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Home My Public Portal About9241 KEY WEST ST_Plumbing__ %6X$67 CBS 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER /F�7OR APPLICANT TO FILL IN DISTRICT _ PLUMBER L ( re?o�' READY FOR RECEIVED BY /DATE ISSUED ADDRESS p� �, mil FIRBT INSPECTION _ (iG '�'°"�� TEL. No� p �y� BUILDING ADDRESS COUNTY CITY LICENSE NO. I / LOCALITY EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OR FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) @ 0.50 ADDRESS BATH TUB @ 0.50 CITY TEL NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE ,S CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0513 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID L08 LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PPRJOPE�j D C�RyIPB�EDpABOVE. � GAS SYSTEM OUTLETS @ 0.50 SIGNATURE OF WATER HEATER @ 0.50 PERMITTEE SLOP SINK @ 0.50 INSPECTION RECORD FLOOR BINK Q 0.50 FLOOR DRAIN Q 0.50 DISHWASHER @ O.SO DRINKING FOUNTAIN @ 0.50 URINAL ({a 0.50 J Q HOUSE SEWER @ 0.50 _Z MISCELL4NEOUS 19 It O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAB PIPING n �. ✓� GAS VENT �� y� CESSPOOL @ 1,00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT I l.00 GAS TEST UTILITY CO.NOTIFIED Q TOTAL FEE I /` FINAL V 78A867 •CER817 4-64 ` / APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER B,UIILDINOHN AG AM B I E SAFETYBUILDING ADDRESS BUI ENGINEER DIN WILLIAM A JENSEN, SUP T OF BUILDING LOCALITY FOR APPLICANT TO FELL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET S1.25 aMAIL 1 BATH TUB 1.25 / ADDRESS SHOWER 1.25 / S CITY TEL. NO. LAVATORY 1.25 a � C 0 N T R A C T 0 SINS 1.25 ADDRESS DISHWASHER 1.25 CITY TEL. NO.-;�7 746"71,r— CONTRACTOR'S ��D /S--C STATE LAUNDRY TUB 1.25 REGISTRATION NO. CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE OCESSED BY WATER HEATER 1.50 OINDUSQ RIAL GAS SYSTEM OUTLETS WASTE"So (� WASTE APPROVAL � a AROVAL O OUTLETS OVER S PER SYSTEM .30 INSPECTION RECORD U oe O W a z 1S r APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT $ 200 UNDER SLAB WORK Z �yl�y U VIS ROUGH PLUMBING 1, TOTAL FEE ZDGAS PIPING ! ° 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION`. GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER (� PLUMBING L 1 HEREBY 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,AND INTEND TO RESIDE IN,THE ABOVE D DEC RESIDENTIAL P PERTY UTILITY CO NOTIFIED SIGNATURE S OF PERMITTEE FINAL p"D ALIDATION ROBERT A WOOD cK M o CASH SUPERVISING MECHANICAL ENG R L�j�a 6 7 7 3 1-4) DEC 14 5 D 12.50- WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure, 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 � / ✓ G(J/� G_ . Certified copy is filed with the county building inspec- ADDRESS �C„�� 1 tion depart ent NUMBER FIXTURE OR ITEM @ FEE LOCALITY e � j WATER CLOSET K.a Date Applicant 1� NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER OWNER _ Gk G.,V1_' I C (This section need not be completed if the work involved by MAL the permit is for one hundred dollars($100)or less ) LAVATORY L I certify'that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY GTEL NOZS 7- q,? so as to become subject to the Workers'Compe tion Laws DISHWASHER CONTRACTOR 1 ( t 7 Date'L D� ` Applicant �r CLOTHES WASHER ADDRESS NOTICE TO APPLICANT If, after making this Certificate of C��•, d� G: Co Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR LJZCompensation provisions of the Labor Code, you must forth- CITY �- T L NO _7q3 LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE �/aA�"� LIC C- �L deemed revoked WATER HEATER LICENSE NO 66``'�CC�L CLASS J� LICENSED CONTRACTORS DECLARATION DISTRICT NO ROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER �� y and Professions Code, and my license is in full force and effect 5 PER SYSTEM FINAL VALIDATION DATE V b ` License Number L� ` Lic Class �✓ v �y(f FINAL I= Contractor 6zsi i 'ICA,e—So kfDate G D BY 0 ❑ U I am exempt under Sec 0. B &P C for this reason H , 5-1(/—V4 Plan check fee pop. Z Date u� PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address 1 1 9.O A Law for the following reason (Section 7031 5, Business and Professions Code) City Tel No # o o� 0 0 5 t I, as owner of the property, will do the work and the •2'0L 0 3'0,'5 Q structure is not intended or offered for sale (Section 7044, Business and Professions Code) = CONSTRUCTION LENDING AGENCY 04,0:0 5 0 5 (]c� I hereby affirm that there is a construction lending agency for O 5 1 4'-8 4 the performance of the woik 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 poll information is correct I agree to comply with all County ordinances and State jaws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date 1 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0804300003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT ILEGAL ID I FEES PAID I BUILDING ADDRESS I ITR 16475 LT 89 I I 9241 KEY WEST ST I I IFEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917803730 I (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET FRATUS I 18590-027-015 101 PERMIT ISSUANCE FEE 27 75 I THOMAS PAGE 596 GRID J5 LOCALITY TEMPLE CITY, Cl 1 113 DISHWASHER(S) 1 00 FIX 16 20 I I ITENANT 125 LAVATORIES/SINKS 1 00 FIX 16 20 (ISSUED ON PROCESSED BY PLAN BY EXPIRES ON I I I TOTAL FEES 60 15 104/30/08 SR 10/27/08 (OWNER TEL NO I JFIW DATE FINr#.Lg�Y CODE I ICANONIC KEITH (626) 287-7422- I 1 � 4- / �) 19241 KEY WEST ST I Ill(Zp � J �/ ITEMP 917803730 I IDESCRIPTION OF WORK 0I I I IREPLACE DISHWASHER AND SINK (APPLICANT TEL NO I I I BUCCOLA (626) 523-4867- I I I ISPECIAL CONDITIONS I I I I I (CONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE I IL AND W KITCHENS AND BATHS (626) 287-1131- 1 1 I 18812 LAS TUNAS LIC NO (UNDER SLAB WORK ISAN GABRIEL, CA 91776 205344B I IWATER SERVICE I I IPLASTIC YIN METAL YIN (ARCHITECT OR ENGINEER TEL NO I I 1 - IROUGH PLUMBING LIC NO 1 �L IGAS PIPING _ GAS VENT I I I I I 1 IHOT WATER HEATER IPLUMBING FIXTURES I I I I I I I ILAWN SPRINKLERS IGAS TEST I I I I I I (UTILITY COMPANY NOTIFIEDI I I I ICWV I I I I IGRAY 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 1 IREPORT ID DPR263 ROUTE TO BS0508 I I I I I I I I I