The URL can be used to link to this page

Home My Public Portal About9243 LA ROSA DR_Plumbing__ s� _ 76A667 DBB 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY • COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTR O. GROUPI ZONE )PERMIT �y��p"�g�,,,� z 3 3J PLUMBER C 1 "�°�"• READY FOR R IWY FIRST INSPECTION DATE 188/L ADORES. / p �� b �1BUILDING ty j Q ,Y CITY TL. No. , Oj� �O ADORES. EBy V COUNTY LICENSE NO. b EXPIRES v a •�� LOCALITY NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE DINNER WATER CLOSET(TOILET) 0 0.50 S MAIL ADDRESS 3 BATH TUB @ 0.50 CITY TEL NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) IV 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY.THAT 1 POSSESS THE ABOVE VALID LOB LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER GAS SYSTEM OUTtET9 Q 0.30 SI THE RESIDENTIALFe, PROP DEED ABfY'M OVE. SIGNATURE OF c® WATER HEATER @ 0.30 PERMITTE SLOP SINK Cel 0.50 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER 0.50 DRINKING FOUNTAIN 0.50 • URINAL Q 0.50 J Q HOUSE SEWER 0.50 Z MISCELLANEOU 0 Q' O APPROVALS DATE INSPECTOR-9 NAME ROUGH PLUMBING OAS PIPING GAB VENT CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT . . . I 1.00 GAS TEST A UTILITY CO. NOTIFIED TOTAL FEE IS-40 FINAL I WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT {� I hereby affirm that I have a certificate of consent to self 76A667A I J insure, &a certificate of Workers' Compensation Insurance, CE 817(REV 10/81) L or ti ied copy thereof (Sec 380Lab C.) A U COUNTY OF LOS ANGELES BUILDING AND SAFETY Po)icV ❑ Certified copy is hereby furnished BUILDING Certified FOR APPLICANT TO FILL IN(PRINT OR TYPE)copy is filed with the county buildinglns ADDRESS tion department NUMBER FIXTURE OR ITEM @ FEE LOCALITY _ / WATER CLOSET Date �( � Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER d2 GZ,rC jS (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or,less.) LAVATORY ADDRESS. /'7 Q I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO so as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS, _31 IV,• SAIC e N I -7'00L NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM -. with comply with such provisions or this permit shall be STATE LIC deemed revoked. WATER HEATER LICENSE NO 77 V3 CLASS I'-Z) C LICENSED CONTRACTORS DECLARATION DIST NQ / PWCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS C f U u (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER J U and Professions Code, and my license is in full force and effect. 15 PER SYSTEM FINAL VALID A ON if�373� C zSG 0 DAT W License Number Lic. Class �ef�.! n FI Contractor 6/i4WO C Date -17-Y? U fY D0 i am exempt under Sec F— U B.&P.C. for this reason r W Plan check fee d Date: PLUMBING PERMIT ISSUING FEE$ S-0 Z Signature TOTAL FEE .;2'727A Mo 0 0 0.o SINGLE FAMILY Plan check applicant #` Jr HOME OWNER-BUILDER DECLARATION Name ( o o l b�rj Q I hereby affirm that I am exempt from the Contractor's License Address Low for the following reason (Section 7031.5, Business and l 6505 Professions Code) I City Tel. No. o io o ❑ -I, as owner of the property, will do the work and the 0.'&l 7,`•8 7 structure is not intended or offered for sale (Section , 7044, Business 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 I certify that I have read this application and state that the above information is correct I agree to comply with all County ordinonces.and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned pro r inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE . ZA�&� . -1747 Signature of Permittee Date WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, affirm'that I ha3e a certificate of consent to self in- 76A667A a/87 sure, ora certificate of Workers'Compensation Insurance, or a CE 817(REV. 8/86) certified copy thereof (Sec. 3800; Lab. C. Policy No Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN (PRINT OR TYPE) ((('�----tttl r ified copy is filed with the.county building'inspection ADDRESS1.0-4/s v department. NUMBER FIXTURE AR ITEM @ FEEELOCALITY /Date ' Applicant ^— WATER CLOSET(TOILET) V� NEAREST CERTIFICATE OF EXEMPTION FROM'WORKERS` BATH TUB CROSS ST. , t COMPENSATION INSURANCEv OWNER S SHOWER (This section need not be completed if the work-involved by MAIL ' the permit is for one hundred dollorw(S100)or less.) LAVATORY a ADDRESS 'I certify that in the performance of the work for which this per SINK mit is issued, I shall not employ any person-in any manner so CITY TEL. NO. as to become subject to the Workers'Co p sation Laws., —� DISHWASHER CONTRACTOR Date plicant CLOTHES.WASHER ADDRESS NOTICE TO APPLICANT: If; atter making.this.Cerfificate-of Ex- SWIMMING POOL RECEPTOR emptioh,you,should become subject to the Workers'Compen- CITY sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM TEL. NO.40 OIZ— ly with such,provisions or this permit shall be deemed revok- STATE ) LIC. ed. WATER HEATER LICENSE NO. 6 ( CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. ,,// PRO SED BY I.hereby offirm•that I.am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER (Ja and Professions Code, and m license is in full force and ef- 5 PER SYSTEM / fect. y FINAL /J VALID ON IL �� DATE • L'G O License Number l Lic: Class (� Contractor- 16,1 5, �✓ Date B 8 2'5 8 A I am exempt under Sec: # o.00c05 B.