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HomeMy Public PortalAbout9701 LAS TUNAS DR_Plumbing__ WORKERS'COMPENSATION DECLARATION APPLICATION PPLIC p TION F®® PLUMBING PERMIT I heSeby, affirm that I have a,certificate of consent to self in- 76666 ADS�� /"� 6tr4 9 1� iJ r i�,�/e surep or'a ceitiftaate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) g �cy NA61i &pany�� �� ., dfYt[77 COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy is hereby furnished. BUILDING ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspection ADDRESS department. `_g) / ] NUMBER FIXTURE OR ITEM @ FEE LOCALITY DcIte D ,�� 26 Applicant�i�4& f/ (j, / WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER' J (This section need not be completed if the work Involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK - CITY TEL.NO. mit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR � Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY sation provisions of'the Labor Code,you must forthwith comp- ly with such provisions or this permit shall be deemed revok- STATELIC. ed. WATER HEATER LICENSE NO. ��� �� CLASS JT LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect. HOSE BIB �' DATE a License Number 639321 —Lic.•Class p 9 V FINAL � � X .� Contractor Sit:! � " 6 C ���Date G^ (6c– �6 BY X O I am exempt under Sec. ~ . V B.&P.C. for this reason W - Plan check fee n, Date' PLUMBING PERMIT ISSUING FEE$ Signature SINGLE FAMILY TOTAL FEE Plan check.applicant licant ' HOME OWNER-BUILDER DECLARATION PP NO FEE I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section.7031.5, Business and Professions Code): Address 0000-0001 6/18/96 ❑ I, as owner of the property,'will do the work and the City Tel. No. 699 1 (�11e0 structure is not intended or offered for sale(Section 7044, Business and Professions Code). CONSTRUCTION LENDING-AGENCY pop 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 regulatU4 Plumbing, and hereby ho ' representativest ' ounty to enter upon the entioned pro f spection.purposes. .96 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date ION DrL ''1K14IIVN ho , •rtificate ` lonsent to"� .. o67A of Work 'ampens, ''on Insurcnce, C118] (RE pi -,ereof (Sec o0C Lab. C, COUNTY OF LOS ANC''ELE$ BUILDING AND SAFETY i V 331 oIpony-_4t: � e C ,tified copy is hereby furnished. BUILDING /^ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certit, d copy is filed with the cc tnty building inspe'- NUMBER FIXTURE OR ITEM @ FEE tion department. LOCALITY •� ._ �1 � �•` WATER CLOSET NEAREST Date�Z / Appli4ant CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB / COMPENSATION INSURAN:E OWNER C SHOWER (This section need not be completed if the work involved by MAIL ` the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this SINK CITY TEL.NO. permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTO to Applicant CLOTHES WASHER ADDRESS C---7.,6' DTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR xemption, you should become subject to the Workers' CITYfy� teJf n 7FY^ TEL. NO.�G�^ :ompensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM LIC. vith comply with such provisions or this permit shall be STATE } -7 deemed revoked. WATER HEATER I1 l� LICENSE NO. (�� /� CLASS �) LICENSED CONTRACTORS DECLARATION V(! DISTRICT NQ. 7 PROCESSED I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS CA/J�J/J (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL �' NALIDATIO a 0 DATE, J V License Number Lic. Class UQ\ FINA BY U I Contractor Date r a ❑ I am exempt under Sec. r Z B.&P.C. for this reason Plan check fee ► Date: PLUMBING PERMIT ISSUING FEE$ 1 1 Signature g TOTAL FEE � Sa � � � �•7•P Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name eby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. ❑ 1 • - 8250 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). T 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.). mcler's Name +er's Address v that I have read this application and state that the , obu )formation is correct. I agree to comply with all County ordina—es and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the ab`.l�/",�t�ned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 1 -2- 6 -9 signature of Permittee Date COUNTY OF LOS'ANGLLES TEMPLE CITY # 0508 .