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Home My Public Portal About9841 HOWLAND DR_Plumbing__ ]6A6B] (CE-RI))- 5/73 14-7 --y APPLICATION FOR PLUMBING PERMIT ' COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER •BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO: BUILDING 'ADDRESS D HARVEY T. BRANDT, COUNTY ENGINEER 1 I LocnuTr FOUTLETSOVER PPLICANT TO FILL IN (PRINT OR TYPE) NEAREST . ST. FIXTURE OR ITEM @ FEE R CLOSET 1.75 }�� OWNER MAIL TUB 1.75 i ADDRESS .i 406 C-A i-�� -t ER 7,75 CITY -- �PL� �+ 1 TEL NO. ZoL�)�jQ-� LAVATORY 1,75 J CONTRACTOR 1.75 ADDRESS w �C�Z� WASHER 1.75 CITY TEL. NO. HES WASHER 1.75 STATE LIC LICENSE NO. - CLASS' ' MING POOL RECEPTOR 1,75 DISTRI TN GROUP ZO E PRE)C ESSED BY N SPRINKLER SYSTEM 1.75 ER HEATER 1.75 `� INDUSTRIAL WASTE APPROVAL a If SYSTEM OUTLETS 7,75 INSPECTION RECORD O ETS OVER SYSTEM ,30 z O H CJ W [L n h Z rhk See Reverse RMIT ISSUING FEE $ 3 00 TOTAL FEE _ APPROVALS DATE nls PecTOR's sI GNATU RE nt UNDER SLAB WORK Name ROUGH PLUMBING .�'f Address GAS PIPING 7/ x- e,r_ City Tel. No. GAS VENT ` HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING /NOTIFIED //jq//� ��/�/ ' PLUMBING. GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CG. I LICENSED AS REOU I RED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL IN g17q SIGNATURE T r ' OF PERMITTEE �"�j�py-D PERMIT VA ATION cic. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH `� C� 5 .-I NAN 29 5 0 - 11.75A98 WORKm that I have TcIONDECLARATION CE 817 APPLICATION FOR PLUMBING PERMIT {� 1 hereby affirm that I have a certificate of consent to self ca etr (z-ea) �J insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab.C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING / Certified copy B filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE ADDRESS department. WATER CLOSET LOCALITY Date— Applicant � NEAREST BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' � COMPENSATION INSURANCE - SHOWER _ OWNER (This section need not be completed if the work involved LAVATORY MAILADDRESS y by the permit is for one hundred dollars ($100) or less.) SINK ��"jj —� / -r ` Il _ 'V CITY TEL.NO.iZ�b�/6UJ 0 1 certify that in the performance of the work for which this DISHWASHERU permit is issued, 1 shall not employ any person in any manner CONTRACTOR cr 5o as to become subject to the Workers' Compensation Laws. CLOTHES WASHER � 0 •p ADDRESS Date7-31-W Applicant �r,ncP/Z7r" l+'✓'�w--�1. r SWIMMING POOL RECEPTOR V NOTICE TO APPLICANT: If, after making this Certificate or CITY TEL. NO. Exemption. you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. to Compensation provisions of the Labor Code, you must forth- LICENSE NO. CLASS Z with comply with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. PR CESSED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER t U 1 hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL / / / /,r VALIDATION ness and Professions Code, and my license is in full force and DATE 4 /S `� effect. FINAL License Number Lic.Class BY Contractor. Date I am exempt from the licensing requirements as I am a Plan Check fee licensed architect or a registered.professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic.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): ® I, as owner of the property, am exclusively contracting with licensed contractors to construct the project 1 49,4A (Section 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY # o 0 o e o rj I�hereby affirm that there is a construction lending agency 2 0 0 2 x 0 0 for the performance of the work for which this permit is issued (Sec. 3097,Civ.C.). Lender's Name 'e 0 0 `2 S 0 0_cz l0 $01 —80 Lender's Address I 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 representatives of this County to enter upon the above-mentioned property for inspection purposes. 1- 7— Signature of Permittee Date DEC TION WORKERS t I have certificate cafe of corse APPLICATION FOR PLUMBING PERMIT � I hereby affirm that I have a certificate of consent to self 76q�7q insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) 7 or d certified cop hereof (Sec. 38 lob. C.) COUNTY OF LOS ANGELES 7—' BUILDING AND SAFETY Pal lcy N a. 7!!�� Compan 6 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINGpC Dr Certified copy is filed with the county building inspe<- ADDRESS tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY DateApplicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAvgiORY ADORE k I certify that in the performance of the work for which this d an permit is issued, I shall not employ any person in any manner SINK CITY TEL. N _ so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRES NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY TEL. N\ Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM lfx�wwith comply with such provisions or this permit shall be STATE /� LIC. deemed revoked. WATER HEATER LICENSE NO. Q CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. ROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER } and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL r d qtq /�� Q DATE - Ste` VALIDATION V License Number�06L Class /�. ,� 60 a: �/ _�'\/� n�� FINAL Contractor-�U {vf J�C d hDole '7 BY V ❑ I am exempt under Sec. lJ N B.BP.C. for this reason � Plan check fee ► Date: PLUMBING PERMIT ISSUING FEE$ / 5 V Signature TOTAL FEE 30 s4aa6g SINGLE FAMILY Plan check applicant 2 era 3 Q'5 0 HOME OWNER-BUILDER DECLARATION Name 1 hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and 09 1 2—8 4 Professions Code): City T.I. 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 / /er L _ / 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 authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE -ia Sig aturb of ermittee Dale COUNTY OF LOS ANGELES TEMPLE CITY 4 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0311190002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 DUPLICATE PHONE: (626) 285-0488 EXT: (LEGAL ID: FEES PAID BUILDING ADDRESS: ITR: 6755 LT: 25 1 9841 0 DR CA 917 FEE DESCRIPTION: QUANTITY: GUM: AMOUNT: I TEMP CA 3233 (ASSESSOR INFORMATION NUMBER: CROSS NEAREST CROSS STREET: BALDWIN 18589-004-019 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY 1 147 WATER HEATER(S) 1.00 WE 16.20 (TENANT: I TOTAL FEES 43.95 (ISSUED ON: PROCESSED BY: PLAN BY: 111/19/03 JK TOWNER: TEL. N0: FINAL DATE FIN BY: CODE: (LAM LINE (626) 573-3256- 19841 HOWLAND DRT//��/ Y (TEMPLE CITY 91780 IDES T OW OF 'WORK� IC/0 WATER HEATER (APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: I I I I 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. NO: - TROUGH PLUMBING Lm. NO: I IGAS PIPING GAS VENT I I I IHOT WATER HEATER I PLUMBING FIXTURES I I I 1 LAWN SPRINKLERS I I I IGAS TEST (UTILITY COMPANY NOTIFZEDI I ICWV I I I 1 I (GRAY WATER SYSTEM I 1 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 II I I I I REPORT ID: DPR263 ROUTE TO: BS0508 I I I I I I