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Home My Public Portal About8905 LAS TUNAS DR_Plumbing__ WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I reby affirm that I have a certificate of consent to self 76A667A ure, or a certificate of Workers' Compensation Insurance, CE 817(REV 10/81) certified copy thereof �(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No.�6ompany ejAUC.. A Pol Certified copy is hereby furnished � I EJFOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING 5 'I u Certified copy is filed with the county building inspec- ADDRESS tion department NUMBER FIXTURE OR ITEM Q FEE _ �� 'L� LOCALITY PL� C Date 3 4 Applicant WATER CLOSET NEAREST .��`` CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST (ZO5 9 ' COMPENSATION INSURANCE SHOWER OWNER , 5 Qty A&� (This section need not be completed if the work Involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this / permit is issued, I shall not employ any person in any manner SINK CITY TEL NO so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR (,,tfV L3e Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT- If, after making this Certificate of l Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY.– TEL. NO Compensation provisions of the Labor Code, you must forth- "}�r :2 LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE RR LIC //�� deemed revoked WATER HEATER �_� LICENSE NO V CLASS l.i`� LICENSED CONTRACTORS DECLARATION y— DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER 1 and Professions Code,and m license is in full force and effect 5 PER SYSTEM � y FINAL p DATE F_�G — VALIDATION License Number e6�m Lic Classes W URIUAL FINAL IM �JWTQE� �ate 3Contractor gY ❑ I am exempt under Sec EM B.BP C. for this reason Plan check fee 111110.Date PLUMBING PERMIT ISSUING FEE$ Signature ` E J 6 A TOTAL FEE zp o c n SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name _ ' c r O I hereby affirm that I am exempt from the Contractor's License u c �,0 Law for the following reason (Section 7031 5, Business and Address Professions Code) City Tel No L C 4 ❑ 1, 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 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 representatives of this Count to enter upon the abov ent ned perty f spe purposes SEE REVERSE FOR EXPLANATORY LANGUAGE .3 -2= Signature of Permittee Date I WORKERS'COMPENSATION DECLARATION 76A667A I hereby affirm that I have a certificate of consent to self ce 817 (z-ao) APPLICATION FOR PLUMBING PERMIT insure, or a certificate of Workers'Compensation Insurance,or "fl a certified copy thereof(Sec. 3800,Lab.C.) COUNTY OF LOS ANGELES e BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ADDRESS ` — •t/I1 t Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE department. WATER CLOSET LOCALITY Date Applicant NEAREST BATH TUB CROSS ST. CE C TION FR W R COMPENSATION INSURANCE SHOWER OWNER O LAVATORY MAIL (This section need not be completed if the work involved ADDRESS by the permit is for one hundred dollars ($100) or less.) SINKd CITY O. O I certify tha in the performance of the wor fo which this DISHWASHER 0 permit is iss d, I sha 1 not em PI ny perso i any manner CONTRACTOR so as t ec a It to the ers' Co pe ration Laws. CLOTHES WASHER ! 0 ADDRESS � 1� � O Date licant SWIMMING POOL RECEPTOR NOTICE TO APPLICANT: If, after akin his ertificate of CITY TEL. NO Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATELIC. Compensation provisions of the Labor Code, you must forth- LICENSE NO.3 6 Q V�J}}CLASS z with comply with such provisions or this permit shall be WATER HEATER deemed revoked. I GAS SYSTEM OUTLETS DISTRICT NO. P CESSED BY LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL ��yyV LIDATION ness and Professions Code, and my license is in full force and DATE ge effect. FINAL l� License Number Lic.Class. � � BY Contractor Date I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and fe Code). TOTAL FEE i Lic.or Reg.No Da—Ai-9A) Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's IlAddress License Law for the following reason (Section 7031.5, Busi- City Tel. No. ness and Professions Code): EJI, as owner of the property, am exclusively contracting 1 67 0 A with licensed contractors to construct the project (Section 7044, Business and Professions Code). # 0 0.0 0 0 5 CONSTRUCTION LENDING AGENCY 2 0 0 1300 I hereby affirm that there is a construction lending agency 1 for the performance of the work for which this permit is o 0 0 6 issued(Sec. 3097,civ.C.). 1023-81 Lender's Name Lender's Addn:ss 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 hereby authorize representatives of this County to enter upon the ab 77re;d;pr�operty �inspec�tionpurp�oses. Signature of Permittee Date 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) j or aer�afie c�py th eof (Sec 3800 Lob C ) COUNTY OF LOS ANGELES / BUILDING AND SAFETY Poli 1 0. -, Company&Q6L ❑ Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS / Certified copy is filed with the county building inspec- PI tion department NUMBER FIXTURE OR ITEM @ FEE LOCALITY 7- 14 Date V Appligant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCEOWNER SHOWER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO so as to become subject to the Workers'Compensation Laws. DISHWASHERLD CONTRACTOR �A_,C Date Applicant CLOTHES WASHER ADDRESS P NOTICE TO APPLICANT If, after making this Certificate of SWIMMING POOL RECEPTOR �!`� Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CIT /� � TEL. NO with comply with such provisions or this permit shall be STATE HCl LIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PP,0CESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS o (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL �j' ( °- VALIDATION License Number ," / 0 Lic Class `' DATE U FINAL 0 Contractor &JIM ate y ❑ I am exempt under Sec. �7 ZL B.&P C for this reason Plan check fee PLUMBING PERMIT ISSUING FEE$ 1cD 's 0 4% �,2 A Signatur TOTAL FEE 1.2 r Iso Plan check applicant SINGLE FAMILY 2 0 2 a E 0 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address ° 2 7-' 5 0 Law for the following reason (Section 7031 5, Business and Professions Code). City Tel. No Q ❑ 1, 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 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 jaws regulating Plumbing, and hereby authorize representatives of this County to enter upon the abo -m ntione roperty for tion rposes. Yo� SEE REVERSE FOR EXPLANATORY LANGUAGE a ure of rm Pei tee Date WOR, ERS'COMPENSATI�.Q DECLARATION 78A887A I hereby of .rm that I have a certificate of consent to self CE e17 (z-eo) APPLICATION FOR PLUMBING PERMIT insure, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800,Lab.C.) � OUNTY OF LOS ANGELES / , � BUILDING AND SAFETY Policy No7Umpany Ins Co.Co•�f the ?^I�st Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ® Certified copy is filed with the county bui ding inspection NUMBER FIXTURE OR ITEM • FEE ADDRESS 8909 Las Tunas Drive p t t. WATER CLOSET LOCALITY Temple Cit Date — Applican •° NEAREST BATH TUB CROSS ST. Reno CERTIFICATE OF EX PTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER Home Savings & Loan LAVATORY MAIL (This section need not be completed if the work involved ADDRESS 3731 Wilshire Blvd CL by the permit is for one hundred dollars ($100) or less.) SINK CITY TEL. NO LOS Angeles 03 _19. I certify that in the performance of the ork for which this DISHWASHER permit is issued, I shall not emp y rson in y manner CONTRACTOR Burco Lawn Sprinkler Co. O so as to become subject to th Wor tion Laws CLOTHES WASHER ADDRESS 18756 Erwin Street w Date ft ?_R�Applicant SWIMMING POOL RECEPTOR Cl- CIT NOTICE TO APPLICANT: If, a er making t Certificate of CITY Reseda Calif,91 EL. NO. —'7603 to Exemption, you should be me subject t the Workers' LAWN SPRINKLER SYSTEM 6 0 STATE LIC. C Compensation provisions of he Labor Code, you must forth- LICENSE NO. 2 6 0. CLASS Ci-61 with comply with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. PROQkSSED BY LICENSED CONTRACTORS DECLARATIONOUTLETS OVER O(f I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000) of Division 3 of the Busi- FINAL VALIDATION ness and Professions Code, and my license is in full force and DATE � `Y effect. CC 21A590 C-61 FINAL License Number Lic.Class U BY U Contractor Burco Sprinklers 8-7-84 I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- 1-1050 iness and Professions Code). TOTAL FEE 1E 0 Lic,or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name z3321A I hereby affirm that I am exempt from the Contractor's Address License Law for the followingreason Section 7031.5, Busi- o o 0 0 o 5 ( City Tel.No. i ness and Professions Code): 2 0 0 1 6 5 0 ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project o o c 1 6 50 U (Section 7044, Business and Professions Code). 0808-84 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and St laws regulating Plumbing, and hereby authorize repre t Iv of this County to enter upon the ab -me io d opert f pection purposes. 8-7-84 Sig of Permittee Date ' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1212030032 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: 1 ITR: 362 LT: 01 1 1 8905 LAS TUNAS DR I I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 91780 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 15387-012-028 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, Cl 1 125 LAVATORIES/SINKS 4.00 FIX 64.80 1 ITENANT: 145 WATER CLOSET/URINAL 5.00 FIX 81.00 11SSUED ON: PROCESSED BY: PLAN BY: 1 ICHASE BANK I TOTAL FEES 173.60 112/03/12 SR 1 1OWNER: TEL. NO: I IFINAL DATE FINAL BY: CODE: CHASE BANK (714) 308-6982- 1 i'-� 1107 S. HARBOR BLVD. I IFULLERTON, CA 92832 I IDESCRIPTION OF WORK 1 1 14 LAVATORIES AND 5 WATER CLOSET FOR CHASE BANK T/I 1 I I I I APPLICANT: TEL. NO: I I I IYARN, JUDY (626) 675-9882- 1 1 1 1392 N. LE MAY COURT I ISPECIAL CONDITIONS: 1 (ORANGE, CA 92867 1 1 1 1 I A k 1 (CONTRACTOR. TEL. NO- I 1A P OVALS T� DATE INSPECTOR SIGNATURE 1DBSI INC (602) 264-7263- 1 1 1 16950 W MORELOS PLACE LIC. NO 1UNDER SLAB WORK I ICHANDER AZ 85226 931142 * 1 11 1 I I IWATER SERVICE 1 I IPLASTIC YIN METAL YIN 1ARCHITECT OR ENGINEER: TEL. NO: I 1 IMORFORD, PAUL (949) 863-9434- I IROUGH PLUMBING I 1 14675 MACARTHUR CT, STE 350 LIC. NO: 1 1 1-1 NEWPORT BEACH, CA 92660 931142 (GAS PIPING 1 1 1 IGAS VENT 1 1 I I I I I I I IHOT WATER HEATER 1 I I 1 1 I 1 I I IPLUMBING FIXTURES I 1 I I I I I I ILAWN SPRINKLERS 1 1 I I I I I I 1 1 IGAS TEST I I I I 1 1 1 I 1UTILITY COMPANY NOTIFIED( I I I I I I I I I 1CWV 1 I I I I I I 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 1 I I I I I I I I 1* ADDITIONAL-DATA ON FILE 1 I I I I I 1REPORT ID: DPR263 ROUTE TO: B50508 I I I I I I