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HomeMy Public PortalAbout5737 LOMA AVE_Plumbing__ 76A667 17 2SM-SETS 7-46 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY, COUNTY OF LOS' ANGELESUmmo WILLIAM J. FOX, CHIEF ENGINEER i DISTRICT NO. GROUP ZONE PERMIT FOR APPLICANT To FILL IN . PLUMBERM12C3 NNoOTCTIaNieGrHly AM Co. READY`FOR \ - RECEIVED<BY 'DATE ISSUED FIRST INSPECTION ADDRESS ! � � �S�•-C� s O / f Of CITY TElpe/)!• E CITY NV A L IF. JOB. © ..-® - COUNTY Y JL1i:A CITY ADDRESS LICENSE NO. EXPIRES LOCALITY I CERTIFY THAT I POSSESS THE ABOVE VALID LOS NEAREST.' ANGELES COU�NNTYYJ LICENSE. CROSS ST. 44 OWNER 'I t WYE MAIL J - CLMBER ADDRESS PERMIT TEE IS $1.00 FOR THE FIRST FIXTURE OR CITYheAaeefad TEL. No., - ITEM LISTED BELOW, PLUS SOC FDR EACH ADDITIONAL 1 AM THE LEGAL OWNER OF THE RESIDE_NTIAL'PROP- ITEM.^ FOR EACH SEPTIC TANK AND PIT OR DRAINFIELD ERTY DESCRIBED ABOVE. $1.00. MINIMUM FEE FOR ANY PERMIT $1.00. EACH - GAS SYSTEMISA SEPARATE ITEM. OWNER NUMBER TYPE OF FIXTURE OR ITEM WATER CLOSET (TOILET) CORRECTIONS - BATH TUB LAVATORY (WASH BASIN) ..KITCHEN SINK LAUNDRY TUB OR TRAY , - GAS SYSTEM_-OUTLETS WATER HEATER SLOP SINK FLOOR SINK - Z FLOOR DRAIN C7 DISHWASHER O DRINKING FOUNTAIN - URINAL MISCELLANEOUS APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING' f I GAS PIPING GAS VENT I - - CESSPOOL I�� I:r.•'�%(• SEPTIC TANK - DRAIN ( ) PIT ( ) $ SEPTIC TANK CESSPOOL $ SEWER HOUSE SEWER $ GAS TEST I1, F//jl : TOTAL FEE ..`UTILITY CO.NOTIFIED I $ (/ V FINAL D.B S-17:25115 SETS 6-46 .. - :I�EP�.RTMENT OF bUILDING' AVID SAFE' API'I.ICATIOid.FOIA PERMIT . COUNTY OF LOS ANGELES: 'WM.J. FOX. CHIEF,'ENGINEER NATURE OF:INSTALLATION DISTRICT NO. GROUPI ZONE PERMIT NO. ROUGH, . FIXTURES COMPLETE HEATER CESSPOOL I_I SEPTIC TANK CEIVED Bl(i•` READY FOR DATE.ISSUED' z. FIRST`INSPECTION GAS MISCELLANEOUS P ANT FILL•IN HEAVILY OUTLINED PORTION ONLY - JOB.. ..NAME. ADDRESS - ' �•'-�'vt�.. W - m. ADDRESS `S(, O U- LOCALITY ' D L]r(f NEAREST.' _J CIT TEL.No. CROSS.ST.- -COL CER o. VV EXPIRES W. NAME . LOC I N.OF SEPTIC TANK, OR CESSPOOL z MAIL ': ADDRESS. NORTH O.' • CITY: TEL..No. - 1 AM THE LEGAL. POSS _ O ri F THE ADOVE. LOS . ANGELES COUNTY CERT C O UALIFICATION. , 1 AM THE LEGAL OWNS F THE PROPERTY DESCRI®ED ABOVE. OWNER - umasaaamam COIBRECTIONS. SOUTH J DESCRIPTION OF-WORD z _BATH TUB,(/ RNACE _ _ - 9 'SHOWER DISHWASHER - _ _ O _LAVATORY // :REFRIGERATOR. - / KITCHEN SINK WATER SOFTENER. —FLOOR:SINK - __�SANDTRAP SLOP SINK: FLOOR DRAIN WASH,TRAY V" URINAL . . _ : APPROVALS .. . . WATER CLOSET .—DRINKING FOUNTAIN' DATE INSPecToR'a Nwra¢ WATER HE TER (/ DENTAL LAVATORY f '7 _ ' ROUGH PLUMBING .I -`/"� l '/I METERL FOUNTAIN :I -�3'-r 9(, d�.;e.. �_ - (( C G PIPING - GAS VENT GEBSPO®L'ommmom j pp I TOTAL NUMBER'OF FIXTURESI , • SEPTIC TANK CESSPOOL SEPTICTANK_ SEINER $ UTILITY CO.NOTIFIED TOTAL FEE . -" I .. „FINAL . D.D.S.