HomeMy Public PortalAbout9682 LIVE OAK AVE_Plumbing__ 7eaes-1 n asp APPLICATION FOR PERM
`^DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRI TNO. GROUP ZONE PERMIT NO.
( (Ary Cl
RECEIVED BY READY FOR DATE ISSU D
PLUMBER RevereTSe ServiceCorp., FIRST Ity$6�TION
ADDRESS118x11 sale St0 SC ( _._
NG
CITY .Culver City TEL. NO. -E 2151 ADDRBUILDESS 9632-E.. Live Oak Ave..
COUNTY6-30-511.
e • LOCALITY Temple City
LICENSE NO. 3495 01
EXPIRES 5
NEAREST
PERMIT FEES CROSS ST. Baldwin &eo•
kUM TYPE OF FIXTURE OR ITEM FEE OWNER Ro.P . }lith
MAIL Same
WATER CLOSET (TOILET) @ 0.50 $ ADDRESS Same as above
BATH TUB @ 0.50 I I CITY TEL. NO.
SHOWER @ o.50 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK @ 0.50I STATE LAWS'REGULATING PLUMBING.
I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 1 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
1 GAS SYSTEM OUTLETS @ 0.501 SIGNATURE OF
WATER HEATER @ 0.50 PERMITTEE
SLOP SINK @ o.so INSPECTION"RECORD
FLOOR SINK @ 0.50
1 FLOOR DRAIN @ 0.50
1 DISHWASHER @ 0.501 `
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.501 .I
1 HOUSESEWER @ 0.501
fI� _Z
MISCELLANEOUS I I
1 Vater Softener 0 a
1� 0
1 APPROVALS
DATE INSPECTOR'S NAME
1 ROUGH PLUMBING 1
1 I GAS PIPING
GAS VENT
CESSPOOL @ 1.00 1 CESSPOOL
1 SEPTIC TANK: 1 SEPTIC TANK
I DRAIN ( ) PIT ( ) Q 1.001 SEWER
PERMIT , I —1.00. GAS TEST
I-
TOTAL FEE $ 1 I 50 UTILITY CO. NOTIFIED
I II
FINAL
APIPUCATPON FOR -PLUMBING PERMIT
DBS-17 IO-55
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County. of Los Angeles BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
CASSATT D. GRIFFIN,SUPT OF BUILDING yy
.r,,:... •. ."e, 4^iL __ LOCALITY
FOR APPLICANT TO FILL IN NEAREST y� 9
� � qq�� �. CROSS ST. �8�� �Imo*
OWNER �f'/- j�fjD/it.a! 'E S EN `DISTRICT NO. GROUP ZONE READY FOR INSPECTION
MAIL ' / t /J,1t -- f�-� h:,Y ' A Kms. I.
' ADDRESS
`"�� r INDUSTRIAL
CITY Cl TEL. NO. '"'U I fo WASTE APPROVAL
PLUMBER .� INSPECTION RECORD
„ ADDRESS
r` CITY TEL. NO.
ix
i LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 $
,a BATH TUB @ $1.00
- SHOWER @ $1.00
LAVATORY(WASH BASIN) @ $1.00
KITCHEN SINK .@ $1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00- �
3 APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING 11
GAS PIPING
TOTAL FEE ;?- d06 GASVENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION '
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING X
G I
PLUMBNFIXTURES
J�
') PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/ORi GAS TEST
LICENSED AS REQUIRED BY LOSANGELESCOUNTY AND STATE OF i
CALIFORNIA OR I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED �. %4
s: DESCRIBED RE DEN. I PROPERTY.
SIGNATURE e".
OF PERM ITT ifFINAL - `(
JOHN A. LAMBIE. COUNTY ENGINEER VALIDATIO/ ROBERT A.WOOD, CHIEF PLBG. INSPECTOR
CH. M.0. l CASH
$. .o 9,- cO 31 3 2.0 0
r . N+lORKERS' COMPENSATION DECLARATION n
... ,20 0026-DPW'4/87
g L
0 0 (� /p� -( (� FOR
o ((
I
In affirm that It have a certificate of consent tc-self in- ���!���� ° �'O�"`' ��It� �� u !u �
76A667A -
sure,or a certificate �No�,2Ws'Compensation Insurance,or a CE 817(REV. 8/8
certified copy thereof (Sec. 3800, Lab C )'• - '
r F N DEPT OF PUBLIC WORKS
Policy,'No. < ompany � ` t �+
COURITY O •LOS A GELES ,�
® ..Certified copy:is,hereby furnished
t FOR APPLICANT-TO FILL iNr(PRINT OR TYPE) BUILDING �` 7,
Cert°fred'copy is`fded'withth'e county building inspectioh ADDRESS b " '� �lC
NUMBER.,, •FIXTUREOR,ITEM FEE
'�
department., @
1 - LOCALITY
Date �''� A Iicant: K �' Gam'
WATER-CLOSET(TOILET)
P.P NEA_RESTr
u .. i B SS STti
CERTIFICATE OF EXEMPTION FROM WORKERS`
-COMPENSATION INSURANCE: ? '' OWNER
BATH TU
«SHOWER-' x _. S
(This section need not be''comple£ed if the work involved.by ' ' .
x..