�PLl1MBTA'G�E MIT r DEPARTMENT OF"PUBLIC.WORKS ( 9701 LAS TUNAS PL 0508 9907210005. BUILDING-AND SAFETY / LAND DEVELOPMENT :TEMPLE.CITY,CA 91780 ' PHONE: (626)-285-0488 EXT:' LEGAL ID: FEES PAID BUILDING A DRESS•• ON FILEiA;S_sTREtT: DR= FEE DESCRIPTION:. QUANTITY: LION: AMOUNT:ASS SSOR I ORMATION NUMB R:• KAUFFMAN 01 PERMIT•ISSUANCE FEE 0.00 •GRID:: LOCALITY: TEMPLE CITY 53-MED/HIGH GAS 5 OUTL.' 1.00 SYS 0.00 TENANT: 54 ADDN OUTLETS > 5 1.00 OUT 0.00 ISS.. 0 P C SSED AN BY: EXPIRES ON: TOTAL FEES - 0.00. 07/22/99 UT 01/18 OWNER: TEL'-NO- FINAL DATE FINAL:BY: DE: CITY OF TEMPLE CITY• .(626).285-2171- 9701 E. LAS TUNAS DR Q TEMPLE CITY, CA DESCRIPTION OF WORK GAS LINE FOR NEW HVAC SYSTEM APPLICANT: TE 0: ARMOND BAGHRAMIAN (818) 249-8852- 2315 MONTROSE AVE. SPECIAL CONDITIONS: MONTROSE, CA CONTRACTOR: TEL. NO: OS ��A APPROVALS DATE INSPECTOR SIGNATURE ARMOND BAGHRAMIAN (818) 249-9751- �. y 2315 MONTROSE AVE, #101 LIC. NO UNDER SLAB WORK MONTROSE CA, 91020 559043.B •1 WATER SERVICE fl PLASTIC Y/N METAL Y/N ARCHITECT 0 EMU HE ---TEL. �- � • ROUGH G. LIC,. NO!' 11111.1] S PIPING ' I T C UBL�C W 0U-mllK y TER TER PLUMBING FIXTMYS • • di LAWN, SPRINKLERS ❑ al R GAS TES A4 ® f ®5UTILITT COMPANY 0 cwy 'c'Service Tha" G AY ATER.S S REPORT•ID: DPR263 • ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT s DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ( PL 0508 0008230013 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID IB I DI G ADDRESS: ON FILE 9701 LAS TUNAS DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 91780 �. ASSESSOR nWORMATION NUMBER: jNEARESTCROSS STREET:;•KAUFFMAN \ 01 PERMIT ISSUANCE FEE 0.00 THOMAS PAGE: GRID: LOCALITY: TEMPLE'CITY 17 FLOOR DRAINS) 2.00 FIX 0.00 TENANT: 25 LAVATORIES/SINKS 4.00 FIX 0.00SSUE, ON: PROCESSED BY: PAN BY: EXPIRES N: 45 WATER CLOSET/URINAL 5.00 FIX 0.00 08/23/00 UT 02/20/01 TOTAL FEES 0.00 1 OWNER: TEL. NO: FINAL;D TE FIN BY: CODE: CITY OF TEMPLE CITY (626) 285-2171- (4,� 9701 E. LAS TUNAS DR TEMPLE CITY, CA DESCR PTIN OF WORK PLUMBING FOR RENOVATIONS TO MEET ADA REQUIREMENTS APPLICANT: TEL. NO: SBS CORPORATION (626) 794-4838- 1260 LINCOLN AVE SPECIAL CONDITIONS: PASADENA, CA P�GELES Co CONTRACTOR: TEL. NO: yGS � APPROVALS DATE INSPECTOR SIGNATURE S B S CORPORATION (626) 794-4838- 1260 LINCOLN AVE LIC. NO UNDER SLAB WORK SUITE 1000 742782 B PASADENA, CA 91103 WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. NO: ROUGH PLUMBING LIC. No , 1111111 GAS PIPING GAS VENT 15)E� �J M w©Fl! OT WATER HEATER ���/ uuu PLUMBING RES y AWN SPRINKLERS A � 0 ® ' ®g GAS EST El r TILIT COMPANY NOTIFIED 46iic mot cWV SL'rVIC@-fhat GRAY WATER SYSTEM 4 * ADDITIONAL DATA ON FILE REPORT ID: DPR263 ROUTE TO: BS0508 iti COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS J PL 0508 0401220029 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 i PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING-ADDRESS:, ON FILE I 9701 LAS TUNAS DR FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 91780 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: KAUFFMAN 01 PERMIT ISSUANCE FEE -' 0.00 THOMAS PAGE: GRID: IT _ LOCALY: TEMPLE CITY 25 LAVATORIES/SINKS 2.00 FIX 0.00 TENANT: TOTAL FEES 0.00 ISSUED ON: PROCESSED BY: PLA BY: EXPIRES ON: CITY OF TEMPLE CITY 01/22/04 VG 07/20/04 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: CITY OF TEMPLE CITY (626) 285-2171- / 9701 LAS TUNAS DR. I -`' _c� TEMPLE CITY, CA i DESCRIPTION 0 PLUMBING FOR REMODEL APPLICANT: TEL. 0: ANGELES CONTRACTOR (714) 899-1826- i SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ANGELES CONTRACTOR (714) 899-1826-' ; 7446 ORANGEWOOD AVE. LIC. NO UNDER SLAB WORK GARDEN GROVE, CA 92841 748477 B WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. NO: ROUGH PLUMBING LIC. NO: GAS PIPING GAS VENT OT WATER HEATER PLUM5fNG FIXTURES LAWN SPRINKLERS GAS TEST I UTILITY COMPANY OTIFIED i CWV GRA I ATER SYSTEM i .I i I I I REPORT ID: DPR263 ROUTE TO: BS0508 • 1 It