HomeMy Public PortalAbout9906-9910 LAS TUNAS DR_Plumbing__ WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT
I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87
insure, oc,a certificate of Workers' Com ensation Insurance, 76A667A
or a certif d coppthereof (Sec 3800, `C )� COUNTY OF-LOS ANGELES 'DEPT. OF PUBLIC WORKS
Policy Np� 9Gs Company w�
❑ Certified copy is hereby furnished
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
Certified copy is filed with the county building inspec= ADDRESS 9908 Las Tunas Dr . #A
t n 0epa t ent NUMBER FIXTURE OR ITEM @ FEE LOCALITY
/SWATER CLOSET Temple C i t
Date Appli4antF_444_,:3� NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST
COMPENSATION INSURANCE- SHOWER OWNER rq t
(This section need not be completed If the work Involved by MAILr
the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRE0,9 0 8 Las Tunas Dr. #A
I certify that in the performance of the work for which this SINK O U CITY TEL N0213/282-E813
permit is issued, I shall not employ any person in any manner -Temple 1 e Cl t
so as to become subject to the Workers'Compensation Laws DISHWASHER
CONTRACTOR
Fran)C Marrone and Sons
Date Applicant CLOTHES WASHER ADDRESS 9860 Lower Azusa' Rd .
NOTICE TO APPLICANT If, after making this Certificate of
Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR
P Y I CITY E1 Monte TEL No 444-254E -
Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM
with comply with such provisions or this permit shall be STATE UC
deemed revoked WATER HEATER LICENSE NO 3 9 7 8 8 4 CLASS C/36
LICENSED CONTRACTORS DECLARATIONTRIC7 NO P E ED BY
I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS
(commencing with Section 7000) of Division 3 of the Business OUTLETS OVER
and Professions Code,and m license is in full force nd effect 5 PER SYSTEM >=
Y FINAL -. VALIDATION n.
�i DATE , F . ,� QQ
License Number O Lic Class � C7
/ G FINAL_ �,, •
Contracto 14 Date / S o BY
I am exempt under Sec. U
B BP.0 for this reason ELI
Plan check fee )
Date PLUMBING PERMIT ISSUING FEE$ dO
Signature70
TOTAL FEE
Plan check applicant
SINGLE FAMILY _ 5
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm that I am exempt from the Contractor's License Address ACCT
04 -
Low for the following reason (Section 7031 5, Business and
Professions Code) City Tel No —"" '"" 3307 p i6, 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) , -i .,_x - IOTA. M-6 o 50
CONSTRUCTION LENDING AGENCY '_ MICK 1bavJtl
I hereby affirm that there is a construction lending agency for �y
the performance of the work for which this permit is issued _ - ONE _ .00
(Sec 3097, Civ C )
Lender's Name1 6/20/89
Lender's Address - 4070 g N1 8o°°24
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
eve-mentione roperty for inspection purposes
SEE OEVERSE'FOR EXPLANATORY LANGUAGE
Signature of Permittee Date
,'r4-' -WORKERS'COMPENSATION DECLARATION '. h 1 ,° •• 1 _ ` , / /���
I•herebq.'efffirrrthaf r'haGe a certificate of corse'nt to self 20,-0026 DPW 4/87 APPHCATION FOR PLUMBING PERMIT
n 76A667A' ;
sure,•or a cFrtificate of.Workers',Compensation Insurance`or a CE 817,(REV 8/86) at =
certified cop h " of (S 3800, Lab C ) .i
Polity No ompany COUNTY OF LOS,'ANGELES „DEPT.,OF•PUBL,IC,WORKSt; _- t
Ce
rtrfied copy is hereby furnished' r" i
