HomeMy Public PortalAbout9750 LEMON AVE_Plumbing__ 76A667 (CE-817)-4/72
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO ADDRESS Le. ;P7a,7
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) SST'
CROSS d
NUMBER FIXTURE OR ITEM @ FEE
` OWNER Q
WATER CLOSET 1.75
MAIL
BATH TUB 1.75 ADDRESS �o
/ SHOWER 1.75 ;A CITY r "' TEL NO. �-3�
LAVATORY 1.75 CONTRACTOR
SINK 1.75 ADDRESS
DISHWASHER 1.75 CITY TEL. NO
CLOTHES WASHER 1.75 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1.75
DISTRICT NO GROUP ZONE FROCESIED BY
LAWN SPRINKLER SYSTEM 1.75i —/ r
WATER HEATER 1.75 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD V
OUTLETS OVER
5 PER SYSTEM .30 O
F-
U
W
a.
N
Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR S SI,NATU RE
Plan check applicant UNDER SLAB WORK /- V 7 22f �
Name ROUGH PLUMBING k v
Address GAS PIPING
City Tel NO GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS �/7��� ��
PLUMBING ii w!a✓�L/�
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REOU I RED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY FINAL
SIGNA I R
OF PERMITT
PERMIT VALIDATION C, M,o CASH
PLAN CHECK V LIDATION CK M O. CASH
� 7631 5 D 13.50
i
i
76AS67 17 9-49 ® APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY 0
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL 1 DISTRICT O. GROUPI ZONE RMIT NO.
i
PLUMBER RECEIVED BY READY IFOR DATE ISSUED
FIRST INSPECTION q _ 7_
ADDRESS
gUILDING
CITY TEL. NO.
ADDRESS "'�® N Q NA �d
COUNTY LOCALITY
LICENSE NO EXPIRES
NEAREST 4 ^P v, ��� -
PERMIT FEES cRoss sr _P 4 +=�i'�[-� j�\ 1(�
NUMBER TYPE OF FIXTURE OR ITEM FEE MAIL
OWNER I�,Iyr�l p �lA' �1 I, ��..{� �il,� p�1*,y,�
N I WATER CLOSET (TOILET) Q O 50 SI I ADDRESS ��) U �_B A U A�S�t•Y� d� 1':I 3 11 NEI .
.
�sJ I BATH TUB @ O 501 I CITY l� y (C 7 < �•�•� TEL NO.p•-.tx 7t-'-)0
L,r�o I SHOWER Q 0.501 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
LAVATORY (WASH BASIN) Q O 50 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK Q O 501 STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY Q O 50 I ANGELES COUNTY LICENSE OR I AM THE LEGAL OWNER
_ OF THE RESIDE TIALIPROPERTY DESCRIBED ABOVE.
GAS SYSTEM=1--, OUTLETS Q O 50 I I SIGNATURE OF )r
111_
WATER HEATER Q O Sol PERMITTEE' - _
SLOP SINK Q o Sol INSPECTION RECORD
FLOOR SINK Q O Sol
FLOOR DRAIN Q O Sol q
DISHWASHER Q O SOI C prI`' t+l• KO !✓L1-TE2 /rT/
DRINKING FOUNTAIN Q O 501 �"pp� 'll t3 yy0 • Y A 7/-�
URINAL Q O 50I L-f�V• � �A'" A-('f`/"(^F+/ Tf �= Q
HOUSESEWER O Sol I Z_
MISCELLANEOUS I6 0
/ Ivy)
Wf` S rF APPROVALS
DATE [ INSPECTOR'S NAME
I� ROUGH PLUMBING t7-l2JJb M'f Ivi
GAS PIPING
j I II GAS VENT I ,✓ /1
A I CESSPOOL Q 1 00 I —L CESSPOOL 2 •L> _ (1 7-.4�
SEPTIC TANK- I I SEPTIC TANK
DRAIN ( ) PIT ( ) Q 1 001 I SEWER —/ - o C lli Yq
PERMIT . . I 1 00 GAS TEST
UTILITY CO NOTIFIED
TOTAL FEE
FINAL
\NORKERS'COMPENSATION DECLARATION
reby, affiim that I'have a-certificate of consent to self-'in- i20-0026 DPW 4/87; APPLICATIOW O,R;PLUMBING PERMIT
76A667A
surp,•or a ce�hficgte of Workers'Compensat(on`Insurance,or CE 817(REV 8/86)
certified copy'thereof (Sec" 3800, Lab C-) L _
COUNTY OF LOS ANGELES
'; =DEPT.-OF, WORKS
wl,'Cy.No' "
Company 3 '
Certified copy'isheTeby'furnished
FOR-APPLICANT TO FILL IN(PRINT OR TYPE)- BUILDING / t '
Certified copy is filed with the,coun'ty building inspection ADDRESS'
'department . _ '1 NUMBER FIXTURE OR ITEM' Lal FEE ;
.N - '', - - _ •r - - LOCALITY
Date A hcant WATER CLOSET(TOILET), `
PP NEAREST 't�1
t"CERTIFICATE OF EXEMPTION FROM WORKERS'
BATH,TUB' 'CROSS-ST,
COMPENSATION INSURANCE'' = OWNER
SHOWER' d,
(Thls'section need not be completed if'the work Involved by T MAIL
the permit is fortune Aundred'dollars-($100)or less.) -LAVATORY
