HomeMy Public PortalAbout5142 KAUFFMAN AVE_Plumbing__ 76A667A ICE 8178)- 11/76 /'7
AGSPL�OCATOQf�-jI-GO .,PLI UllW� BOISICcs PERlelObi'
BUILDING.AND SAFETY DIVISION
t :.'F. n;x y FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING'
NUMBER FIXTURE ORITEM@ FEE ADDRESS 5142 Kauffman Avenue
WATER CLOSET LOCALITY Tem le Celt
NEAREST
BATH-TUB CROSS ST.
SHOWER i OWNER Herman Rodriguez
LAVATORY MAIL
ADDRESS 5142 Kauffman
SINK CITYTemple CityTEL.NO. 287-2594
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
LAWN SPRINKLER SYSTEM STATE
WATER HEATER
LICENSE NO. 221751 LIC CLASS C20 <'
GAS SYSTEM OUTLETS 'DISTRICT NO GROUP ZONE PROCESSEIV
Y
6�2 1 4��i
OUTLETS OVER
1 S PER SYSTEM INDUSTRIAL
'WASTE APPROVAL
INSPECTION RECORD
6S
H
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
a
Plan check applicant
• APPROVALS DATE INSPECTOR'S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
¢ City Tel.No. GAS PIPING
IHEREBY 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 r
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES j
REQUIRED BY LOS ANGELE7 COUNTY AND,$TATI OF CALIFORNIA OR THAT I AM THE GASTEST /•
LEGAL OWNER OFWI;NTEO E I HE ABOVE DESCR BED RESIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE e�
OFPERMITTE FINAL ( ^J
PLAN CHECK VALIDATION CK. M O. CASH PERMIT VALIDATIONcK. M.O. CASH'
76A667-CE0817 9/63 - -,_A p pL-fa _
APPLICATION FOR PLUMSING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT
BUILDING ANDD SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS )
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY
FOR 1�lPPLICANT TO FILL IN ' CROSS ST. L 1 c
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25 MAIL LL
BATH TUB 1,25 ADDRESS J .
SHOWER 1.25 CITY ' , TEL. NO.
144
LAVATORY 1.25
CONTRACTOX 'ate"_ f - ,
SINB 1.25 ADDRESS j o i
DISHWASHER 1.25 CITY L TEL. NO:
LAUNDRY TUB 1.25 CONTRACTOR'S STATE _❑
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 M1 DISTRICT N0. GROUP ZONE P PCESSED BY
° WATER HEATER 1.50 S 5�
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL a
WASTE APPROVAL 0
OUTLETS OVER 5 PER SYSTEM .30. INSPECTION RECORD U
O
F-
U
W
a
N
Z
4 APPROVALSDATE INSPECTOR'S SIGNATURE
PERMIT 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL.FEE v GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY I GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING. y _
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR o PLUMBING FIXTURES
�\
LICENSED AS REQUIRED LOS ANGELES COUNTY AND STATE GAS TEST
CALIFORNIA OR THAT I AMM TO THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL P PERTY, UTILITY CO. NOTIFIED
3
SIGNATURE
OF PERMITTEEj
FINAL
VCKALIDATION ROBERT A. WOOD
M.O. CASH SUPERVISING MECHANICAL ENG'R
L&0'6 2 � 0� �:tiu 2 7 5 D 3.5 0�{ CQ
� 1
76A667-CE817 12/59 Awa `l��_� �ECITY
A PLRCA` DON FOR PLUMB#NG PERWT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY RIVISION BUILDING /
JOHN A. LAMBIE. COUNTY NGINEER ADDRESS
WILLIAM A'JENSEN SuFT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST —�
CROSS ST.
NUMBER FIXTURE OR ITEM - -
OWNERf/d �R
WATER CLOSET ' MAIL
BATH TUB ADDRESS
CITY. y/TEL. NO.
SHOWER
/ LAVATORY CONTRACTOR Q
_ SINS ADDRESS
DISHWASHER CITY TEL. NO.
