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Home My Public Portal About9219 KEY WEST ST_Plumbing__ w 76A667 (CE-817) - 5/73 APPLICATION FOR PLUMBING PERMIT < : COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE AKE CHECKS PAYABLE TO ADDRESS HARVEY T. BRANDT, COUNTY ENGINEER /y LOCALITY / �r FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST y NUMBER FIXTURE OR ITEM @ FEE CROSS ST r::-iv , - � „ WATER CLOSET 1,75 OWNER CC � MAIL BATH TUB 1 75 ADDRESS SHOWER 1,75 CITY TEL NO S— 71 LAVATORY 1,75 CONTRACTOR 4f7 I SINK 1,75ADDRESS �Gt a Cy N CA DISHWASHER 1,75 <' 5 CITY TEL NO ' WLID-16JO CLOTHES WASHER 1.75 STATE LIC, LICENSE NO CLASS. SWIMMING POOL RECEPTOR 1,75 DISTRICT NO GROUP ZONE CESSED BY LAWN SPRINKLER SYSTEM 1,75 ^ p -WATER HEATER 1:75 -INDUSTRIAL U WASTE APPROVAL d GAS SYSTEM OUTLETS 1.75 O INSPECTION RECORD v OUTLETS OVER ' 5 PER SYSTEM 30 p LLJ t� a � cn I Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR 5 SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING G City Tel NO GAS VENT HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT, THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH- ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING GAS TEST O � I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REOUI RED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY FINAL SIGNATURE OF PERMITTEE - , PERMIT VALIDATI N CK M 0 CASH PLAN CHECK VALIDATION CK M 0 CASH / 5 8 6 N JUN 18 5 8.2 5 e�8 75.4667, DBS 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OFNG AND SAFETY COUNTY OFF LOS LOS ANGELES ' WILLIAM J. FOX, CHIEF ENGINEER PLUMBING 1 TR O. . FOR APPLICANT TO FILL IN Iv / PLUMBER, . • , " �a • RECKIVED BY READY FOR DATE ISSUED Lti•�/ FIRST INSPECTION : BUILDING CITY VL ADDRESS ISI L c � - . � fat^� '��C TENor Q ry�� ADDRESS COUNTY O '4 J,0 e L LOCALITY `�"•'� LICENSE NO. EXPIRES NEAREST PERMIT FEES CROBB ST. 'r6.ms NUMBER TYPE OF PIXTLRE OR ITEM FEE OWNER MAIL D WATER CLOSET(TOILET) 0 0.50 111 ADDRESS BATH TUB 0.50 CITY mar,,. TEL. SHOWER _ @ 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE_ABOVE IB CORRECT _ AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK 0.50 AND STATE LAWS REGULATING PLUMBING. I O CERTIFY THAT 1 POSSESS THE ABVE VALID LOB LAUNDRY TUB OR TRAY (� 0.50 ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER OAS SYSTEM OUTLETS 0.50 OF THE RESIDENTIAL PRO ERTY DESCRIBEDBE. ,QAOV SIGNATURE OF WATER-HEATER @-O.50 PERMITTEr • _ SLOP SINK 0.50 INSPECTION RECORD FLOOR SINK 0.50 FLOOR DRAIN 0.50 DISHWASHER Q 0.50 DRINKING FOUNTAIN 0.50 URINAL 0.50 J Q HOUSE SEWER @ 0.50 _Z MISCELLANEOUS 0 APPROVALS DATE INSP£CTOR•B NAME ROUGH PLUMBING l • GAS PIPING GAS VENT CESSPOOL @ 1,00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 1 SEWER PERMIT I 1.00 GAB TEST t UTILITY CO. NOTIFIED TOTAL FEE 4/ / FINAL WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I-hereby affirm that I have a certificate of consent to self 200026 DPW 6/87 insure, or a certificate of Workers' Compensation Insurance, 76A667A or a 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 inspec- ADDRESS v( LiJ tion department NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET Date Applicant CROSS NEARESTT CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE OWNER & � ! (This section need not be completed if the work involved by SHOWER the permit is,for one hundred dollars($100)or less.) LAVATORY MAIL ADDRESS� I certify that in the performance of h this permit is issued, I shall not emXX y mannerSINK CITYso as to become subject to thesation Laws�yDISHWASHE CONTRACTOR-�/�645 ,Date"' Applican CLOTHES WASHER NOTICE TO APPLICANT If, ofertificate of ADDRES (J yLd Exemption, you should become subje t the Workers' SWIMMING POOL RECEPTOR CITY ,Q��/� Compensation provisions of the Labor C d , you must forth- LAWN SPRINKLER SYSTEM "�v dr with comply with such provisions or t is permit shall be STATE LIC M� deemed revoked WATER HEATER LICENSE NO CLA LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS T (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and m license is In full force and effect 5 PER SYSTEM 1" y FINAL- - VALIDATION 0 DATE _g License Number Lic Class " U FINAL Contractor Date BY 0, ❑ I am exempt under Sec 4U� B&P C for this reason = �� Plan check fee N Z Date PLUMBING PERMIT ISSUING FEE$ rl_r 1.4 Signature TOTAL FEE Plan check applicant 1 I T EM':- SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name (f_f j�� 4-0 - 65 j hereby affirm that I am exempt from the Contractor's License f'` s r