P ° FOR APPLICANT TO FILL IN PRINT OR•TYPE BUILDING;
Certified copy is filed with the tour ty building inspection ( ) ADDRESS't Af7W4 ,-i
` department �" f'•
NUMBER FIXTURE OR ITEM.. - Lla FEE"
LOCALITY
Date Applicant J , WATER CLOSET(TOILET). 0D• D NEAREST -• C
s '
BATH TUB CROSS ST i•
CERTIFICATE OF EXEMPTION FROM,WORKERS' _
' `'COMPENSATiION INSURANCE .' :. * I . OWNER i
SHOWER' y _
(This section need'not be-completed If the work)nvolved°by _ s n f MAIL
the permit,is'for one hundred dollars ($1,00)or les's_:) LAVATORY a ADDRESS ��
Idcerirfy,that in the+performance of the'work for which this per- SINK ` �.p
mit rs issued, I shall not employ any person in an'y mar ner so ' x CITY a } TEL N Pd'D 1�If /yDa
as'to•become.sublect-tosth'e,Workers' Compensation Laws
- DISHWASHER. ,
:CONTRACTOR t,e ,
Date Y ' App icant- o• IN CLOTHES WASHER R �1
NOTICE TOAPPLICANT If;'after making this Certificate of Ex'- ADDRESS--
8
emptior, you shouSWIMMING POOL RECEPTOR
ld become subject to the Workers Compen- CITY�� �� TEL NO
m3t'
sation provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM Sa
ly with-'such'provision's of this permit shall'be deemed revok- - STA LIC ,
ed'• '�• �� WATER HEATER D LICENSE NO i�z3i CLASS C
LICENSED CONTRACTORS DECLARATION . DISTRI O PROCESSED BY- `
I•hereby'faffirm"that I am licensed under pfovisions of Chapter F GAS SYSTEM , OUTLET �, , Aa
9(commencing with Section 7000;8.f Division 3 of the Business, OUTLETS OVER ,
„and,Profess(ons Cod and miceenns_e is m9full force and ef- 5 PER SYSTEM FINAL VALID ON �'
feet �3 D. _ b !� 0
_ DATE- O
License Number Lic' Class (>
r
ContractorT`� �Gyi!- Da v BIZILY . O
I am'exempt under-SecLLI
B'BPC for ihi`s'reason ^� Plawch'eck fee,'
`%, K. 9'8 2`7 A g
1 '; Date PLUMBING PERMIT ISSUING FEE'$
Sig'nature a _ .''• # d,o;o 0 0 5
TOTAL FEE a
SINGLE FAMILY
r Plan check a licant - ,'( �-2 9&•5 0
HOME OWNER-BUILDER DECLARATION PP r
_ i.
I hereby affirm that I.am exempt from the,,Contr6ctor _'s License Name ' - + `✓ o o •
F _ 29&-50=U
Law for the following reason (Section-7031'5, Business and ' a 4•t',
Professions Cade) r Address' t . ?a , , �, i t i 0.•6, 0 9 8 8''S'>
I,"as-.ow,ner of the•property, will do the work'and they' City,_ �. ' ? '''. Tel- No
structure is not intended or'offered,fo"r sale'(Section 7044,'
Business-and-Professions.Code)
' CONSTRUCTION LENDING•AGENCY ��
;,r' _ s '
I hereby affirm'that there is a construction lending agency for
the performance of the'wor*,'or,which,this permit ,s issued
(Sec 3097, Civ
Lender's Name'
Lender's Address °' - N • �• ' - _ - Y • . - • '
I certify that•I have lead this:application and-'state that the'
above information is correct kagreta comply.with'all County
ordinances and State laws regulating Plumbing, and hereby „
authoni representatives of this'County to enter upon the' "
above; entioned proper ori ectwn purpose q- r
SEE-REVERSE FOR EXPLANATORY,LANGUAGE
g atur0 Permittee 160te _
^ , )
WORKER'S,COMPENSATION DECLARATION 20-0026 DPW 9/89 f
76A667A
I hereby affirm that I have a certificate of consent to self insure, APPLICATION FOR_ • PLUMBING PERMIT-
'
or a certificate of Worker's Compensation Insurance, or,a certified '
copy thereof(Sec 3800 Lab C) -
COUNTY OF LOS ANGELES' DEPT OF PUBLIC WORKS DEPT.OF PUBLIC WORKS,DIV-.