CONTRACTOR'S STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY ❑
CLOTHES WASHER a DISTRICT NO. GROUP ZONE XPOCESSED BY
WATER HEATER ✓ ��/
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
P.N
5 O
U
a
O
E-
D
W
z
@ $1.00 PER ITEM
OR FIXTURE $ I - APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 200 UNDER SLAB WORK
ROUGH PLUMBING
r' TOTAL FEE roll
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING. sc�•`P/f} - _
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURESV�(�
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABO ---
'•. DESCRIBED RESIDENTIAL PROPE TY. UTILITY CO.NOTIFIED �-----^�-a•-
SIGNATURE
OF PERMITTEE - FINAL
®p. VALIDATIROBERT A. WOOD.
CK. m.O. CASH )SUPERVISING MECHANICAL ENG'R
L ;�7139 :' ; � � 5 D 50 N
WORKERS'COMPENSATION DECLARATION APPLICATION
/� TION COR PLUMBING PERMIT
I hereby, affirm that I have a certificate of consent to self in- 76A667A PW a/87 Mr r M 1 1r (� 1� ,Y, r LR,Y,
sure,or a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86)
certified-copy thereof (Sec. 3800, Lab. C.
COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
Policy No. Company
Certified copy,is hereby furnished.
-FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING /�//''
Certified copy is filed with the county building inspection ADDRESS � ,Z (/ Arn an ye..
department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY
Date Applicant WATER-CLOSET(TOILET) NEAREST e e C,
CERTIFICATE OF EXEMPTION FROM,WORKERS' BATH TUB' CROSS ST. p
COMPENSATION INSURANCE SHOWER - OWNER 14,-R
(This section need not be completed if the work involved by MAIL /c /A t �/
the permit is for one-hundred dollars•($100)or less.) LAVATORY ADDRESS p2 kQu1f1l2un ve r
I certify that in the performance of the work for which this per-
mit is,issued, I shall not employ any person in any manner so SINK CITY C 1 C/4 TEL. NO. 5
as to become subject to the Workers' ompensotjw DISHWASHER
CONTRACTOR Q AIie2
Date ;APP• Applicant CLOTHES WASHER
NOTICE- O.APPLICANT: If, after making this Certificate o x- ADDRESS
tion,you should become subject to the Workers'Com en- SWIMMING POOL RECEPTOR
em
P Y I P CITY TEL. NO.
sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM
ly with such provisions or this permit shall be deemed revok- STATE — LIC.
ed. ' WATER HEATER w.7 LICENSE NO. /"`� CLASS
-LICENSED CONTRACTORS DECLARATION vl� D STRICT NO. C SSED BY
I hereby affirm that I am licensed under provisions of Chapter ' GAS SYSTEM OUTLETS do &J • 0259(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER
fe d Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL ,VALI ION
DATE
License Number Lic. Class 0
FIN
Kr
t�
Contractor Date BY O
FII am exempt under Sec. a 2
B:BP.C. for this reason Plan check fee 't
Date: PLUMBING PERMIT ISSUING FEE$ `� ► F•'--'-a r _
Signature 2-2. d'
TOTAL FEE
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Plan check applicant
I hereby affirm that I am exempt from the Contractor's License Name -y = _ 0
Law for the following reason (Section 7031.5, Business and EI, :jamin
Professions Code): Address _•ii�r� =--
-.t n --
�' I, as owner of the property, will do the work and the Cit Tel. No. q_ya ys� =IJI_1
structure is not intended'or offered for sale(Section-7044,
Business and Professions Code).
CONSTRUCTION LENDING AGENCY ® f I""l)
I hereby affirm that there is a construction lending agency fori ("1 , f{
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 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- entioned prop f% inspection purposes.
