HomeMy Public PortalAbout6123 IVAR AVE_Plumbing__ 76A667A'ICE 8176) -4 77 '
APPLOC ATOON FOR PL Uevil o OILING pC RW1f'
B I ING AND SAFETY ISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS 61-23 Ivar Ave .
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET LOCALITY Temple City
NEAREST
BATHTUB CROSSST.LOngden Ave .
SHOWER OWNER H. F. Austin
LAVATORY MAIL
ADDREss6l.23 N Ivar Ave , p
SINK CITY 'Temple City TEL.NO. 287 351.7
DISHWASHER CONTRACTOR -Valley Heating CO .
CLOTHES WASHER
ADDRESS 1.1,1.6 S . San Gabriel Blvd.
SWIMMING POOL RECEPTOR CITY San Gabriel TEL.NO. 285 38 1.8
LAWN SPRINKLER SYSTEM �7 f�(�
WATER HEATER LICENSE NO.1'4( 899 CLASS C 20
GAS SYSTEM OUTLETS DIT T NO. UP ZON P CESS BY
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OUTLETS OVER v
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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a.
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Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
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
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 REG ISTER5p.AA /OR LI SED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY�AND STATE OFC --I NIA OR THAT IAM
THE GAS TEST
LEGAL OWNER OF,AND INTENDESIDE IN THE OVE DESCRIBED RES ENTIAL
PROPERTY. f; UTILITY CO.NOTIFIED
SIGNATURE
OFPERMITTEE"� AL Q O O
PLAN CHECK ALIDATION CK. M.0. CASH PERMIVVAl-►9ATiON_ o OD CK. M.0. CASH
fa S� O [V
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Oo O O Cn D
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WQRKERS'COMPENSATIONDECLARATION CE 817 ) �PPLICATI®N FOR PLUMBING, PERMIT
I hereby affirm that I have a' certificate of consent to self cE av (z-so
insure, or a certificate of Workers'Compensation Insurance,or
a certified'copy thereof(Sec.3800,Lab.C.) .
CONTY S ANGELES BUILDING AND SAFETY
Policy No. Company
Certified copy is hereby furnished. FOR APPLICANT TO FILL 1N (PRI OR TYPE) >61L G
ADDRESS J—V��
Certified copy is filed NUMBER FIXTURE OR ITEM with the county building inspection O FEE
C
J_
department. LOCALITY 1 1—•IM , .�1
Date Applicant WATER CLOSENEAREST , �vI-+,
BATH TUB CROSS ST. Loki & 00 ;
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE SHOWER OWNER
MAIL
LAVATORY , �
(This section need not be completed if the work involved ADDRESS •S�nI"a.� O
by the permit is.for one hundred dollars ($100) or less.), SINK .
CITY TEL.NO. U
I certify that in the performance of the work for which this DISHWASHERcc
permit is issued, I shall not employ any person in any manner CONTRACTOR 0
so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER
ADDRESS U
Date Applicant SWIMMING POOL RECEPTOR OW.
NOTICE TO APPLICANT: If, after making this Certificate of CITY TEL. NO. W
Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. Z
Compensation provisions of the Labor Code, you must forth- LICENSE NO. CLA
with comply with such provisions or this permit shall be WATER HEATER
deemed revoked. GAS SYSTEM OUTLETS TRICTG�/)� P C SED B
LICENSED CONTRACTORS DECLARATION OUTLETS OVER
I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM
9 (commencing with Section 7000) of Division 3 of the Busi- FINAL VALIDATION
ness and Professions Code, and my license is in full force and DATE
effect.