Policy No Company r r
Certified copy is hereby furnished 1
`;FOR-APPLICANTJO FILL IN(PRINT OR TYPE) - -" BUILDING G• �-
Certified copy'is fled with the county budding inspectionADDRESS - /D -(!« -74 -3S Q Q 7
department NUMBER FIXTURE OR ITEM R FEE,, LOCALITY
WATER
Date Applicant CLOSET
NEAREST _
,,,,CERTIFICATE OF EXEMPTION-FROM WORKERS'-, CROSS ST
BATH TUB `
COMPENSATION INSURANCE ASSESSORQ 7 9 /�
- S - - MAP BOOK U�� PAGE �V PARCEIs��
(This section,need not be completed if the the work involved by the
permit is for one hundred'dollars($100)or less.) OWNER
LAVATORY
I certify that in the performance of the work for which this permit
is issued, I shall not employ any person in any manner so as toMAIL
SINK a Q ADDRESS
become subject to the Workers! Compensation Laws
DISWASHER CITY - - TEL NO
-
Date Applicant t��GtwL ��"� CLOTHES WASHER
NOTICE TO-APPLICANT If, after making this Certificate of CONTRACTOR 0 G�02
Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR
provisions of the Labor Code, you must forthwith comply with,such ADDRESS 20• iJ�-�,
provisions or this permit shall be deemed revoked LAWN SPRINKLER SYSTEM p `501 •GAO
LICENSED CONTRACTORS DECLARATION CITY 1�- TEL NO
I hereby affirm that I am licensed under provisions of Chapter 9- 77 WATER HEATERLIC
(commencing with Section 7000) of Division 3 of the Business,and GAS SYSTEM OUTLETS LICENSE STATE, NO �5Z I 03 6 CLASS O
Professions Code, and my license is in full force and effect '
OUTLETS OVER DISTRICT NO PROCESSED BY Q
F2 5 PER SYSTEM J Q
License Number 5 6 22S6 Lic Class�m LJ•*��
FINAL LL!
VA-,V, 1w�4�Z DATE
r 1 VALIDATION a
Contractor �/rr7/V� V r�'�� -Date
❑ I am exempt under Sec FINALZ
B&P C for this reason _ _ •
Date
Z j� .� Plan check fee "
Signature PLUMBING PERMIT ISSUING FEE$
❑ TOTAL'FEE 3i r-
Plan check applicant,
SINGLE FAMILY .i T:
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm that I am exempt from the Contractor's License Law , �.4- a�;�' i- Y
for the fallowing reason (Section 7031 5, Business and Professions` Address _,
Code) \ ! - —
" City Tel No
❑ - I,as owner of the property,will do the work and'the`structure jTt j t t
is not,intended or offered for sale (Section 7044, Business
_and Professions Code)- , i;3 ,',' J ,
CONSTRUCTION LENDING AGENCY '" 2.
I hereby affirm that there is a construction lending agency for the _
performance of the worOfor,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 County to enter upon the above-mentioned }
property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE "
Slgnature-of Permittee Date - } ,
WORKERS' COMPENSATION DECLARATION- APPLICATION. FOR PLUMBING PERMIT `
I hereby affirm that I have a certificate,of consent to self 20*0026 DPW 6/87
insure, or a certificate of Workers' Compensation,ln-surance, 76A667A
or-a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
A
'Policy No='-7-Company
Fl Certified copy is hereby furnishedBUILDING
FOR APPLICANT TO FILL IN(PRINT OR TYPE) ; t
Certified copy is filed with the county building inspec-. ADDRESS
tion department e NUMBER FIXTURE OR ITEM ,;`CV FEE
P ! `ik• a, LOCALITY
WATER CLOSETTem'ple City
`° S
Date % Applicant I NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' I BATH TUB CROSS ST
,;COMPENSATION INSURANCE OWNER
- SHOWER
(This '
(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 fo�-which this r,
permit is issued', I shall not employ any person in any,manner' SINK f. CITY TEL NO
so as to become subject to the Workers'•Compensation Laws DISHWASHER $�
, CONTRACTOR if
Date Applicant CLOTHES WASHER''-
NOTICE TO 'APPLICANT If, after making this Certificate of ADDRESS �$�Q`` li Azusa 7.
Exemption, you should become subject •to the Workers' SWIMMING POOL RECEPTOR t
CITY �,; TEL NO
Compensatioh'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 ` CLASS i
LICENSED CONTRACTORS DECLARATION+ 4n. DISTRICT NO PROCESSED BY '
LETS
I hereby affirm.thot I am licensed under provisions of Chapter 9 GAS SYSTEM OUTm: aI
(commencing with Section 7000) of Division 3 of the Business OUTLETS OVER
and Professions Code,and my license is m full force.and effect 5 PER SYSTEM- �NA + VALIDATION