&P.C. for this reason_ ► CO) v Plan check fee Dote: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE ') o o 4.0,5 O SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant , o ,Q cJ ,01 I hereby affirm that I am exempt from the-Contractor's License Name' Law for the following reason (Section 7031.5, Business and ,), 1, 2 87 Professions Code): Address Q I, as owner of the property, will do the work and the. City Tel. No. structure.is-not intended or offered for sale(Section 7044, Business 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 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 representes' es of this County to enter upon the above-mentioned per for inspection purposes. 7__�� SEE REVERSE FOR EXPLANATORY LANGUAGE S, ature of ermittee ! Date j o' W 'S COMPENSATION DECLARATION 20-0026 DPW 9/89 I J 76A667A APPLICATION FOR PLUMBING PERMIT JI,JI I hereby affir til have a certificate of consent to self insure, v or a certificaterker's Compensation Insurance, or a certified copy ihereo'(S 00 Lab. CJ - m Policy No. pany Co 5? COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. El Certified copy is hereby furnished n FOR APPLICANT TO FILL IN(PRINT OR TYPE) 1 BUILDING ; ADDRESS Certified copy is filed with the county budding inspection department. [UMBER, FIXTURE OR ITEM ® FEE Date Z _�Applicant�" 1! tN LTVI^' WATER CLOSET NEARE TY NEAREST• (ZL� r 14 .CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST r BATH TUB COMPENSATION INSURANCE ASSESSOR (This section need not be completed'if the work Involved by the �-► SHOWER MAP BOOK PAGE PARCEL permit is for one hundred dollars($100)or less.), LAVATORY _ OWNER I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to SINK MAIL ADDRESS Is/4en ,become subject to the Workers'Compensation Laws. DISWASHER CITY TEL NO��S�� Date Applicant CLOTHES WASHER CONTRACTOR NOTICE-YO APPLICANT: If, after making this Certificate of A( 1 (� Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS provisions of the Labor Code, you must forthwith comply with such 2-7 provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY O CST TEL NO S7 J 6 } I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER ` ^0. (commencing with Section 7000) of Division 3 of the Business and �� LICENTATESE NO LIC GAS SYSTEM OUTLETS 4kA SS V- Professions Code,and my license is in full force and effect. PROCESSED BY DISTRICT NO. OUTLETS OVER -"-'-- 5 PER SYSTEM, License NumberFINAL Lic.Class O _ f QQQ �--� DATE /� � _/ — VA-00ATION io a; Contractor T' tie" Z� 3 -j CO) ❑ I am exempt under Sec. BY AL i l i i l�'�)L 72 7 5 Z B.BP.0 for this reason / f" Jr E' Date: .�1�•'� Plan check fee, ' Signature PLUMBING PERMIT ISSUING FEE$ (� , CHANGE g TOTAL FEE Plan check applicant I f('_f�f f—Ei!_�Il f j X _ SINGLE FAMILY � jj)�.^f' HOME OWNER-BUILDER DECLARATION Name I t1f•�tt 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 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 I hereby affirm that there is a construction lending agency for the l j performance of the work 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 they above , information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and h,ereby authorize representatives of this County to enter upon the above-mentioned property fo inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1110170036 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 IT: 102 I 1 9243 LA ROSA DR I I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917803732 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: RIO HONDO 1 18590-010-002 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY, Cl 113 DISHWASHER(S) 1.00 FIX 16.30 I I (TENANT: 125 LAVATORIES/SINKS 1.00 FIX 16.30 (ISSUED ON: PROCESSED BY: PLAN BY: I TOTAL FEES 60.40 110/18/11 SR I (OWNER: TEL. NO: 1 IFINAL DATE FI AL BY: CODE: 1 IWEIS STEVE;SHELLY (626) 285-3836- I 1 19243 LA ROSA DR ITEMP 917803732 I IDESCRIPTION OF WORK I IPLUMBING FOR KITCHEN REMODEL I (APPLICANT: TEL. NO: 1 1 11 IO'LEARY, TOM (626) 287-0927- I I 15823 AGNES AVENUE I ISPECIAL CONDITIONS: ITEMPLE CITY CA 91780 I 1 I I I I I I I I I ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1 ITOM O-LEAKY CONSTRUCTION (626) 287-0927- 1 1 I 15823 AGNES AVENUE LIC. NO I (UNDER SLAB WORK I I I ITEMPLE CITY, CA 91780 489354 * 1 1-1 1 I IWATER SERVICE I I IPLASTIC YIN METAL YIN I I 1 1ARCHITECT OR ENGINEER: TEL. NO: I I I 1 (ROUGH PLUMBING _ 11 1 LIC. No: I I I I I I IGAS PIPING I I I IGAS VENT I I I I IHOT WATER HEATER I I I I I I I I IPLUMBING FIXTURES I I I I I I I I I I I ILAWN SPRINKLERS I I I I I I I I I - IGAS TEST I 1 1-1 (UTILITY COMPANY NOTIFIED( I I I I CWV I I I I I I I I I 1GRAY 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 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 I I ADDITIONAL DATA6N FILE _ o •. _ - REFI9RT 'ID-.--DPR263 .�ROUTB TO ; ®