-17 25M SETS 6746 APPLICATION FOR PERS DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS'ANGELES a WM.J."FOX. CHIEF ENGINEER NATURE OY INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO. ROUGH FIXTURES COMPLETE ®®f HEATER, CESSPOOLI-I SEPTIC TANK RE6EIVED BY READY FOR DATE ISSUED FIRST ENSPEC.ION / GAS"- MISCELLANEOUS APPLICANT, FILL IN HEAVILY OUTLINED PORTION ONLY OB NAM • NOTTINGHAM CQ_ ADDRESB/3S� 9 OF TEMPLE CITY ADDRESS LOCALITY129 y a" AVE. NEAREST - a _clTv TEMPLE GITT�EL.6N , ,� CROSS ST. COUNTY t CERT.No: EXPIRES I NAME LOCATION OF SEPTIC TANK, OR CESSPOOL 3 MAIL ADDRESS r NORTH O CITY TEL.No. 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. d" PLUNDER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. 3 U) OWNER CORRECTIONS SOUTH ' J DESCRIPTION OF WORK z BATH TUB FURNACE Lo SHOWER DISHWASHER O LAVATORY REFRIGERATOR KITCHEN SINK' WATER SOFTENER - FLOOR SINK SAND TRAP SLOP 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 GAS PIPING OUTL _ - GAS VENT CESSPOOL IZ 7' 17'Gi0" B TOTAL NUMBER OF FIXTURES SEPTIC TANK. y CESSPOOL. AEPTIC TANK SEWER I I $ UTILITY CO.NOTIFIED TOTAL FEE mss"' ���/// FINAL UR"K�RS COMRENSATIONDECLARATION APPLICATION FOR PLUMBING PERMIT " that I have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, 'CE 817(REV. 10/81) or a cern a copy he o (Sec. 3800, Lob: C.) COU LOS ANGELES ' BUILDING AND'SAFETY Pohcy.No. Company S'� Certified copy is hereby furnished.. �J Q FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING' /4 ^'—/ _ Certified copy,is filed with the cou. building inspec ADDRESS �./� �/n/ �. tion dep, rtment. NUMBER FIXTURE OR ITEM a`, FEE" LOCALITY rMpz_ 6 1. Date / Applicant WATER CLOSET NEAREST .CERTIFICATE OF EXEMPT14iFM W KERS' BATH TUB CROSS ST. ^� COMPENSATION INSURANCE OWNER, (This section need not be completed if the work involved by SHOWER , the permit is for one hundred.dollars ($100)or less.) LAVATORY MAIL ADDRESS I certify that in the performance of the work for which thi's permit is issued, I shall not employ'any person in any manner SINK CITY L TEL. NO-Z /Sv so as to'become subject to the Workers`Compensation Law's. . DISHWASHER CONTRACTOR �- I- Date Applicant CLOTHES WASHER ADDRESS y_L Jt� �L / NOTICE TO APPLICANT: If, after making this Certificate of � 7•�J c� /�"Gr✓� `' `' •' Exemption, you should become subject to'the Workers' 'SWIMMING POOL RECEPTOR Compensation,provisions of the•Labor Code, you must forth- ` CITY i TEL. NO.Q LAWN SPRINKLER SYSTEM / � with comply with such provisions or this'permit shall be - STATE7 LIC. deemed revoked. WATER HEATER ' LICENSE NO. .�S / %�;7 CLASS LICENSED CONTRACTORS DECLARATION r �. DISTRICT NO. OCESSED BY GAS SYSTEM OUTLETS I hereby affirm that 1 am licensed under provisions of Chapter 9 s o • (commencing with Section 7000) of Division'3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM '/ /� F NAL VALIDATION License Number ` 15-771k 7 'Lic. Class TE �" j OU FINAL 09 Contractor Z� C�iPST/SCi� I�(T. 7 g c.t r ,, 0 I am exempt under Sec. tU CL B.&P.C. for this reason ,n Plan check feePoo. z Date: PLUMBING PERMIT ISSUING FEE$, � �C�i . -Signature 'l TOTAL'FEE ® V Plan check'applicont ...4.2 7 A SINGLE FAMILY / a HOME OWNER-BUILDER DECLARATION Name % c. 0 0 o o J I hereby affirm that I am exempt from the Contractor's License Address c Law for the following reason '(Section 7031.5,-Business and 2 o io J 0, `,0 Professions Code): City Tel. No. ❑ I, as owner of the property, will do the work andthe o o'o 0 Q.5 structure is not intended-or offered for sale (Section o7. 