exempt under Sec. - W
B.BP.C, for this reason - - - , H
Plan check fee ;?05 2 8 A ?
Data: PLUMBING PERMIT ISSUING FEE$ G
Signature ' # • • • • • 5
TOTAL FEE
SINGLE FAMILY Plan applicant
:( •'•.3��'5 0
an cec
HOME OWNER-BUILDER DECLARATION pp • • • 34,505
I hereby affirm that I am exempt from the Contractor's License Nome
Law for the following reason (Section 7031.5, Business and _ Q a25-88
Professions Code): Address
170 I, asowner of the property, will do,the'work and the City Tel. No. ,
'Y--� structure is not intended o`r 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 haveread this application and stme'thot 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
obove-mentioned�pro/g�,r�tyfor inspection purpqses.
acf .� 11� SEE REVERSE FOR EXPLANATORY LANGUAGE -
Signature of Permittee Dote '
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0108090004
• BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
• PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING SS:
TR: 3623 LT: 111 UN: .002 8810 HERMOSA DR
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801815
ASSESSOR 1 R ON NUMBER: NEAREST CROSS STREET: MUSCATEL
5387-010-027 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY
25 LAVATORIES/SINKS 1.00 FIX 16.20
TENANT: 45 WATER CLOSET/URINAL 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLAN EXPIRES .
TOTAL FEES 60.15 08/09/01 UT 02/05/02
OWNER: TEL. NO: FINAL DAT FI ` `-"- CODE:
HUEI C
TSONG CHUANG;HSIN T2U CHEN (626) 287-7717- r��1�10
8810 HERM DR EEE II'�LPPPTTTIII QQQIlN11
TEMP 917801815 D SCR OF 0
PLUMBING FOR BATHR R ODEL
APPLICANT: TEL. NO:
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. NO: - - APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NO - UNDER SLAB WORK
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TEL. Nu-
ROUGH
PLUMBING
LIC. NO: -
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
UTILITY COMPANY NOTIFIED
CWV
_ - AY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508