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Home My Public Portal About10153 LA ROSA DR_Plumbing__ . rWO that I have FENSATION DECLARATION 7BA667 DPW 9/89 APPLICATION FOR PLUMBING PERMIT 20-002 A I hereby affirm that have a certificate of consent to self insure, , or a certificate of Worker's Compensation Insurance, or a certified - - - - - cdpy th2reof(Sec.3800 Cab.C.) - - COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. P❑olsy No. Company .. Cerllfied copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADUILDING DRESS lO/S'3 th /?,g S ❑ departed copy is tiled with the county building inspection ' department. / NUMBER 'FIXTURE OR ITEM Lry FEE LOCALITY Date Applicant Z WATER CLOSET �,5 �� D NEAREST COMPENSATION INSURANCE x / CROSS ST. M CERTIFICATE OF EXEMPTION FROM WORKERS' .BATH TUB D� ASSESSOR - . (This section need not be completed:if the work Involved by the SHOWER MAP BOOK PAGE PARCEL permit is for one.hundred dollars($100)or less.) ]• LAVATORY '!'O ip O OWNER MAIL 'v U `, I certify that in the performance of the work for which this permit J ✓ •/� '/ is issued, I shall not employ any person in any manner so as to I SINK ADDRESS ✓ ze become subject to the Workers' Compensation Laws. ��/ DISWASHER CITY TEL.N Dale Applicant CLOTHES WASHER CONTRACTOR NOTICE TO APPLICANT: If, after making this Certificate of / Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code,.you must forthwith comply with such ADDRESS - - provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM Flu - LICENSED CONTRACTORS DECLARATION CRY TEL.NO. } I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER d (commencing with Section 7000) of Division 3 of the Business and STATE LIC. Q Professions Code, and my license is in full force and effect.. GAS SYSTEM _OUTLETS LICENSE NO. CLASS V OUTLETS OVER DISTRICT NO. - �- PROCESSED BY 5 PER SYSTEM ��- /G O License Number Lic.Class FINAL DATE `L q/ VALIDATION a z Contractor Date C0 ❑ I am exempt under Sec. FINAL, Z B.&P.C.for this reason _ Date: Plan check fee Poo. Signature PLUMBING PERMIT ISSUING FEE$ O ❑ TOTAL FEE SINGLE FAMILY Plan check applicant - HOME OWNER-BUILDER DECLARATION Name 1 hereby affirm that I am exempt from the Contractor's License Law _ for the following reason (Section 7031.5, Business and Professions Address —.7137 ?±,..i_)I Code): - ' - City Tel.No. 1 1 TE;'I`, I,as owner of the property,will do the work and the structure is not intended or offered for sale (Section 7044, Business , INIAL 73 — 00 and Professions Code). - - __ CONSTRUCTION LENDING AGENCY - CHECK IS+UU I hereby affirm that there is a construction lending agency for the I•:IF!HHVE 1 performance of the work for which this permit is issued (Sec. 3097, -- - - - r Civ. C.) Lender's Name — i l�IUi i-[Ii f J 1 12114/?i t 7 ,li 1 P}I1 c �' J Lender's Address I certify that I have read this application and state that the above - Poo.information is correct. I agree to comply with all County ordinances - and State laws regulating Plumbing, and hereby authorize - - representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ` WORKERS,tthot)COMPENSATION DECLARATION I APPLICATION'. FOR, PLUMBING PERMIT 20-0026 DPW 4/8] hereby;r ccrciifiTfi ate have" certificate' o ns s- self in 76A667A 9 - ;5. sure.or a certificate of Work 3807,ompensafion Ins uronce,ora CE 817(REV 8%66) ' - :r^ T ,.. . ' -' - - ceftified copy-thereoY(Se<. 3800 Lab C):•: - COUNTY OF.LOS ANGELES DEPT: OF PUBLIC WORKS Policy No Company - I l }. - ' ,Certified,copy is hereby furnished FOR APPLICANT:TO FILL IN (PRINT OR.TYPE) BUILDING%0/�� :.Ce rt,f,ed copy is filed with the county building inspection FIXTURE OR ADDRESS y department. - NUMBER ITEM @, FEE. to ALI7Y__ WATER CLOSET (TOIL ET) ¢` , _ NEAREST O55 a -� _ • WORKERS' ' . BATH TUB J CRST.. ,� jV CERTIFICATE OF EXEMPTION FROM " f COMPENSATION INSURANCE . 'SHOWER - OWNER ! C. fn C lit _ (This secfio_n need not'be'complefed if the work involved by - _ - MAIL - fha permlf is for one hundred dollars (5100)or lessO - - LAVATORY! - ADDRESS - me- Rp.D V I certify that in the performance of the work for which this per _ TEL;NO.,g 6 YV,b mit is issued, I7s .shall not employ any peon'in any mr anneso SINK CITY a ; t D•' ' as'Lto becomesubjed'to fhe'Workers Compensation Laws.t - DISHWASHER ' CONTRACTOR Date a4 Applicont CLOTHES WASHER ADDRESS NOTICE TO APPLICANT.co after+m ct t gthe WCertificaterkesompex SWIMMING POOL RECEPTOR.. - emon you s provisions f the subject o the Workers'Compen CITY EL. NO. - jy w't uch of the Labor Code; yololl b forthwith comp- < LAWN SPRINKLER SYSTEM r. 