FINAL
License Number Lic.Class BY
Contractor Date
DI am exempt from the licensing requirements as I am a Plan check fee
licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$
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
Licen ` Law for the following reason (Section.7031.5, Busi- City Tel.No.
nes nd Professions Code):
I, as owner of the property, am exclusively contracting z 1 b 2.9 A
with licensed contractors to construct the project
(Section 7044, Business and Professions Code). # o o o o o 5
CONSTRUCTION LENDING AGENCY 2 0 - 2200
I hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is o 0 0 2200 c0' ,
issued(Sec. 3097,Civ:C.). '
Lender's Name 0 8 0 8-8 O
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 representatives of this County to enter upon the
Wabove-m 'ntioned proMtf nspection purposes. •
_h
Signature of Permittee Dat
WORKERS'COMPENSATION DECLARATION FPo 0 0 0 0 0
I herek�j'affirm that I have a certificate. of consent to self 75A667A LdCh% HQN FOR PLUM • IG PERMY
insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81)
.mr..�a,6ertified rcoopl!y thereof (Sec. 3800, Lab.. C. _• COUNTY OF LOS'ANGELES BUILDING AND SAFETY.
Policy No, OV Company 4 rikOWT 7A4
❑
Certified copy is hereby furnished. BUILDING �`j/
FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS �p� A j v
Certified copy is filed with the county building inspec-
tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY
�Date v Applicant WATER CLOSET NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. `
COMPENSATION INSURANCE SHOWER OWNER /7 01,1 6,)e
f
(This section need not be completed if the work involved by MAIL
the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I
I certify that in the performance of the work for which this
permit-is issued,'I shall not*employ any person in any manner SINK CITY TEL. NO.
so,as to become subject to the Workers'Compensation Laws. DISHWASHER /
CONTRACTOR
Date Applicant CLOTHES WASHER
NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS
Exemption, you should become subject to the Workers' `SWIMMING POOL RECEPTOR
CITY "TEL. NO. {�
Compensation provisions of the Labor Code, you must forth- � `Vr � -.�
LAWN SPRINKLER SYSTEM
with comply with such.provisions or this permit shall be STATE Q ry LIC.
deemed revoked. WATER HEATER LICENSE NO. IL/a J�J CLASS C39
LICENSED CONTRACTORS DECLARATION, DISTRIC NO/. � P OCESSED BY
I hereby affirm that lam licensed under provisions of Chapter-9 GAS SYSTEM B OUTLETS G tf
(commencing with Section.7000,) of Division 3 of the Business OUTLETS OVER y
and Professions Code,and my,license is in full force and effect. 5 PER SYSTEM FINAL
&6373-5'
yam y - DATE dA DATIOYI�I O
License Number
! �37 3 S Lic. ClassC' � 6.8
(tf 0/UI l C �—�S" b N
Contractor Date B
I am exempt under Sec. UJ
B.&P.C. for this reason C/l
Plan check fee DZ
Date: PLUMBING PERMIT ISSUING FEE$ 5 23.8 3 7 A
Signature,
TOTAL FEE # o,-0 0 6 5
Plan check applicant ( o,o1 6 5 0
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Name
- 16.505
I hereby affirm that I am exempt from the Contractor's License Address
Law for the following reason (Section 7031.5, Business and 1 11 5_8
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 o 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 l 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
a7bo -�dor inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date
DEPAR
LOCATIONF JOB
CO�N
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R
ANS
Street... .. LEDPE OF
3 PermitNo. �.........Date.-, " ...... BLDG. 1
a LOG. SETBA
PLUMBING
3
COUNTY OF LOS ANGELES . � �, o i NAM[
-- BUILDING BUREAU , . ® 4. u m
W Zi ADDRESS_
THE REGIONAL PLANNING COMMISSION _ ---
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0 I NAME
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............... Y `.:"`.:were'................................... .... ^S •• < I /,D D R E$8
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Plumber �'
Z CITY
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ATE
` LICENSE N
....•............................................................................».._.«.. ....+k .. r
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Plumbers Address....................
.. .......................... .,. NEW I—
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.................................................--..................................._... }:. ALTERATIONS_
USE OF
- < Plumber's Flione.............................................................. ... 14 CLOG.
2 ~,`t' SIZE OF /
BLDG.
..•.........................................................................................»..»
