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Home My Public Portal About9090-9092 LAS TUNAS DR_Plumbing__ D.B.S.17 25M SETS 12.44 APPLICATION FOR PERMIT . DEPARTMENT OF BUILDING AND SAFETY, PLUMBING COUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE e � �v HEATER CESSPOOL I-I SEPTICA TNK RECEIVED BY DATE ISSUED READY FOR * FIRST INSPECTION ; � GAS MISCELLANEOUS //7 `Y`�/ APPLIC FILL IN HEAVILY OUTLINED PORTION ONLY JOBC NAMEck2e�� ',/ L ADDRESS W t m ADDRESS " LOCALITY '� c NEAREST IL CITY ♦- TEL.N ��fl CROBH ST. v EXPIRES A m NAME LOCATION OF SEPTIC TANS, OR C SSPOOL, z MAIL ,/ 3 ADDRF.88 / �g/(O NORTH O CITY TEL.NO. 1 AM THE LEGAL 088E R O LOH ANGELES COUNTY CERTIFIC E OF IC 1 1 PLU B[R 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. OWNER CORRECTIONS SOUTH I.a d DESCRIPTION OF WORK c� PATH TUB FURNACE ►w a 0 SHOWER DISHWASHER LAVATORY REFRIGERATOR -KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INBPZCTOR'S NAME _WATER HEATER DENTAL LAVATORY ROUGH PLUMBING re METER GAS ODA FOUNTAIN Y M OUTL S GAS PIPING �� .i GAS VENT IV CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSPOOL BEPTICTANK SEWER I 4 TOTAL FEE UTILITY CO.NOTIFIED I f1�/ FINAL r- °.a.s."•` z_"' APPLICATION FOR PERM DEPA€tTT OF BUILDING AND SAFETY COU ��'�� COUNTY OF LOS ANGELES Wm. J. FOX, CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE _ HEATER CESSPOOL 1-1 SEPTIC TANK RECEIVED BY READY FOR DATS ISSUED FIRST INSPECTION AS MISCELLANEOUS AAPPPL`I'CANT FILL IN HEAVILY OUTLINED PORTION ONLY NAME �./ �Q... C.C/Lr... JOB k% NAME „.�.•, —ADDRESS W ADDRESS 5`�j �1a., f ,. LOCALITY NEAREST C CITY TEL.NO. -,4�_4n7�+' CROSS ST. COUNTY / CERT.No. - EXPIRES Ir NAME W LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL.No. IAM THE LEGAL POSSESSOR OF THE ABOVE LOS E ANGLES COUNTY CERTIFIC/�TJz-0F QUALIFICATION. }. �ter• 7 � ! f PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ry► ABOVE. Ili D 3 i OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK a z is HATH TUB FURNACE 13_ IY SHOWER DISHWASHER Q LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INBPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER--GAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT I I CESSPOOL TOTAL NUMBER OF FIXTURES C SEPTIC TANK CESSPOOI SEPTIC TANK SEWER UTILITY CO.NOTIFItD TOTAL FEE FINAL L 1 76A667 (CE-817)-4/72 APPLICATIO F 4L MBI N PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION 17Te ! MAKE CHECKS PAYABLE TO- oZ a"AS HARVEY T. BRANDT, COUNTY ENGINEER V m G l FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST �� CROSS ST. NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET 1.75 OWNER S MAIL M BATH TUB 1.75 ADDRESS SHOWER 1,75 CITY TEL. NO 7 LAVATORY 1.75 CONTRACTOR , �Ci --7--AkPnq SINK 1.75 ADDRESS ! '0 DISHWASHER 1.75 CITY ' TEL N04(V 017O CLOTHES WASHER 1.75 STATE h LIC LICENSE NO pL/ 9 CLASS SWIMMING POOL RECEPTOR 1.75 TRICT NO. GROUP ZONE FRO SED BY LAWN SPRINKLER SYSTEM 1.75 D r 1 C WATER HEATER 1.75 INDUSTRIAL WASTE APPROVAL a GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD U OUTLETS OVER ,30 5 PER SYSTEM O F- C� W N Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE Plan check applicant APPROVALS DATE INSPECTOR 5 SIGNATURE UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING 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 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REOUI L RED BY OS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE DES IBED RESIOENL PROPERTY FINAL SIGNATURE &W^f OF PERMITTEE 17N4L PERMIT VALIDATION OCKM.o c s PLAN CHECK VALIDATION CK. M 0 CASH 4 Ar, 8 o � .3 AUGAUG21 5 D 4;754 pp__ T D.B.S.