'LICENSED CONTRACTORS DECLARATION 're"vok - •_ R STATE - LIG. ly with such provisions or this permit sfioll be deemed ed. - WATER HEATER ., "'• LICENSE NO. CLASS ' � DISTRICT NO. ROCESSED BY I.hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM / OUTLETS 9(commencing with Section 7000)of Division 3 ofThe Business OUTLETS OVER and Professions,Code'and my license'is'!in full force and of .5PER SYSTEM - FINAL., 'VALIDATION Y 'DATE - W License Number Uc Class - - U ' .FINAL Co*tractor --- Dote ^ . " - . ., - _ BY ,. U 0' I am exempt under Sec _ _ a' B 8P C for this reason Datel - N Plan check fee ► • - Z • - `' PLUMBING`PERMIT ISSUING FEE$ �Q - 1 .r Signature�� - - x i,: Ti y. TOTAL FEE SINGLE'FAMILY - a0 r HOMEOWNER-BUILDER DECLARATION c:. Plan check applicant - - - Ta hereby affirm that I 'm exempt from the Contractor'sLicense' Name t Law;for the;following reason,(Section 7031.5,. Businessrand. 'tx•. .•Jirj %.fjll Professions Code): - • - ..Address I, as owner of the property will do the work and the City. Tel. No rvr _y 1 structure is not intended ar.offeredfor sale(Section 7044 ;, �.; - „.. .. s /.. - - i t .Business and Professions Code). TO ]tg TE I 0 -,CONSTRUCTION LENDING AGENCY - - t,AO�-i. N�;tICI her affrm-that there is a construction lending agency;for �, " _ - . , the`performance of lhe'work for which nth is permit_is issued " - - - ... l H&H •- ,1•flf, (Sec.-3097. Civ: C:).• '? r•. - Lenders Na ✓ . • t� � O`. r V Lender's Address' ✓ - - - - .`_r J:�L e, � 9-_? ; —� ' I certify that_I have read this application and state that.the - ►, - - , above information is carred. l agree 93'comply'with'all County "'Y -ordinances and State laws regulating Plumbing, and hereby - authorize representatives of this County to enter_upon they. - above-mentioned property for inspection purposes. - ; f ; - ' SEE REVERSE FOR-EXPLANATORYLANGUAGE Signature of Permittee . 'Date - - COUNTY OF LOS ANGELES ' " - - TEMPLE CITY - .# 0508 . ' „PLUMBING PERMIT "`'”' • DEPARTMENT OF'PUBL IC WORKS 9701 LAS TUNAS PL 0508 0504180004 , BUILDING AND SAFETYi/'LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAIDBUILDING S: TR: 10821 LT: 13 BL: .001 - 10153 LA ROSA DR FEE DESCRIPTION: QUANTITY: LION: AMOUNT: TEMP CA 917803305 ASSESSORN - - NEAREST CROSS STREET: BADWIN 8585-007-021 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, C 07 BATHTUBS/SHOWERS:* "' 1.00 FIX 16.20 TENANT: 21 HOSE BIBB(S) 1.00 FIX ' 16.20 ISSUED 0 OC 0 : 25 LAVATORIES/SINKS 1.00 FIX 16.20 04/18/05 JK 10/15/05 45 WATER CLOSET/URINAL 1.00 FIX 16.20 OWNER: EL. 47 WATER HEATER(S) 1.00 WTH 16.20 FINAL DAbTEE FINAL BY: COD : CHING MU YU;PIAO CHIEN WANG (626) 448-4887- 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 1 a/ 10153 LA ROSA DR 60 DWV REPAIR OR ALTER 2.00 SYS 32.40 l to TEMP 917803305 TOTAL FEES 157.35 UESGRIPTIUN PLLMBING FOR GUEST HODS APPLICANT: SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TEL. 0: APPROVALS D INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO UNDER SLAB WORK zr r WATER SERVICE / PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: CHU, JACK (626) 448-4887- O G G 130 EVERETT LIC. NO: MONTEREY PARK, CA 91755 NONE WS-'M I NG GAS VENT HOT WATER HEATER_� 1 PLUMBING RES AWN SPRINKLERS S TEST UTILITY COMPANY NOTIFIED CWV GRAY ER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508 r . COUNTY OF LOS ANGELES TEMPLE CITY # 0508 - PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0504180003 BUILDING AND-SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-.0488 EXT: LEGAL D: FEES PA _ BUILDING DRESS: TR: 10821 LT: 13 BL: .001 10153 LA ROSA DR FEE DESCRIPTION: QUANTITY: LION: AMOUNT: TEMP CA 917803305 ASSESSOR INFORMATION NUMBER: - NEAREST CROSS STREET: BADWIN 8585-007-021 01 PERMIT ISSUANCE FEE - ' 27:75' - THOMAS PAGE: 597 GRID: 84LOCALITY: TEMPLE CITY, C 11 CLOTHESWASHER(S) 1.00 FIX 16.20 TENANT. 21 HOSE BIBS(S) 2.00 FIX 32.40 SS ON: PROCESSED BY: PLAN BY: EXPIRES ON: 25 LAVATORIES/SINKS 2.00 FIX 32.40 04/18/05 JK 10/15/05 45 WATER CLOSET/URINAL 1.00 FIX 16.20 OWNER: TEL. NO: 47 WATER HEATER(S) 1.00 WTH 16.20 F N D FINAL BY: CODE: CHING MU YU;PIAO CHIEN WANG (626) 448-4887- 60 DWV REPAIR OR ALTER 2.00 SYS 32.40 10153 LA ROSA DR TOTAL FEES 173.55 Z TEMP 917803305P OF WORK PL 8(NG FOR NEW SATHR GABA 0 BATHTUB APP L. NO: SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DTE I SPECTOR SIGNATURE SAME AS OWNER - LIC. NO U R SLAB 0 WATER SERVICE / PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: CHU, JACK (626) 448-4887- ROUGH PLUMBING �j, 130 EVERETT LIC. N0: MONTEREY PARK, CA 91755 NONE S I [ G GAS VENT NOT TER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANYN cWV G AY WATSYSTEM REPORT ID: DPR263 ROUTE TO: BS0508.