� 0 L gal Description
..........Block.......d...k,.,a-............. «:
Tract...........U...................•......... .................. •.......««..._ MATFR1A!
...-
-----
I THICKNESS—T
Nearest Cross Stree t.L,�'-�.,C�.L .. �...... THICKNESS.-.—N
....................Bath Tubs ...Furnaces v
DEPTH IN c;ROI
rr ............ .....Shoscers ..................«Dish Washer °Y
..................Lavatory ....................Refrigerator '
....................Kitchen Sink ....................Water SOftene. _R_ W. PLATES
t
....................Floor Sinks ..Sand Trap ` { GIRDERS
Slop Floor Drain...... ' —
_.......SIO Sink .................. JOISTS--FLOOI
: 3h Trays .Urinals } ' JOISTS__CEILI'
..........
ater C1oBrta ..................Drink Fountain'!;.;
Water Heatnrs ..........._.......Dental Lavatory' [fEARING WALL
....................Gas-FLel-Light ................ .Soda Fountain PARTITIONS
tEQ
...Cesspool....................Septic Tank .............:.......«»....»....«.....�....:.�'",' POOF RAFTERS
...
........... ...............«.«........................—.... " SELL BOLTS
ToUl No. Fixtures......``_.............
WALL v
CostFM . u.,.�..._,,..,.,.
x Dist..-ict No :�..».�..»... t
f VALUATION I
00•• 40.37
- ev�
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1308280028
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
ITR: 5904 LT: 18 6123 IVAR AV
IFEE DESCRIPTION:. -,--, QUANTITY: UOM: ,' AMOUNT: ( TEMP CA 917801524
ASSESSOR INFORMATION NUMBER: , - - NEAREST CROSS STREET:
15386-010-060 101 PERMIT ISSUANCE FEE 27.•80 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY CAI
1 107 BATHTUBS/SHOWERS'' - 5.00 FIX .81.-00 1 1
(TENANT: Ill CLOTHESWASHER(S) _ 1.00 FIX 16.20 11SSUED ON: PROCESSED BY: PLAN BY:
1 125 LAVATORIES/SINKS 4.00 FIX 64.80 108/28/13 SR
1 145 WATER CLOSET/URINAL 4.00 FIX 64.80 I
(OWNER: TEL. NO: 147 WATER HEATER(S) 1.00 .WTH 16.20 IFINAL DATE FIN L CODE:
ILEI, MEI XIAO - 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20
16123 IVAR AVE I TOTAL FEES 287.001
(TEMPLE CITY CA 91780I IDESCRIPTION OF WORK. 14
(BATHTUBS/SHOWERS, CLOTHESWASHER, LAVATORIES, WATER CLOSETS, 1
1 _1 (WATER HEATER AND GAS LINE 1
(APPLICANT: TEL. NO:
ILI, GUANG JIN (626) 672-8360- 1 1 1
1522 W WINNIE WAY - ISPECIAL CONDITIONS:
IARCADIA CA 91007 -
(CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE
IGUANG JIN LI (626) 672-8360- I 1
1522 W WINNIE WAY LIC. NO (UNDER SLAB WORK
IARCADIA CA 91007 - 688406 1 ✓ \f/
1 1 (WATER SERVICE
(PLASTIC Y/N METAL Y/N _
(ARCHITECT OR ENGINEER: TEL. NO: . 1,
ILANTRIK DEVELOPMENT LLC (626) 379=4900- (ROUGH PLUMBING I'
1560 W MAIN STREET C278 LIC. NO:
ALHAMBRA CA 91801- - - 688406-*-_' - --- -- - - - - - (GAS PIPING - / -'---
IGAS GENT
1 1 IHOT WATER HEATER I 1 1
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IGAS TEST
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(UTILITY COMPANY NOTIFIEDI I I
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IGRAY WATER SYSTEM I
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1* ADDITIONAL DATA ON FILE
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1 IREPORT ID: DPR263 ROUTE TO: BS0508
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