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Home My Public Portal About5709 KAUFFMAN AVE_Plumbing__ 76A667-CES17 3-59 , APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT_ OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING DRESS �7d a ale JOHN A. LAMBIE, County. En nee: CASSATT D. GRIFFIN, Sup t of Building LOCALITY FOR APPLICANT TO FILL IN im NEAREST' CROSS ST. NUMBER FIXTURE OR ITEM OWNER WATER CLOSET MAIL BATH TUB ,ry _ J ADDRESS� cX �.S ef1fe e2 Cl' rL ' SHOWER CITY % , ppqq TEL. NO. 4 LAVATORY CONTRACTOR y�c� �J116V EN PL�1 MB CO- SINK ADDRESS 2220 SIWdkyd b*:"'Y DISHWASHER CITY Ok0 �-T OUSEL. NO.Ir�uo U6'cam U UPJ CONTRACTOR'S �7 p STATE LAUNDRY TUB REGISTRATION NO. / / COUNTY E CLOTHES WASHER DISTRICT NO. GROUP I ZONE P CESSED BY WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD (� $I.M PER ITEM e OR FISTURE $ /1,00 APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 2 00 UNDER SLAB WORK D TOTAL FEE 13 ,00 ROUGH PLUMBING 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 PLUMBING. HOT WATER HEATER 1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES -.� LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENT/I7AALL_PRROOPrkRTY. UTILITY CO.NOTIFIED y® SIGNATUR /O/.T� C%� OF PERMtrrFF FINALan ®r VALIDATION ROBERT A:WOOD.` M.O. CASH SUPERVISING'MECHANICAL ENG,R 9 .6 2 5 APR',2 1 5 A 1 3.0 0 FOR ,WORKERS' COMPENSATION DECLARATION PLICATION PLUMBING PERMIT hereby affirm that I have a certificate 0? con4.nt'to sed 76A667A -APinsure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) 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 f'-7 � Certified copy is filed with the county building inspec- ADDRESS Nd�'67i�J Tiori deart t. NUMBER FIXTURE OR ITEM @ FEE _ LOCALITY WATER CLOSET Date Applicant NEARECROSS ST. � � 4 ' CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE SHOWER OWNER C31� (This section need not be completed if the work involved by MAIL � /` the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS J �� I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK / CITY TEL. NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY `�o/ TEL. NO.T�*'Q[) Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM �'v��v� with comply with such provisions or this permit shall be STATE y LIC. deemed revoked. WATER HEATER LICENSE NO. �V CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL r l VALIDATION DATE License Number Lic. Class FINAL / Contractor Date BY illi ❑ I am exempt under Sec. r� a� B.&P.C. for this reason Plan check fee � Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 1 8 3, 1 A I hereby affirm that I am exempt from the Contractor's License t( 0,0 0 0 0.5 Law for the following reason (Section 7031.5, Business and Address Professions Code): City Tel. No. 2 o,o 1 6.5 0 ❑ 1, as owner of the property, will do the work and the structure is not intended or offered for sale (Section ® 0 0 _1 6•" 0 mQ 7044, Business and Professions Code). 6103'_8 4 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 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 entioned property for inspection purposes. / 7—,Yy 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 1203130008 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: 1TR: 6561 LT: 56 UN: .003 5709 KAUFFMAN AV I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802506 ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LIVE OAK 18587-022-003 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl 1 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TENANT: I TOTAL FEES 44.00 JISSUED ON: PROCESSED BY: PLAN BY: 103/13/12 SR I (OWNER: TEL. NO: IFINAL 9ATE FIN Y• CODE: 1WREEDE, JOHN & DENISE (626) 286-6383- L/ 15709 KAUFFMAN AV I TEMP 917802506 DESORIPTAON OF WORK IGAS/LINE FOR BACK UP G E TOR (APPLICANT: TEL. NO: (YOUNG, DON (909) 797-1307- I 1 138648 OAK GLEN RD. I (SPECIAL CONDITIONS: IYUCAIPA, CA 92899 1 1 (CONTRACTOR: TEL. NO: JAPPROVALS DATE INSPECTOR SIGNATURE SMART SOLAR POWER (909) 797-1307- 1 138648 OAK GLEN RD. LIC. NO I JUNDER SLAB WORK I I I (OAK GLEN, CA 92399 934322-B * I I 1 1 I I (WATER SERVICE I I I I I (PLASTIC Y/N METAL Y/N 1 I 1 (ARCHITECT OR ENGINEER: TEL. NO: I I I I I 1 I (ROUGH PLUMBING 1 I I LIC. NO: I I I I I I I IGAS PIPING 1 1 I I I I I I I I IGAS VENT 1 I I I I_ I i I IHOT WATER HEATER I I I I I I I I I (PLUMBING FIXTURES I 1 I I I I I I I (LAWN SPRINKLERS I I I I I I I I I IGAS TEST I I I I 1 1-1 1 1 I (UTILITY COMPANY NOTIFIED( I I I I I I I I I I ICWV I I I I I I I I I 1 1 1GRAY WATER SYSTEM 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 I I I I I I I I I I 1* ADDITIONAL DATA ON FILE I 1 I I I I I I I I I (REPORT ID: DPR263 ROUTE TO: BS0508 1 I I I I I I I I