License Number Lic Class W
4 FINAL _ U.
Contractor s Date• BY
❑ . I am,exempt under Sec a
B&P C -for this reason ir
Plan check fee ? ® 0
Date
PLUMBING PERMIT ISSUING FEE$ LLJ
Signature i ^
TOTAL FEE a
Plan check applicant
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION, Name
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason'(Section 7031 5, E;usiness and Address
Professions Code) City Tel No- _ ' >•+�? R �_
❑ I, as owner of the property, will do the wofk and the
structure is not intended or offered for"sale (Section
7044, Business and Professions Code) _-� _ ® = T r�
AL
f
:CONSTRUCTION LENDING AGENCY';
I hereby affirm that there is.a construction lending agency for _ r the performance of the work for which this permit is issued
(Sec 3097, Civ C ) "' 7
Lender's Name=
Lender's Address a�
I certify that I have read this apphco c n and state that the,
above information is correct I-agree to comply with`oll County'
ordinances ands tate laws regulating Plumbing, and hereby, _
authorize representatives of this County to enter upon the p°
` above-mentioned property for inspection purposes "
SEE REVERSETOR EXPLANATORY LANGUAGE
Signature of Permittee Date
.4�;
ION
WORKER'S I have
a certificate
of cLARATION l 76A666DPW9/89 APPLICATION FOR PLUMBING PERMIT -
.I heiefiy affirm that I have a certificate of consent to self insure, 7sA667A' - ,
or weertificate df Worker's Compensation Insurance, or a certified T
copy thereof(Sec 3.800 Lab C)' t� -•• -
4 COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV.,
Policy No Company i- , t,
❑ Certified copy is hereby furnished — BUILDING
❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) - ADDRESS �� S
Certified copy is filed with the county building inspection
department NUMBER FIXTURE OR ITEM @ FEE C
c - TY
LOCALIc'' � � � •
Date'' ' Applicant WATER CLOSET NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS`ST
COMPENSATION INSURANCE ASSESSOR N
(This sectiow need not be completed if the work Involved by the t SHOWER MAP BOOK -• PAGE gPARCEC -
permit is,for one hundred dollars($100)or less.) LAVATORY OWNER-
I certify that in the performance,of the work for which this'permit
is issued, I shall not employ any person in.any manner so as to SINKMAIL
become subject tot Workers Compensatio aws - ADDRESS
q/� y DISWASHER CITY TEL NO
Date pphc CLOTHES WASHER ' CONTRACTOR r�
NOTICE TOA PL ANTXafter make his Certificate of V a
Exemption,you hould be me sub a Workers',Compensation SWIMMING POOL RECEPTOR
provisions of the Labor ou must forthwith comply with such ADDRESS D
provisions or this permit shall.be deemed revoked LAWN SPRINKLER SYSTEM L�
LICENSED CONTRACTORS DECLARATION CITY TELO
I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER d
(commencing with Section 7000) of Division 3 of the Busines§ and STATE LIC O
w
-OUTLETS LICENSE NO CLASS (�
Professions,Code, andGAS SYSTEM-my license is in full force and effect, DISTRICT NO PROCESSED BY
OUTLETS OVER 0
5 PER SYSTEM -
License Number Lic ClaFINAL
ss`?%=--
_ U
f/xG I DATE_ _Z q L VALIDATION LU
Contractor Y/ Date
> n. I'am exempt under Sec FINAL J Z
'13&P C for this reason BY
-Plan check fee `
' Date �"
PLUMBING PERMIT ISSUING FEE$
Signature
❑ TOTAL FEE Q �,
SINGLE FAMILY Plan check applicant ( CC'Ter
HOME OWNER-BUILDER DECLARATION Name ;;
I hereby affirm that I am exempt from the Contractor's License Law, I KI �
I
for the following reason(Section 7031 5, Business and Professions Address ` S
Code) TTE =
❑ City' Tel No
TOTAL ,� m �
I,as owner of the property,will do the work and the structure
is not intended or offered for sale (Section 7044, Business. S ' l
and Professions Code) , ` I... `19°ti1 .
