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HomeMy Public PortalAbout5817 KAUFFMAN AVE_Plumbing__ 76AS67 APPLICATION 9 IOGC9 ® ®R0 L`LdMBING PERMIT Fi/11I a , DBS-171DIVISION OF BUILDING AND SAFETY Deportment of County Engineer .<.• County of Los Angeles BUILDING��/ JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS !! CASSATT D,GRIFFIN SUPT OF BUILDING IM LOCALITY FOR APPLICW TO FILL IN NEAREST CROSS ST. OWNER A DISTRICT NO. GROUP ZONE I READY FOR INSPECTION MAIL ADDRESS n �..iS g INDUSTRIAL CITY EL. NO C/ J WASTE APPROVAL PLUMBEjV { ) W. INSPECTION RECORD ADDRESS a Jy' CITY TEL. N � LICENSE e06 NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 BATH TUB @ $1.00 SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $1.00 KITCHEN SINK @ $1.00 DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 �y AA d; WATER HEATER ' @ $1.00 w GAS SYSTEM @ $1.00 F APPROVALS DATE INSPECTOR'S SIGNATURE y UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING GAS PIPING TOTAL FEE GAS VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER _ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY , (1 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1=PPER _LEGAL OWNER OF T E ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL SIGNATURE OF PERMITTEE FINAL +. Imo( `SCL, [ �,y,_.._ JOHN A. LAMBIE. COUNTY ENGINEER VALIDATIOROBERT A. WOOD, CHIEF PLBG. INSPECTOR CK. H.0. //4 CAS.. ^1 DEPARTMENT OF COUNTY ENGINEER PLUMBING V I DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDING © WILLIAM 3:. FOX, COUNTY ENGINEER ,ADDRESS -- OR A PLICANT TO I L IN LOCALITY 77 BUILDING / NEAREST ADDRESS CROSS ST. DIST NO. GRO P I/1 ONE PE �N0. LOCALITY I® 6 �QJ NEAREST CROSS ST. EC VED�BY Ready for In9Pection DATE ISSUED OWNER %,#%j MAIL INOUSTRIAII ADDRESS WASTE APPROVAL CITv .NO a INSPECTION RECORD PLUMBE q�ggJG ADDRESS CITY TEL.N 7, P-STATE LICENSE N ® ❑COUNTY .3 PERMIT FEES B Z JLIM9ER TYPE OF FIXTURE OR ITEM FEE Vr WATER CLOSET(TOILET) @ 0.80 S O BATH TUB @ 0.80 SHOWER @ 0.80 LAVATORY(WASH BASIN) @ 0.80 KITCHEN SINK @ 0.80 LAUNDRY TUB OR TRAY @ 0.80 SLOP SINK @ 0.80 FLOOR SINK @ 0.80 FLOOR DRAIN @ 0.80 DISHWASHER @ "0.80 DRINKING FOUNTAIN @ 0.80 URINAL @ 0.80 GAS SYSTEM--------------OUTLETS @ 1.00 WATER HEATER @ 1.00 MISCELLANEOUS APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK ` qq PERMIT $ 1 00 ROUGH PLUMBING Z.I Sd i(I TOTAL FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI• GAS VENT CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST AND STATE OF CALI ORNIA OR THAT 1 AM THE LEGAL OWN- ER OF THE ABOVEYFESqRIBED RESIDENTIAL P OPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTE - -- F1NAL ep--z Z - 76A667 DBS 17 b 12-53 'S ._'.#ORD20-0026 DPW 4/87 ERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT � erEiby,�,affirm that I have a certificpte of consent to self in- 76A667A Sure, Dr a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) certi'fi* copy thereof (Sec. 3800, Lab. C.)' ti Policy No Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE.OR ITEM @ FEE LOCALITY WATER CLOSET(TOILET) Date Applicant NEAREST CERTIFICATE OF EXEMPTION FROM;WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE' SHOWER OWNER � 1�,)✓ �J, y cz SSG�� ^i0 (This section need not be completed if the work involved by MAIL 9 ! y, /� // the permit is for one hundred dollars $100) or less.) LAVATORY ADDRESS ��L 7 t^ � � /Jy%�� �f" I c tify that in the performance of th rk for which this per- %J^n CITY (� IST�i� C`)/'� TEL. NO. this issued, I shall not employ ny er�o`n"in any manner so SINK / ` Ito become subje o the ?k s' Compensation Laws. DISHWASHER j� CONTRACTOR CLOTHES WASHER OTIC TO A PLCAN f fter making this Certificate of Ex- ADDRESS em tionyou should come subject to the Workers'Com en SWIMMING POOL RECEPTOR , p Y, I p CITY - TEL. NO. sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION ADISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER c fe d O Professions Code, and my license is in full force and ef- 5 PER YSTEM FINAL/ VALID N e& DATE 2 O License Number Lic. Class U FIN cc Contractor Date BY O I am