-17 25M SETS 12-4. APPLICATION FOR PERMIT DEPARTMENT OF BUILDING SAFETY PLUMBING 1 COUNTY OF LOS ANGELES , Wm.J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. I GROUPi `fZ,ONE PERMIT No, ROUGH _ FIXTURES_ COMPLETE F I /, 'wl�6`--' D BY READY FOR DATE ISSUED HEATER _ CESSPOOLRECEIVE I SEPTIC TANK FIR READY _. GAB I MISCELLANEOUS STINSPECT APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY JOB 410TANA PLUMRI�CONTRACTORS ADDRESS / id III ADDRE� W, Garvey)�Mont;ere} P8T��, LOCALITY D �JAnti% 24654 NEAREST .J CITY TEL.No. __ _ CROSS ST. IL COUNTY'' A CERT.IVdr EXPIRES 3O It NAME a. W i— LOCATION OF SEPTIC TANK, OR CESSPOOL 3 AMAIL DDRESS NORTH O - -- -- -� CITY TEL.No. IAM THE LEGAL POSSESSOR OF TH.Ilf ABOVE LOS ANGELES COUNTY CERTIF10 1GAT1 N PLUM EER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. M D -- rOWNER CORRECTIONS SOUTH a DESCRIPTION OF WORK --- ---- -- BATH TUB FURNACE aHOWER DISHWASHER O LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP RLOP SINK ---FLOOR DRAIN —WASH TRAY URINAL APPROVALS WATER CLOSET ___ DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER _---DENTAL LAVATORY ROUGH PLUMBING P` METER�dAB SODA FOUNTAIN GAS PIPING OUTL GAS VENT _ _CESSPOOL TOTAL NUMBER OF FIXTURES ._.._^_ SEPTIC TANK CESSPOOL- 91EPTIC TANK SEWER TOTAL FEE Q v1 Al •- UTILITY CO.NOTIFIED '�-� I FINAL "e A ou CE 817 868 s APPLICATION FOR PLU BIN PERM COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FNEAREST JOHN A. LAMBIE, COUNTY ENGINEER _S COLEMAN W. JENKINS. SUPT. OF BUILDING �- FOR APPLICANT TO FILL IN(PR NT OR TYPE) CROSS ST. Q? NUMBER FIXTURE OR ITEM EACH FEE WATER CLOSET 1.50 OWNER I� 1, S GlL MAIL BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY TEL. NO. LAVATORY '� 1.50 '^b CONTRACTOR h A ki 617AG SINK 1.50 ADDRESS jo P5 DISHWASHER 1.50 CITY 1 TEL. 2 /�Le°7 CLOTHES WASHER 1.50 STATE VLICENSE NO. LIC LICENSE �i CLASS C 311�J e, SWIMA1ING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE SSED BY a LAWN SPRINKLER SYSTEM 2.00 U WATER HEATER 1.50 INDUSTRIAL Z WASTE APPROVAL C:) GAS SYSTEM 7Z-OUTLETS 1.50 INSPECTION RECORD v w OUTLETS OVER a 5 PER SYSTEM 30 Z Plan check fee 2S% of above. See reverse. PLUMBING PERMIT ISSUING FI,:E•; 8 2 00 TOTAL FEF. O APP O A DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER-il*i WO K - I Name ROUGH PLUMBING Address GAS GAS PIPING GAS VENT City Tel• No. 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 GAS TEST PLUMBING. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,A INTEND TO 4L 07 RESIDE IN,THE ABOVE DESCR BED RESIDENTIAL P7lOPE �/. FINAL / SIGNATURE PERMITTEE d � ^'"�� '� JACK R. ALLEN SUPERVISING HANICAL EN G'R. PERMIT VALIDATION CK.' M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH v 6 3' jUN 4 5 D 9.50- �tir�J t1 BS-I DAPPLICATION FOR PLUMBING PERMIT Bs., sDSIVISION OF BUILDING AND SAFETY Deportment of County Engineer County of Los Angeles BUILDING JOHN A LAMBIE, COUNTY ENGINEER ADDRESS %-a !. CASSATT D GRIFFIN,SUPT OF BUILDING i LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. OWNER DIST RI