MAIL.-
the permit is forone hundred do116rs ($100)or,less.)' ' ,,. n LAVATORY `', ADDRESt.
i'certify'that in th'e'performarice,of,the work'for which-this per-
.. .. .. - r' :. SINKS y-'. t , ,�•�! CITY. 't� TEL.' NO
mit is issued h shall not employ any person in any manner so
as ta'become subject to the,Workers Corripensation Laws i
s;
z .� Rt
- � DISHWASHER CONTRACTOR dO•' ' � `:
Date Applicant. CLOTHESWASHER'
p, r
NOTICE To APPLICANT If 'after making,thi's,;Certificate of Ex-.. = x Via ' , 4. -
-
• SWIMMING POOL RECEPTOR
ADDRESS f -
emption, you shou`Id becdmessublecYto the Workers Compen- / a
'•sation`fovisions,of the•,Lab'or Code;•ou must forthwith coin �. GZ�.O '
Y p LAWN•,SPRINKLER'SY$TEM CITY' TEL
O
I,y with,:such provisions or,-this permit shall:be deemed revok- STATE- Llc:
ed ER HEATER ENO. CLASS
_.WAT
- _ .. � LICENSE � � .� ,.
LICENSED CONTRACTORS DECL"ARATION,, DI
" l GAS SYSTEM OUTLETS
L hereby affirm that I cim licensed 'under pro'vision's-of-Chapter: `
:DISTRICT NO. Z�C ED BY
9_(commencing'with:Section 7000)of DiGision 3-of the Business" -. ",OUTLETS OVER.
and Professions Code, and my license is rn'full force and ef- 5',PER SYSTEM FINAL �1_&
_ ALIDATIOfiI
fect DATE
License Number Lic.•Class•
0.
��J'-L�%G I A / Qty BY
Contractor m ti` to =30 9/� BY 0
T - F'
„
I am exempt under Sec
B•&P.0 for this reason Plan Check fee s
,.
<: Date
p _
Signature i,
,PLUMBING PERMIT ISSUING,FEE$ �: G 3 O'O A
ry ns
LE.FAMILY
TOTAL FEE
SING Plan check a Ircant °
HOME OWNER-BUILDER DECLARATION PP
:>. 1',hereb'y affirm that.l am exempt from the Contractors4License; '-.' •Ndme
Law for`,..the,following,rea'sop (Section 7031..5, Business.and - °. ,
Professions Code);1` Address '
- 34.5
I as`bWh6r of the property,"will do--the work.and the Clry;' Tel No.'4 ,
structure isnot intended or-offered.for"sale(Section-7044„ • -: Q 7,.[8 Y.,8 8 U
W.
Business and Professions Code): -
:
" . CONSTRUCTION LENDING AGENCY
11
-'„ I.h'ereb affirm'tiiat there is a construction'lending:agency for
the erformance of the-work for which fhis'per,mit.is issued' .,
P
(Sec. 3097, Civ:C:
•
Lenders Name
IF
Lender's'Address -
I certify,that I!hove read this application and state:that-the
above information is correct:.)agree`to comply witholl County T
ordinances;and,State laws.regulating Plumbing, and hereby
authorize Yepr-esentatives.afa:tKis County to;ent& urpon the -
-above-mentioned property'-' or inspection'purposes.
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 1302280037
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: . I FEES PAID - I BUILDING ADDRESS:
1 ON FILE 1 9682 LIVE OAK AV
1 IFEE DESCRIPTION: - QUANTITY: UOM: .AMOUNT:( TEMP CA 917802522
(ASSESSOR INFORMATION NUMBER: - I - I NEAREST CROSS STREET: KAUFFMAN
18588-011-031 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY CAI
1 107 BATHTUBS/SHOWERS 3.00 FIX 48.60 I 1
(TENANT: 113 DISHWASHER(S) 1.00 FIX 16.20 (ISSUED ON: PROCESSED;BY: PLAN BY: I
I 125 LAVATORIES/SINKS 3.00 FIX 48.60 102/28/13 SR I
I 145 WATER CLOSET/URINAL 2.00 FIX 32.40 1 1
10WNER: TEL. NO: I TOTAL FEES 173.60 IFI AL DATE FINAL BY: CODE: 1
IPUI, WAN HO (626) 993-5469- I 1 1
19682 LIVE OAK AVE
ITEMPLE CITY CA 91780 1 IDE RIPTION OF WORK 1 1
I I IBATHTUB/SHOWERS, DISHWASHER SINK, LAVATORIES AND WATER 1
1 ICLOSETS I
1APPLICANT: TEL. NO: 1 I 1
(SAME AS OWNER I I
I ISPECIAL CONDITIONS:
I I I
(CONTRACTOR: TEL. NO: 1 1APPROVALS DATE 'INSPECTOR SIGNATURE
ISAME AS OWNER - I
I LIC. NO 1 _ (UNDER SLAB WORK I I 1
I I IWATER SERVICE I I
IPLASTIC Y/N METAL Y/N
1ARCHITECT OR ENGINEER: TEL. NO: 1 - I 1
I 1 1ROUGH PLUMBING
I LIC. NO:
I IGAS PIPING I
I I I
I I IGAS VENT 1 1 I
I I I
IHOT WATER HEATER I I I
I I I
1 1 IPLUMBING FIXTURES 1 1 1
I I I
1 I ILAWN SPRINKLERS I 1 1
_ I I I
IGAS TEST I
I I I
(UTILITY COMPANY NOTIFIEDI I I
1 ICwv I I I
I IGRAY WATER SYSTEM
I 1 1 1 IZ �9 1
I I I I I I
I I I I I I
I I I I I I
IREPORT ID: DPR263 ROUTE TO: BS0508 I I A
I I I I I I