HomeMy Public PortalAbout9442 KENNERLY ST_Plumbing__ 76A667-CE8 V-8-58
APPLICATION FOR - PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DnnSION BUILDING
JOHN A. LAMBIE, County Engineer ' ADDRESS 9442 E.Kennnerl
CASSATT D. GRIFFIN,Supt of Building LOCALITY ' Temple City
FOR APPLICANT TO FILL IN CRNEAREST
ARESOSS ST over y
NUMBER FIXTURE OR ITEM
OWNER
1 WATER CLOSET MAIL
BATH TDB ADDRESS
1 SHOWER CITY TEL. NO.
t\T TIF,-1�,,,n{'O
1 LAVATORY �. CONTRACTOR o �+ tr�4=Rs B /`
SINK o ADDRESS 548 I�'.Darlin ton CT-
DISHWASHER CITY S.San Gabriel TEL. No. AT 01224
CONTRACTOR'S STATE x[]
LAIINDRY TUB REGISTRATION NO. 107821 COUNTY
CLOTHES WASHER DISTRIO. GRP ZONE I P CE D Y
WATER HEATER
INDUSTRIAL
WASTE APPROVAL
rINSPECTION RECORD
APPROV
5 @ $1.00 PER ITEM 5.00
OR FIXTURE $ DATE INSPECTOR'S SIGNATURE
UNDER SLAB WOgr,
PERMIT 2100 ROUGH PLUMBING
TOTAL FEE 7. GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED I LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THA 1 M THE L AL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDE IAL ROP .
SIGNATURE FINAL Z—t-��
OF PERMITT
ROBERT A.WOOD.
OF VALIDATION' - SUPERVISING MECHANICAL ENG'R
CK M.0. CASH
(r j',o,3 1 8 T UA SEP 25 5 9 7.0 0
WORKERS'COMPENSATION DECLARATION 76A667A
I hereby affirm that-I have a- certificate of consent 'to self ce at 7 (2-60) APPLICATION FOR PLUMBING' PERMIT
insure,or a certificate of Workers'Compensation Insurance,or
a cer 'fled �I reof(Sec. 3800,Lab. C.)
�. COUNTY OF LOS ANGELES 7` �' BUILDING AND SAFETY .
Tolley No. Company
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING NZ a ne�c.
ADDRESS
OCertified copy is filed with the county building'ins ection NUMBER FIXTURE OR ITEM. i FEE
fle artm nt- LOCALITYre
P WATER-CLOSET M.
`
Date Applicant NEAREST ' ,
BATH TUB CROSS ST.
CERTIFICATE QF-EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE' SHOWER' OWNER G
LAVATORY
MAIL
(This section need• not be completed if the work involved ADDRESS.
by,'the permit is•for one hundred dollars ($100) or less.) SINKCITY � }
TEL:.N0.33� � -
I certify that in the• performance of the work for which this DISHWASHER V,• '
permit is issued;I shall not employ any person in any manner CONTRACTOR LUMQUICt
so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER - ADDRESS L QQ _ C1
Date Applicant •` �VG O "' ..// ~
SWIMMING POOL RECEPTOR CITY, TEL. NO,.�q(e•b�ZI W
NOTICE TO APPLICANT r If, after making,this Certificate of rcA
Exemption, ,you should become subject to the Workers' LAWN SPRINKLER SYSTEM d
P 1 STATE LIC. CAI -
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 N
deemed revoked. DISTRICT NO. PR ESS�D'BY
GAS SYSTEM OUTLETS r -
LICENSED CONTRACTORS DECLARATION,- OUTLETS OVER u Op
o f
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 ^Z
effect.
/' FINAL
License Numberi 3yS3.,.- Lic.Class* � BY
ContractorAU*yiAaMA Date al q IR
Plan check fee
F' I am exempt'from the licensing requirements as'1 am a
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
ti.
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,-Buri- City •Tel':No. A 7, A
ness_and Professions Code).'
` ET„I, as owner of-the property; am exclusively contracting
with' licensed, contractors to-construct the project 2 0.o 0, 0 .
(Section 7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY
I hereby 'affirm that there'is a construction lending agency 0.2.2 4_8 1 -
I for .the performance'of the work for which this permit is m_ _
issued(Sec. 3097,Civ.
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 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. -
signature of Permittee Date,
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0911300014
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: I FEES PAID BUILDING ADDRESS: I
ITR: 15890 LT: 12 9442 KENNERLY ST 1
I IFEE DESCRIPTION: QUANTITY. DOM: AMOUNT: 1 TEMP CA 917803835 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: CLOVERLY I
18590-011-017 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 , GRID: J5 LOCALITY: TEMPLE CITY, Cl
1 107 BATHTUBS/SHOWERS 2.00 FIX 32.40 1
(TENANT: 111 CLOTHESWASHER(S) 1.00 FIX 16.20 (ISSUED ON: PROCESSED BY: PLAN BY. EXPIRES ON. 1
113 DISHWASHER(S) 1.00 FIX 16.20 111/30/09 SR 11/30/10 1
I 119 FLOOR SINK(S) 2.00 FIX 32.40 1 I
(OWNER: TEL. NO: 125 LAVATORIES/SINKS 2.00 FIX 32.40 IF NAL DATE FINAL BY: CODE: 1
1HUYNH, TONG (626) 246-5613- 145 WATER CLOSET/URINAL 1.00 FIX 16.20 I
19442 KENNERLY ST 147 WATER HEATERS) 1.00 WTH 16.20 I
ITEMP 917803835 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 I CR TION OF WORK 1
I 1 TOTAL FEES 205.95 IPLUMBING FOR NEW BATHROOM, LAUNDRY AND KITCHEN REMODEL 1
(APPLICANT: TEL. NO: 1 I I
ILAM (626) 272-2478- I I I
11501 E. ROWLAND AVE. I ISPECIAL CONDITIONS: I
IWEST COVINA CA 91791 I I I
1CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
(OSCAR AMADOR (951) 533-4069- I I I'll I
16082 HUMBLE ST. LIC. NO 1 1UNDER SLAB WORKI
(RIVERSIDE, CA 92509 676446 B 1 1 /1 1 1 �-ID I
IWATER SERVICE I
I IPLASTIC YIN METAL YIN 1 I I
ARCHITECT OR ENGINEER: TEL. NO: i 1ROUGH PLUMBING
LIC. N0: I IGAS PIPING I I I
1 1 IGAS VENT I I I
IHOT WATER HEATER I I I
I I IPLUMBING FIXTURES I I I
ILAWN SPRINKLERS I I
I I
IGAS TEST 1
I I
I 1 1UTILITY COMPANY NOTIFIED( I I
1 ICWV I I I
IGRAY WATER SYSTEM I
1 I I k 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: BS0508 I I I I
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