O. I GROUP ZONE NE I READY FOR INSPECTION MAIL ADDRESS 7ZG U (�Li�µ•E�p WJ�-" INDUSTRIAL CITY TEL. NO WASTE APPROVAL PLUMBER ',, nom. ) INSPECT ON RECORD ADDRESS Lp '�J CITY TEL NO i LICENSE NO.NO. 1 P Q .. ` / NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 $ BATH TUB @ $1.00 SHOWER @ $1.00 fi LAVATORY (WASH BASIN) @ $100 KITCHEN SINK @ $1.00 DISHWASHER @ $100 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $100 WATER HEATER @ $1.00 GAS SYSTEM @ $1 00 APPROVALS DATE INSPECTOR'S SIGNATURE A UNDER SLAB WORK A PERMIT $ 100 ROUGH PLUMBING 1 A A1SApc�-�... — GAS PIPING TOTAL FEE �� GAS VENT I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE J OF PERMITTEE FINAL i� A JOHN�A. LAMBIE, COUNTY ENGINEER /'�(ALIDATION ROBERT A.WOOD, CHIEF PLBG. INSPECTOR CK J M.0 CASH 8503U. mm2/ 3 3.00 In 1 . G> , 16 A 67—CE 817 8/68 APPLICATION FOR PLUMBING PER; /iT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER F ILDiNG r �BUILDING AND SAFETY DIVISIONDRESSJOHN A. LAMBIE. COUNTY ENGINEERn AsCOLEMAN W. JENKINS SUP T OF BUILDING CALITYf f C FOR APPLICANT TO FILL IN PR NT OR TYPE) ARESTAOSS ST. NUMBER FIXTURE OR ITEM EACH FEE WATER CLOSET 1.50 OWNER MAIL BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY TEL. NO. LAVATORY 1 50CONTRACTOR SINK 1 s0 ADDRESS DISHWASHER 1 50 CITY ) TEL. N6' . /'�� CLOTHES WASHER 1.50 ATE LIC LICENSE NO C( / CLASSIC 3't43c 2 SWIMMING POOL RECEPTOR 1.50 DISTRICT GROUPZONE Pfo E a LAWN SPRINKLER SYSTEM 2 00 U WATER HEATER 1 50 INDUSTRULL WASTE APPROVAL CD GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD w OUTLETS OVER 30 N 5 PER SYSTEM Z Plan check fee 25io of above. See reverse. PLUMBING PERMIT ISSUING FEF. 8 2 00 TOTAL FEE - APPROVALS DATIF INS4CTOR g Sr NATURE Plan check applicant UNDER SLAB WORK (� Name ROUGH PLUMBING / Address GAS PIPING GAS VENT CIL)' Tel No 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 GAS TEST PLUMBING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL OP Y FINAL SIGNATURE / OF PERMITTEE 9 _ l.�L/�� JACK R. ALLEN SUPERVISING ECH ANICAL EN G'R PERMIT VALIDATIO cK M o CASH PLAN CHECK VALIDATION CK M o CASH i tt'- 0 Z 5 5 r JUN 5 D 3,50 76A667-CE#617 5/63 /K>�''"�✓ _ APPLICATION FOR "'PLUMBING FERMI COUNTY OF LOS ANGELES "�t DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUIiniNG JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS' Q�/� WILLIAM A. JENSEN, SUPT OF BUILDING OOCALITY FOR APPLICANT TO FILL IN NEAREST CROSSST: NUMBER FIXTURE OR ITEM EACH FEE . OWNER WATER CLOSET $1.25 MAIL /,nn BATH`TUB 1,25 ADDRESS V t! SHOWER 1.25 CITY L, Tn. NO.. SZ fl 16 LAVATORY 1,25 CONTRACTOR SINK 1.25 d ADDRESS ' DISHWASHER 1.25 CITY' TEL. NO LAUNDRY TUB 1.25CONTRALTO / STATE REGISTRATION NO. (: COUNTY p' CLOTHES WASHER 1.25 .DfTR�T,NO. UP ZONE WATER HEATER 1:50 /L-3 r 1.50 INDUSTRIAL a GAS SYSTEM OUTLETS WASTE APPROVAL O OUTLETS OVER S PER SYSTEM .30 INSPECTION RECORD V a � r r Z APPROVALS DATE -INSPECTOR'_S S GI NATURE PERMIT $ 2 00 UNDER SLAB WORK 1 ) 1 ROUGH PLUMBING ,� - 1 �✓✓ TOTAL FEE 31 GASR.IPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION` GAS VENT' ,AND STATE THAT THE ABOVE IS CORRECT AND AGREE TOCOMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING' HOT WATER HEATER PLUMBING. 1. HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF: GAS TEST CALIF„ORNIA ,OR..THAT M THE LEGAL OWNER OF AND INTEND TO .RESIDE IN;THE ABOV D CRIBED RESIDENTIAL P RTY. UTILITY CO. NOTIFIED NATURE SOF\P E�RMITT EE - ..F�NA.L ,/ /fiK7t ICASS�!) ROBERT A. WOODCK. M.Ot SUPERVISING MECHANICAL ENG'R - ,&� .7'6 9 9'10: AN 2 0 5 D 3.5 O'N a , D.B.B.17+25M�ET8 10-47 APPLICATION FOR P$RMIT D41W&ENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES �`uB' G 1 WN.J.FOX.CHIEF ENGINEER NATURE-OF INSTALLATION DISTRICT NO. GROUPI o l P IT O. ROUGH FIXTURES COMPLETE J �7 e-Z"` I? �p HEATERCESSPOOL I-I BFI+TiC TANK RECEPAD BY READY FOR FIRST DATE ISSUED -- PiRST I � -wAS- MIBCELLAN UB 11111111211 -.,e r APPLICANT 1FILL IN HEAVILY OUTLINED PORTION ONLY � 1 E NAME/ L 2_7 �/tom. . ,Givw{ ADDRESS 6 /e+4�J4 GLO ADDRH��89g8 62 7 Aj/ �I ,i T 7 LOCALITYNEAREST /C{ G CITY /'j dt>` TEL.No./t J 1� ' / CROSS 67. COUNTY- No CERT. . 71 S FIti. EXPIRES d / O 0 NAME /JJ1 LOCATION OF SEPTIC TANK R CESSPOOL z MAIL 1� ` /C� NORTH /� ��( 4-%a,40 ADDRE86�7� V P CITY A � TEL.No.� IS I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. PLUMBER f-^� I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED. ! ABOVE. t9 i OWNER IIIIIII CORRECTIONS �I dam' SOUTH I _I DESCRIPTION OF WORK z BATH TUB FURNACE ROWER DISHWASHER 0 LAVATORY REFRIGERATOR -KITCHEN BINK WATER SOFTENER FLOOR BINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE IN CTOR'B NAME _WATER HEATER DENTAL LAVATORY ROUGHPLUMBING I ,� METER L GAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT CESSPOOL I /D TOTAL NUMBER OF FIXTURES J a SEPTIC TANK I A CESSPOOL SEPTIC TANK SEWER I / I. $ !' �Y UTILITY CO.NOTIFIED I I TOTAL FEE J I7 FINALI �^• D.B.S.-17 25M SETS 6-46 APPLICATION FOR PERMIT.. DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBINGWM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRI GROUP ONE PERMIT NO. ROUGH FIXTURES, COMPLETE 9-fv HEATER CESSPOOL I I SEPTIC TANK IY D BY READY FOR DATE ISBUEEEppp FIRST INSPECTION AS MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY K NAME M. C. NOTTINGHAM CO. ADDRESS 7 IQ ADDRESS 123 No. Cloverly Ave. LOCALITY D NEA REST I CITY TEMPLE, aw-yNu iir czosB ST. COUNTY T CERT.NO. EXPIRES W NAME LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 2 It NORTH O ADDRE8 C/A �($�I404— CITY TEL.No. 1 AM THE L6 AL POSSESSOR OF THE ABOVE LOS ANGELES COON CERTIFICATE OF QUALIFICATION.. PLumeER/ I AM THE LEGAL OWNER OF THE PROPERTY✓ ESCRISED ABOVE. 3 OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK a z_ BATH TUB FURNACE SHOWER DISHWASHER Q LAVATORY REFRIGERATOR KITCHEN BINK WATER SOFTENER FLOOR SINK SAND TRAP GLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER GAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT I j .CESSPOOL TOTAL NUMBER OF FIXTURES y� SEPTIC TANK —CESSPOOL SEPTIC TANK SEWER I. I UTILITY CO.NOTIFIED + I TOTAL FEE 'FINAL WhKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT m that I have a certificate of consent to self 20-0026 DPW 6/87 insure, or a certificate of Workers' Compensation Insurance, 76A667A br a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS P❑oll&y'No Company &rtified copy is hereby furnished ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING t •� y Certified copy is filed with the county building inspec- ADDRESS tion department ti NUMBER FIXTURE OR ITEM @ FEE LOCALITY • �l_17 _?? qq�r 2!