1 7044, Business and.Professions Code). .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:). {' 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 tate laws regulating Plumbing, and hereby authorize repr entatives of this County to enter upon the abo e Ti ed property for inspection,purposes. - SEE REVERSE FOR EXPLANATORY LANGUAGE. , Sign Zf Per tee I Da e WORKER'S COMPENSATION DECLARATION 76A667A 6DPW 9189 APPLICATION FOR PLUMBING PERMIT • 76A66 "' . I hereby affirm that I have a certificate of consent to self insure, ' 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. 'I Policy No. Company , ❑ Certified copy is hereby furnished. 4 ` ,n\ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ADDRESS 5-7 ,31 O '"\ A NS ❑, Certified copy is filed with the county building inspection i department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant I WATER CLOSET CROSS ST. RS CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the work involved.by the SHOWER MAP BOOK PAGE PARCEL. permit is for one hundred dollars($100)or less.) ' OWNER `^ I I certify that in the performance of the work for which this permit MAIL LAVATORY 1! is issued, I shall not employ any perso in any2m.aer so as to SINK - ADDRESS Do �\ Vbecome subject to the Workers' Compen tion La - C C,"� DISWASHER CITY 1� TEL.NO. Y-S q(�i 5 Date J / " Applicant , Q CLOTHES WASHER 1[3� NOTICE TO APPLICANT: If, aft ma ng this Certificate of CONTRACTOR Q Q� Exemption, you should become subj ct tote Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS C��`�& provisions or this permit shall be deemed revoked. LAWN SPRINKLER- YSTEM -- LICENSED CONTRACTORS DECLARATIONr_ CITY 1OS b)o b �- TEL.N0. 2 L S I WATER HEATER Q�, J J CL I hereby affirm that I am licensed under provisions of Chapter 9 O STATE LIC. (commencing with Section 7000)of Division 3 of the Business and LICE SE NO. 3521 c) CLASS C'� V Professions Code,and my license is in full force and effect. GAS SYSTEM OUTLETS OUTLETS OVER DISTRICT NO. PROCESSED BY cc 5 PER SYSTEM License Number 35 2\ Lic.,Class C-- FINAL 1 VALIDATION W DATE G. Contractoriv, Date 6 C0 ❑ - f FINAL Z I a exe pt under Sec. � BY B.&P.C.for this reason I&Y 2� W/ /� V te: �1 g-5 3 Plan check fee Signatur , PLUMBING PERMIT ISSUING FEE$ � 7 e - • ❑ TOTAL FEE ��. r� AC .-T a e Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License.Law ITEMS for the following reason (Section 7031.5, Business and Professions Address €I;HL "313 2 Code): CityTel. No. ` := - I, as owner of the property,will do the work and the structure i�4 is not intended or offered for sale (Sect CHANGE7044, Business ® GE and Professions Code). 