HomeMy Public PortalAbout9583 KENNERLY ST_Plumbing__ DEPARTMENT OF COUNTY ENGINEER PLUMBING
DIVISION OF BUILDING AND SAFETY '(PPE6Qt'MIT APPLICATION
COUNTY OF LOS ANGELES ABUILDING
DDRESS
WILLIAM J. FOX, COUNTY ENGINEER
FOR APPLIC NT TO FILL IN LOCALITY
BUILDING NEAREST /]�_ /J a
n 2 CROSS ST 1.��.6r�1 !'1=✓'LJ�-�-✓1
ADDRESS o A .T - rI 2 DISTRICT NO. GRQUP /ZONE PERMIT NO.
LOCALITY /�3( Q �T- L /4 I 17 /g6 � 3 J�
NEAREST /�
CROSS ST // n �CEIVEReady for Inspection �DATE ISSUED
OWNER V n 11
MAILL ) A _ U_ INDUSTRIAL
ADDRESS n _(�,/�(� WASTE APPROVAL
CITY ,/ dAt./.l�
,, ),,n TEL.NO CU o r INSPECTION RECORD
e� �D��n41
PLUMBER / l� .I W W i
ADDRE S D �0 , r
CITY ' f///l :OUNTI
TEL.NO. J
J`f CU
LICENSE N0. J
PERMIT FEES a
z_
NUMBER TYPE OF FIXTURE OR ITEM FEE _ E9
WATER CLOSET(TOILET) a 080 � � 0
(� O
BATH TUB @ 080 p O
SHOWER @ 0.808/ U
LAVATORY(WASH BASIN) @ 0 80 ( Q
KITCHEN SINK @ 0 80 bp7 Uh
LAUNDRY TUB OR TRAY @ 0 80 h(/
SLOP SINK @ 0 80
FLOOR SINK @ 080
FLOOR DRAIN @ 080
DISHWASHER @ 0 80
DRINKING FOUNTAIN @ 080
URINAL @ 080
GASSYSTEM_ �._OUTLETS @ 1.00 OaaQ
WATER HEATER@ 1 00 U
)MISCELLANEOUS/
qq
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
i
TOTAL FEE Q GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPA- 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
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY ANGELES COUNTY GAS TEST
LEROF
ATE OF CALIFORNIA OR THAT A THE LEGAL OWN-
HE ABOVE DESCRIBED RESI NT�ALPROPERTY. UTILITY CO.NOTIFIED
RE � ^(,�„� __ .....__ __..
FINAL
76A667 DBS 17 1/53
r,
WQRKER' 'COMPENSATION DECLARATION 76AG67A
I hereby affirm that I have, a certificate of consent to self CE s» (z-eo) A P P L'I C A,T I O N FOR PLUMBING PERMIT
insure, or a certificate of Workers'Compensation Insurance,or
a certified copy thereof(Sec 3800,Lab C)
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No Company ' C r
a;Cert
ifie copy i ereby furnished FOR APPLICANT TO FILL IN (PRINT OR TYPE), Bl1ILDING
ADDRESS
s ed co is filed wi count�buildin�inspecti NUMBER FIXTURE OR ITEM • 'FEE
n LOCALITY
Dat WATER CLOSET
ppli NEAREST
! BATH TUB CROSS ST {�A
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE SHOWER OWNER
MAIL p p
(This section need not be completed if the work"'involved LAVATORY ADDRESS f 15% e?_11 ' }
.by the permit is for one hundred'dollars ($100) or less.) _
SINK CITY"'^� TEL NO /� _ �Qa
I certify that in the performance of the work for which this DISHWASHER 0
permit is'issued, I shall not employ any person in any manner CONTRACTOR
so as to become subject to the Workers' Compensation Laws CLOTHES WASHER 0
ADDRESS
Date Applicant _ _ SWIMMING POOL RECEPTOR- V_
NOTICE TO APPLICANT If, after,making this Certificate of CIT m QXJL TEL NO'9(/2_`��(� d
Exemption, you 'should become subject to the Workers' LAWN SPRINKLER SYSTEM .-STATE (n
Compensation provisions of the'Labor Code, you must forth- Q LIC / Z
with, comply with such provisions or this permit shall be WATER HEATER LICENSE NO 1 ASS