\�� WATER CLOSET Date Applicant 1NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST .y COMPENSATION INSURANCE SHOWER OWNER tl J .ry This section need not be completed if the work involved by MAIL the permit Is for one hundred dollars($100)or less.) LAVATORY ADDRESS ,� I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL NO2$ � so as to become subject to the Workers"Compensation Laws DISHWASHER CONTRACTOR �f ,�1,y,7 C.►'— Date` 'r/ 7- Pic, �z y CLOTHES WASHER oo ADDRESS NOTICE TO APPLICANT- If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR . wt Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITYjGvl TEL NO.3r� 7Gt Q with comply with such provisions or this permit shall be STATE �.� LICC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION YSTRICT 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 J and Professions Code,and my license is in full force and effect 5 PER SYSTEM FINALVALIDATION 8v ��`j Lic Class C` '3 C DATE "(� U License Number Contractor IV "�1� Date-1-7�Y� BY AL ��Q / ` O, ❑ 1 am exempt under Sec �j V L� B 8P C for this reason Plan check fee Date � PLUMBING PERMIT ISSUING FEE$ 161 Signature � TOTAL FEE SINGLE FAMILY Plan check applicant C' HOME OWNER-BUILDER DECLARATION Name ACCT •a I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031 5, Business and ��7 �} tl Professions Code) City Tel No❑ 1 ITEMS 1, as owner of the property, will do the work and the structure is not intended or offered for sale (Section TOTAL 22 -50 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY CHECK 222 50 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued CHANE • (Sec 3097, Civ C ) Lender's Name R'� 00900-0001 5/17/35 Lender's Address 3349 1 AM 10'- 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 County to enter upon the above-mentioned property for inspection purposes J��• 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 1404210002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0486 EXT ILEGAL ID FEES PAID BUILDING ADDRESS I ITR 590547 I I 9092 1/2 LAS TUNAS DR E I I IFEE DESCRIPTION QUANTITY UOM- AMOUNT I TEMP CA 91780 I (ASSESSOR INFORMATION NUMBER I 1 NEAREST CROSS STREET 15387-023-013 101 PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE. 596 GRID H3 LOCALITY TEMPLE CITY CAI 1 125 LAVATORIES/SINKS 1 00 FIX 16 20 I 1 ITENANT I TOTAL FEES 44 00 (ISSUED ON PROCESSED BY PLAN BY I I I 104/21/14 SR I I I I• I 10WNER TEL NO I INAL DATE FI AL CODE I IWONG, AMY (626) 215-6522- I 1 I 11541 WALNUT STREET I 1FII ISAN GABRIEL CA 91776 I IDERIPT'IOWOFJWORK I (REPLACE KITCHEN SINK I I I I I (APPLICANT TEL NO- ITRAN, BAC (626) 409-8820- I I I 14213 ROSEMEAD BLVD I ISPECIAL CONDITIONS IROSEMEAD CA 91770 1 1 I I I I I I I I ICONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE IBAC TRAN (626) 409-8820- I I 14213 ROSEMEAD BLVD #G1 LIC NO (UNDER SLAB WORK I I IROSEMEAD CA 91770 884875 I 1 I I I I (WATER SERVICE I I I I (PLASTIC YIN METAL YIN I I 1 (ARCHITECT OR ENGINEER TEL. NO I I I I I - I IROUGH PLUMBING LIC NO I 1 ( 1 I I IGAS PIPING I I I I I I I I 1 IGAS 'DENT I I I I I I I I IHOT WATER HEATER I I I I I I IPLUMBING FIXTURES I I I I I I I I ILAWN SPRINKLERS I ! I I I I IGAS TEST I I I I i 1 11 1 (UTILITY COMPANY NOTIFIEDI I I I I 1 1 1 I I ICWV 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 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 (REPORT ID DPR263 ROUTE TO- BS0508 I I I I I I I