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, r Civ.C.) i:': i ANIA:71 Lender's Name t 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 f and State laws regulating Plumbing, and hereby authorize repre ntatives of this ou ty to enter upon the above-mentioned pr e y for inspectio u ses. SEE REVERSE FOR EXPLANATORY LANGUAGE Sign re of Permittee Date • COUNTY OF LOS ANGELES - TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1306110038 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID I BUILDING ADDRESS: ITR: 12977 LT: 2 1 1 5737 LOMA AV 1 I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917802453 (ASSESSOR INFORMATION NUMBER:. I I NEAREST CROSS STREET: 1 15387-022-002 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY CAI 1 113 DISHWASHER(S) 1.00 FIX 16.20 1 TENANT: 125 LAVATORIES/SINKS 1.00 FIX 16.20 JISSUED ON: PROCESSED BY: PLAN BY: 1 TOTAL FEES 60.20 106/11/13 SR (OWNER: TEL. NO: FINAT4 DATE FI Y: CODE: IMP. A LEE 15737 LOMA.AV 1 1 1 ITEMP 917802453 I ID SCRIPTION OF WORK 1 REPLACE DISHWASHER AND KITCHEN SINK APPLICANT: ,TEL. NO: IFAN, JOHN (626) 622-9090- 15740 OAK AVENUE I ISPECIAL CONDITIONS: 1 TEMPLE CITY CA 91780 ICONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE + IJOHN G FAN _ (626) 622-9090- 1 15740 OAK AVENUE LIC. NO 1UNDER SLAB WORK TEMPLE CITY CA 91780 702434 * i WATER SERVICE IPLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. NO: i IROUGH PLUMBING I LIC. NO: I �Q I GAS PIPING 1 1 IGAS VENT 1 I IHOT WATER HEATER ( 1 1 1 1 IPLUMBING FIXTURES I 1 1 1 1 1LAWN SPRINKLERS 1 1 1 IGAS TEST (UTILITY COMPANY NOTIFIED( I I 1CWV I I GRAY 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 * ADDITIONAL DATA ON FILE I IREPORT ID: DPR263 ROUTE TO: BS0508 I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1308020006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: - FEES PAID '1 BUILDING ADDRESS: ITR: 5904 LT: 351 _ - I 6013 LOMA AV IFEE DESCRIPTION: �-, QUANTITY: UOM: AMOUNT: ( TEMP CA 917801926 1 (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: 15384-014-023 - 101. PERMIT .ISSUANCE FEE> -.,27-080 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY I I 160 DWV REPAIROR' ALTER 1.00 SYS "16'.20 1 I ITENANT: I TOTAL FEES 44-.00 (ISSUED ON: PROCESSED BY: PLAN BY: I 1 t 108/02/13 SR (OWNER: TEL. NO: IFI.NAL DATE FINAL BY: CODE: ISCHUCH, AARON - I I - 1 16013 LOMA AVE 1 ^- I 1 (TEMPLE CITY CA 91780 - I ID S RIPTION OF WORK I IDRAIN REPAIR FOR SEWER I (APPLICANT: o TEL. NO: I I I IZAMKOCHYAN, STEPHAN (818) 765-2424- I 110723 SHERMAN WAY 1 ISPECIAL CONDITIONS: 1 1SUN VALLEY CA 91352 I I' Id(911A CtfQ4 ICONTRACTOR: TEL. NO: I ]APPROVALS DATE IN R SIGNATURE I INEW PIPE PLUMBING AND ROOTER (818) 765-2424- I 1 110723 SHERMAN WAY LIC. NO 1 (UNDER SLAB WORK I 1 1 ISUN VALLEY, CA 91352 651047 C36 I I I 1 IWATER SERVICE 1 1 I 1 ' 1PLASTIC Y/N METAL Y/N 1 I 1 (ARCHITECT OR ENGINEER: TEL. NO: I ' 1'• I I 1 1 - I IROUGH PLUMBING 1 LIC. NO: II I 1 I IGAS PIPING 1 I 1 I I •4 - �.. . I I I IGAS VENT I I I I I I y•.. (HOT WATER HEATER 1 1 I I I I 1 1 (PLUMBING FIXTURES 1 1 I 1 1 ILAWN SPRINKLERS I I I IGAS TEST I I1 11 I 1 1 JUTILITY COMPANY NOTIFIED] I cWV 1 1 1 1 I IGRAY WATER SYSTEM 1 I 1 _ 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 1 1 1 I (REPORT_-ID: DPR263 ROUTE TO: BS0508 I I I I I I