CONSTRUCTION LENDING AGENCY r I' CHANGE
I hereby affirm that there is a construction lending agency for the 1
performance of the work for which this permit is issued (Sec 3097, '
Giv C)
0000-0001 -8/17/9"
't i ti
Lender's Namei 5IJJ 9 i L A t•6
Lender's Address ( /
I certify that I liave 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 1 -
property for inspection purposes SEE REVERSE FOR-EXPLANATORY LANGUAGE
Signature of Permittee i Date
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ff, Y GING-PERMI=T,3
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS - RLZ-0508-9609060009
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 6561 LT: 411 BL: .001 9908 LAS TUNAS DR
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802200
ASSESSOR INFORMATION NURNEFF NEAREST CROSS STREET:
8587-030-028 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY•
47 WATER HEATER(S) 1.00 WTH '16.35
TENANT: 60 DWV REPAIR OR ALTER 1.00 SYS 16.35 TTSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
BNK WEDDING GROUP 64 WATER PIPNG <= 1 1/2 1.00 LIN 16.35 09/06/96 TC 09/06/97
65 WATER PIPING 2-3 IN 1.00 LIN 50.70
OWNER: TEL. NO: TOTAL FEES 127.50 FINAL DATE FINAL BY: CODE:
LUI WAI YU ALBERT;LUK WAN YUN (818) 291-2900-
1709 PALM AV
ALHM 918032925 DESCRIPTION OF WORK
NEW PLUMBING FOR DARK ROOM FOR WEDDING SHOP
APPLICANT: TEL. NO:
STC CONSTRUCTION CORP. (818) 579-6561-
; SPEC AL CONDITIONS: -
CONTRACTOR: TEL. N0: D APPROVALS DATE INSPECTOR SIGNATURE
STC CONSTRUCTION CORP. 818 579656 - -1
1709 PALM AVE. LIC. NO �'^ UNDER SLAB WOR
ROSEMEAD, CA 91770 684954 B
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCH OR ENGINEER: TEL. 0:
ROUGH PLUMBING
LIC. N0:
cGAS TM NG��j
trULu_ UCWo"' GSVENT
ID S
HOT WATER R
co PLUMBING FIXTURES
LAWN SPRINKLERS
GAS -/I
�eryo �� UTILITY COMPANY NOTIFIED
CWV
�� GRAY WATER SYSTEM
REPORT 'ID: DPR263 -ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY #' 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1307230018
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE" (626) 285-0488 EXT
LEGAL ID FEES PAID I BUILDING ADDRESS -
ITR: 6561 LT 411 BL: 001 1 9908 A LAS TUNAS DR
I IFEE DESCRIPTION QUANTITY- UOM: AMOUNT TEMP CA 917802200
ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET. AGNES
18587-030-028 101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID: A2 LOCALITY: TEMPLE CITY CAI
I 125 LAVATORIES/SINKS 1.00 FIX 16 20 1
TENANT I TOTAL FEES 44 00 JISSUED ON. PROCESSED BY- PLAN BY
IMIN W FINE ART & SCHOOL I - 107/23/13 SR
I I I I
OWNER TEL NO- F DATE FINAL B CODE_: 1
LUI WAI YU ALBERT,LUK WAN YUN (626) 571-1832-
Y
19040 TELSTAR SUITE 1 I �j� � i
1EL MONTE CA 91731 1D�IPTION OF WORK
IREPLACE WATER CLOSET
I I
(APPLICANT TEL. NO 1 1
ITC FULTON CONSTRUCTION (626) 482-5117- 1 -
16475 ATLANTIC #995 I (SPECIAL CONDITIONS
LONG BEACH CA 90805 I 1 1
1 1 I
1 1
ICONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE
ITC FULTON CONSTRUCTION (626) 482-5117- I
16475 ATLANTIC SUITE 995 LIC NO 1UNDER SLAB WORK I
LONG BEACH CA 90805 718272 1 1 I 1
I I (WATER SERVICE
1 IPLASTIC YIN METAL YIN
(ARCHITECT OR ENGINEER TEL NO. I 1
IROUGH PLUMBING 1
LIC NO-
IGAS PIPING
I I
IGAS VENT I
I I I
IHOT WATER HEATER I I
I I I
1 _ IPLUMBING FIXTURES
I I I
I ILAWN SPRINKLERS 1 1 1
I I I
1 I IGAS TEST
I I I
I 1UTILITY COMPANY NOTIFIEDI I I
I ICWV I I I
IGRAY WATER SYSTEM 1 I I
I I I I I I
I 1 I I I I
I I I I I I
I I I I I I
IREPORT IO DPR263 ROUTE TO BS0508 I I
I I I I I I