s r i -ADDRESS
I certify thdin the performance oethe vork'for which this per;' ' »
mit is'issued,'_I shall not employ any person in any-manner'so SINK` ' CITY . LC =� 'TEL' r
a s'to,becaine's`ublect to the Workers Compensa4fifi .t�'w.fs,"Ex-
laws,re6ulating
a - ,
-- DISHWASHER -
a- _ r CONTRACTOR
Do 6. `I ' =YA'pplicanT � •CLOTHES WASHER r r ,•
ADDRESS
NOTICE TO.APPLICANT If, after ma mg thi"s CerSWIMMING POOL RECEPTOR 4
emptidn,yu"should become sublect to the Workers'Compen-
sation provision s'of-'the Labor Code,"you,must forthwith comp- LAWN SPRINKLER SYSTEM
ly with'such provislons,or this-permit shall be,deemed revok- . STATE •LIC
ed ° - �' ,y- - WATER HEATER , t LICENSE NO -.� •' CLASS
;,LICENSED GONTRAGTORS,DECLARATION DISTRICT NO P SSED BY
I her'eb`y affirm that I'am licensed,under`provisions of Chapter GAS SYSTEM - OUTLETS /• "
commencing'with Section 7000)of Division 3 of the Business OUTLETS OVER
and Professions Code, and my-license is'in full force and of-•'. 5 PER SYSTEM FINAL VALI ATION
y!` feet.',, t, :- DATE a
Licens4,Number Lie Class V'
Contractor' Date 1 e BY O
E! Itam exempt under Sec i
4 LAA
B 8P C for this.reason- r d
Plan check fee _ ► j
Date ''PCUMBING'PERMIT ISSUING FEE$
Signature - -
e TOTAL FEE - 1
SINGLE FAMILY'" Plan check's licant -,'
HOME OWNER-BUILDER DECLARATION: PP
I hereb ffirm that I am exempt from Contractors License Name' �(, - '• ` ; .
Law f -the follow mg r'ea'son (Section 7031 5, Business and `
Prof sions Code) 'Address ���1► /�U� a` - .,
0
o- _Ir as owner of the property, 'will-do the•work,and the - C ty.;�= - v, �,�a 'Tel No s � f �'�C/ y '
structure is not'hntended or offered for sale(Section 7044, _'
,Business'and Professions Code)
CONSTRUCTION LENDING AGENCY -
iUo.
I hereby affirm that there is arconstruction lending agency for k 37-7:
the perforrridnce,of the workifor which this permit is issued ' , = _ ITEMS
(Sec„3097-;Civ:G) `
L'ender's Name r 22.50
Lender's Address �, * F / "`'_HANj3E' ;�j'o;
I'certify thatr'I have,read this application-and state that the
above-information is correct'I-agree to comply with all County r
ordinances and State Plumbing, and-hereby, _ ► Sj =jj��j]1 1; 4/89
au thonze'representatjGes'of this County-to enter upon the. 111".e' '
above=mentione 'proper for nspection purposes , • , r` , Y' ' �I j7 AM 59
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature,of OJAIt
ee Date •- .a :
( _l
COUNTY OF LOS ANGELES TEMPLE CITY $ 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0603130006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 -�
PHONE: (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE - 9750 LEMON AV E
FEE DESCRIPTION. QUANTITY UOM AMOUNT: TEMP CA 917800000
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET
5383-016-006 - 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE, GRID LOCALITY TEMPLE CITY, C
51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20
TENANT TOTAL FEES 43 95 ISSUED ON PROCESSED BY. PLAN BY EXPIRES ON
03/13/06 JK 09/09/06
OWNER TEL NO FINAL DAT BY: CODE
CHANG CHARLES S,ANN Y (626) 241-2899-
9750 LEMON AV
TEMP 917800000 DESCRIPTION OF WORK
GAS LINE FOR AIR CONDITIONG AND HEATING SYSTEM
APPLICANT TEL NO
GEAR HEATING & COOLING (323) 724-9800-
1415 ESPANOL AVE SPECIAL CONDITIONS.
MONTEBELLO, CA 90040
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
GEAR HEATING & COOLING (323) 724-9800-
1415 ESPANOL AVENUE LIC NO UNDER SLAB WORK
MONTEBELLO, CA 90640 522700 C20 _
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER TEL NO.
- ROUGH PLUMBING
LIC NO:
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
UTILITY COMPANY NOTIFIED
CWV
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO BS0508