deemed revoked GAS SYSTEM OUTLETS DISTRICT NQ OCE p BY
LICENSED CONTRACTORS DECLARATION OUTLETS OVER _ //� _ /y
I Hereby affum that I am licensed under provisions of Chapter 5 PER SYSTEM-
9 (commencing with Section 7000) of Division 3 of the Busi- FINAL ,� J� Vi4LIDA ION
ness and Professions Code, and my license is in full force and DATE
effect
FINAL
License Number Lie Class BY t
Contractor P.77 Date
ElI am exempt from the licensing requirements as I am a Plan check fee
licensed architect or it registered professional engineer PLUMBING PERMIT ISSUING FEE$
acting in my professional capacity (Section 7051,,,Bus-
mess and Professions Code) TOTAL FEE
Lie or Reg No Date Plan check applicant
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm "that I am exempt from the Contractor's
Address 5
License Law for the following reason (Section 7031 5, Busi- City Tel No
ness and Professions Code) , - 9 3 7 0 5 A'
I, as owner of the property, am'exclusively contracting
with licensed contractors to construct the project
(Section 7044, Business and Professions Code) # 0 0 0 0 0 5
CONSTRUCTION LENDING AGENCY _ � 12 0 0 11250
I hereby affirm,that there is a construction lending agency 0 0 0 1 2,5 0�
for the performance'of the work for which this permit is
issued(Sec 3097,Civ C) _8
Lender's Name `` �i t+ G.a {�� ,� , "
1 �' � A'
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 hereb
auth` represen s of this County to ent r upon t e
ab e-mentioned propert or mspe on urposes l
/ 4/
Signat ermrttee �.
t
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0108220017
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES A S:
TR: 19316 LT: 12 9583 KENNERLY ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803838
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: CLOVERLY AVENUE
8590-013-004 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY
07 BATHTUBS/SHOWERS 2.00 FIX 32.40
25 LAVATORIES/SINKS 3.00 FIX 48.60 ISSUEDR C RE ON:
45 WATER CLOSET/URINAL 2.00 FIX 32.40 08/22/01 UT 02/18/02
47 WATER HEATER(S) 1.00 WTH 16.20
OWNER: TEL. NO: 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 FINAL D EFIN CODE:
KWOK, JOHN (626) 577-8900- TOTAL FEES 173.55
586 LA PAZ DR 101 2
F�&
SMAR 911081459 DESCRIPTION
RELOCATE WATER HEATER, REPLACE SHOWER, BATHTUB, 3 SINKS, 2
TOILETS
APPLICANT:
MON POND CONTRUCTION INC. (626) 683-7219-
745 VALLEY BLVD.#637 SPECIAL CONDITIONS:
SAN GABRIEL CA 91776
CONTRACTOR: TEL. NO: ®� APPROVALS DATE INSPECTOR SIGNATURE
MON POND CONSTRUCTION INC. (626) 683-7219-
745 E. VALLEY BLVD. 637 LIC. NO UNDER SLAB WORK
SAN GABRIEL, CA 91'T76 534094 B
WATER SERVICE
ARCHITECT \R 0: PLASTIC Y/N METAL Y/N
\fes
LIC. N0!' PIPING
GAS VENT
J7 17
HOT WATER HEATER
l - -- --- ------- --- ---- - PLUMBING FIXTURES
SPRINKLERS
GAS
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to �I _ti
fo
CWV
GRAY WATER SYSTEM
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REPORT ID: DPR263 ROUTE TO: BS0508