Law for the following reason (Section 7031 5, Business and Address HE *0.6? Professions Code) City Tel No r= tE�t}� "If i ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY (li his(-111!tj r ` f y I hereby affirm that there is a construction lending agency for t')ct = AN IFJ 1 1 the performance of the work for which this permit is issued (Sec 3097, Civ C ) Lender's Name Lender's Address T I certify that I have read this application and state that the above informo n is c I agree to comply with all County pop- ordinance nd a la regulating Plumbing, and hereby authors re sent es of this County to enter upon the abov -me roperty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signa Per Date ' WORKER'S COMPENSATION DECLARATION 20-0026 DPW 9/89 `I hereby affirm that I have a certificate of consent to self insure, 76A667A APPLICATION FOR PLUMBING PERMIT or a certificate of Worker's Compensation Insurance, or a certified copy thereof(Sec 3800 Lab-C) J COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS DEPT.' OF PUBLIC WORKS DIV. 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 department NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Y�12 (( ` 2—Applicant 14ea , WATER CLOSET \ NEAREST CERTIFICATE OF EXEMPTION FROM4ORKERS' CROSS ST BATH TUB COMPENSATION INSURANCE AV ASSESSORG�,S�p (This section need not be completed rt SHOWER MAP BOOK PAGE v2 /-7 PARCEL./7the work involved by the - , permit is for one hundred dollars($100)or less) OWNER- � ` �� I certify that in the performance of,the work for which this permit LAVATORY, , MAIL is issued, I shall not employ any person in any manner so as to ( SINK ADDRESS / / �Q_ _ become subject to the Workers'Compensation Laws , DISWASHER CITY y�TEL NO Date Applicant CLOTHES WASHER 'r�G NOTICE TO APPLICANT If, after making this Certificate of CONTRACTOR Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR A) {/ provisions of the Labor Code, you must forthwith comply with such/ ADDRESS /X provisions or this permit shall be deemed revoked I LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION % CITY �IHJ TEL NO d I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER _ // f (commencing with Section 7000) of Division 3 of the Business and GAS SYSTEM OUTLETS L CESTAN SE NO / CO CLASSfZ� J�� O Professions Code,and my license is in full force and effect OUTLETS OVER DISTRICT NO PROCESSED BY ([ 5 PER SYSTEM �0 Q License Number Lic Class I3� ((G�i 0 FINAL DATE C ` 3 VALIDATION IL Contractor P Date F-1 �— FINAL a- 5 Z I am exempt under Sec BY -r-C E o g B&P C for this reason jff f i4�,lC Date Plari check fee a 1 ITEM. Si nature, 1 nom` PLUMBING PERMIT ISSUING FEE$ _ g �(/l�tj/ TOTAL FEE TOTAL 14 1 ® 15 ❑ t_HEC K 1411.15 SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name � '--- , C MANGE ,JA hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031 5, Business and Professions Address Code) City Tel No ❑ I, as owner of the property,will do the work and the structure �ic t -K ,■�` is not intended or offered for sale (Section 7044, Business 1 7-1r, 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 1 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/Co nfy to enter upon the above-mentioned ' - property for inspection p oses---�� SEE REVERSE FOR EXPLANATORY LANGUAGE , C7' r� ;- 4 Signature of Permittee / Dafe CG'JN1Y OF LOS ANGELES TEMPLE CITT 0508 PLUMBING PERMIT DEPARPOENT OF PUBLIC WORKS 9701 LAS TuNAS PL 0508 0406290007 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE, (626) 285-0488 EXT: GAL ID: FEES PAID U G ADDRESS: TR: 16475 LT: 93 9219 KEY WEST ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP C4 917803730 ASSESSOR I F MATIOp t 'NEER: - NEAREST CROSS STREET: _FRATUS 8590-027-019 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY, C _ 63 WATER PIPING BR/FIX 7.00 FIX 47.25 TENANT: 64 WATER PIPNG <= 1 1/2 1.00 LIN 16.20 ISSUEDPROCESSED BEXPIRES ON: TOTAL FEES 91.20 06/29/04 JK 12/26/04 OWNER: TEL. NO: FINAL DATE FINAL BY: LODE: ENG, TIMOTHY 9219 KEY WEST ST TEMP 917803730 D SCRi N r- WORK REPIPE AND REPLACE GALVANIZED STEEL PIPING WITH COPPER APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: CONFRACTOR: _ TEL. NO: APPROVALS DA E IrISPcC10R SIGtr'ATURE SAME AS OWNER - -� LIC. NO UgbTR- SLAB WOR WATER SERVICE _ PLASTIC Y/N METAL Y/N ARCHI7 CT OR NuINEEP.: TE ::0: � _ ROUGH PLUMSI'G —' LIC. N0: _ GAS P;PINC i UA—SVE—NT— HOT WATER R EAT E— PLUMBING FIxTURES LAWN SPRIK:'LERS GG SA�L�� UTILITY COMPAN —WOTIFIED CW GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: 350508