2 Z 89 SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0809180009 '
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: .(626) 285-0488 EXT:
ILEGAL ID: I FEES PAID BUILDING ADDRESS:
ITR: 15683 LT: 22 1 5142 KAUFFMAN AV
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917803945
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LA ROSA
18589-010-022 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, Cl
1 .126 MISCELLANEOUS FIXTUR 1.00 FIX 16.20 1
(TENANT: .1 TOTAL FEES 43.95 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1
109/18/08 SR 03/17/09 1
1OWNER: TEL. N0: 1 1FINAL DATEExpi RENAY:� CODE: 1
IRODRIGUEZ HERMAN;BEATRIZ (626) 287-2594- 1 1 I
15142 KAUFFMAN AV 1 I I
ITEMP 917803945 1. IDESCRIPTION OF WORK 1
IEXTEND SANITARY DRAIN APPROX 8-TO 9' TO WEST WALL OF 1
ISTRUCTURE & INSTALL CLEAN OUT THAT POINT FOR EASIER CLEAN 1
1APPLICANT: TEL. NO: 1 1OUT ACCESS 1
ISAME AS OWNER - 1 I- 1
I 1 1SPECIAL CONDITIONS: 1
I I I I
ICONTRACTOR: TEL. NO: 1 1APPROVALS DATE INSPECTOR SIGNATURE 1
ISAME AS OWNER - 1 I 1
I LIC. NO 1 (UNDER SLAB WORK 1 I 1
1 I I I I I
1 I 1WATER SERVICE 1 1 I
I I IPLASTIC Y/N METAL Y/N 1 I I
1ARCHITECT OR ENGINEER: TEL. NO: I I
1 - 1 IROUGH PLUMBING I
LIC. NO: i I 1 I I
I I IGAS PIPING 1 I I
I IGAS VENT I I
1 i (HOT WATER HEATER
I I IPLUMBING FIXTURES 1 I I
1 I ILAWN SPRINKLERS 1 I I
1 1 IGAS TEST 1 I 1
I I -Z I I
1 I U L'ITY COMPANY NOTIFIED( I I
I I
jCWV I I I
1 I 1GRAY WATER SYSTEM I 1 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 IREPORT ID: DPR263 ROUTE TO: BSO508 I I I I
I I I I I I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT,O.F PUBLIC WORKS 9071 LAS TUNAS PL 0508 9611200031
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID- FEES PAID BUILDING ADDRESS:
TR: 15683 LT: 22 5142 KAUFFMAN AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803945
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LA ROSE
8589-010-022 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY
07 BATHTUBS/SHOWERS 1.00 FIX 16.35
TENANT: 25 LAVATORIES/SINKS 1.00 FIX 16.35 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
TOTAL FEES 60.45 11/20/96 TC 11/20/97
OWNER: TEL. NO: FINAL DATE FINAL BY CODE:
RODRIGUEZ HERMAN;BEATRIZ (818) 287-2594- //'
5142 KAUFFMAN AV Z lD ��,���^^^iii
TEMP 917803945 DESCRIPTION OF WORK
REPAIR OF SHOWER
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: EL. NO:
ROUGH PLUMBING
LIC. N0: GAS PIPING
I��_�� �,'� -
YAK-- �C it GAS VENT
�u J L \J l h \lti HOT WATER HEATER
-- — --
a 1
19 PLUMBING FIXTURES
LAWN SPRINKLERS
02, GAS TEST
UTILITY COMPANY NOTIFIED
�o ��� CWV
�� �1 GRAY WATER SYSTEM
I
REPORT ID: DPR263 ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0303110018
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 15683 LT: 22 5142 KAUFFMAN'AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803945
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LOMA
8589-010-022 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY
47 WATER HEATER(S) 1.00 WTH 16.20
TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
03/11/03 JK 09/07/03
OWNER: TEL. NO: FINAL ATE FINAL BY: CODE:
RODRIGUEZ HERMAN;BEATRIZ (626) 287-2594-
5142 KAUFFMAN AV �( D /
TEMP 917803945 in,SCRI TIO F WORK
WATER HEATER C/O
APPLICANT: TEL. N0:
ACTION CONTRACTORS (310) 515-1311-
17111 S BROADWAY SPECIAL CONDITIONS:
GARDENA 90248
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
ACTION CONTRACTORS (310) 515-1311-
17111 SOUTH BROADWAY LIC. NO UNDER SLAB WORK
GARDENA CA 90248 B/L 27953
WATER SERVICE
ARCHITECT OR ENGINEER: TEL. N0: PLASTIC Y/N METAL Y/N
- ROUGH PLUMBING
LIC. NO:
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
UTILITY COMPANY NOTIFIED
CWV
GRAY WATER SYSTEM
* ADDITIONAL DATA ON FILE
REPORT ID: DPR263 ROUTE TO: BSO5O8