exempt under Sec. B,&P.C. for this reason Plan check fee , U) Date: PLUMBING PERMIT ISSUING'FEE$ Signature TOTAL FEE S^ �0 5 3 3 A SINGLE FA ILY HOME OWNER-BL�iL DECLARATION Plan check applicant # 0 0 0 6 0 5 ereby affirm th t I a e p from the Contractor's License Name ) o - 46,50 Law for the fol in a (Sectio 7031.5, Business and Address o 0 o4&5 0 5 I, as ov7rrer f e property, ill do the work and the City Tel. No. structure is not intended or offered for sale(Section 7044, Business and Professions Code). ► O&2 6 8 8 CONSTRUCTION LENDING AGENCY 1 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 inf anon is correct. l agree to comply wi a I County ordinan e and State laws r gulating P n and))hereby uth iy�representatives this Co ty o r�upon the Abeint4,.n d proper for inspti oses. SEE REVERSE FOR EXPLANATORYLANGUAGE rttee Dat ORKERS'COMPENSATION DECLARATION 6 DPW 4/87 APPLICATION FOR PLUMBING PERMIT r t dfTeregy, affirrp that I have a certificate of consent to self in- 76A6676A667A `Ifull sure, or a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) c.rt i ri ed 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 .,q\y lj/ department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET(TOILET) O a Date Applicant v NEAREST •. CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. r . COMPENSATION INSURANCE SHOWER O OWNER vie ftsation n need not be completed if.the work involved by MAIL is for one hundred dollars ($100)or less.) LAVATORY QADDRES I'm the performance of the work for which this per- SINK d, I shall not employ any person in any manner so CITY � EL0me subject to the Workers' Compensation Laws. DISHWASHERCONTRACTOR Applicant CLOTHES WASHER ADDRESS APPLICANT: If, after making this Certificate of.Ex- SWIMMING POOL RECEPTORou should become subject to the Workers'Compen- CITY TEL. NO. isions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO, CLAS LICENSED CONTRACTORS DECLARATION DISTRICT NO. FIR/CESSED BY I hereby affirm that I am Licensed under provisions of Chapter GAS SYSTEM OUTLETS �� 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER fand e Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL f VALIDATION 0. DATE 0 License Number Lic. Class () FI L Contractor Date 10,0, 0 I am exempt under Sec. LLI B.&P.C. for this reason , Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ Q �� 0 b 5 b A Signature TOTAL FEE SINGLE FAMILY - # 0 0 0 o 05 HOME OWNER-BUILDER DECLARATION Plan check applicant 1 .'6 4&5 0 I her affirm that I am exempt from the Contractor's License Name x La for the following reason (Section 7031.5, Business and o 0 0 4650 v fessions Code): Address 0 9,'1 3; 8 8 I, as owner of the property, will do the work and the City Tel. No. 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 Lender's Address I certif at I hive read this application and state that the ► abov i r n is correct. I agree to comply with all County ordi e nd State laws regulating Plumbing, and hereby ut ze r sentatives of this County to enter upon the e m ti ed rt for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE gnat re of ermittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0701030017 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 6561 LT: 515 5817 KAUFFMAN AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802206 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8587-021-005 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, C 45 WATER CLOSET/URINAL 1.00 FIX 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 01/03/07 JK 07/02/07 OWNER: TEL. NO: FINAL DATEEXPIRMY; CODE: LU, TONY (626) 390-3563-5817 KAUFFMAN AV TEMP 917802206 DESCRIPTIO OR WATER HEATER CHANGE OUT APPLICANT: TEL. NO: TOM (323) 346-8609- 970 E. MAIN ST. #200 SPECIAL CONDITIONS: GRASS VALLEY 95945 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE WATER HEATERS ONLY (530) 274-3001- 970 E MAIN ST LIC. NO UNDER SLAB WORK STE 200 374573 C36 GRASS VALLEY CA 95945 WATER SERVICE PLASTIC YIN METAL YIN ARCHITECT OR ENGINEER: TEL. NO: ROUGH PLUMBING LIC. NO: . I GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508