HomeMy Public PortalAbout8637-8639 LONGDEN AVE_Plumbing__ DeS.17 APPLICATION FOR 'PLUMBING PERMIT .1
DBS•'"DIVISION OF BUILDING AND SAFETY
Depccrtment of County Engineer
County of Los Angeles BUILDING 8639 Longdon
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
CASSATT D. GRIFFIN,SUPT OF BUILDING
wmMjMj LOCALITY San Gabriel
FOR APPLICANT TO FILL INI NEAREST
tt����ff TAT CROSS ST
OWNER A�'�• • M. bre-1SOn DIST RI T 10 GP ZONE I READY FOR INSPECTION
MAIL
ADDREss8639 LO don -7
A
CITY San Gabriel TEL. NO At• 77291 INDUSTRIAL
NA TEAPPROVAL
PLUMBER San Gabriel Plumbing INSPECTION RECORD
ADDRESS 1731 S. San Gabriel Blvd
CITY Sart /G�a�briel TEL NO.At• 0-8183
LICENSE No14.4/715
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1 00 $
BATH TUB @ $1 00
SHOWER @ $1.00 .
LAVATORY'(WASHBASIN) @ $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 '
APPROVALS
DATE INSPECTORS SIGNATURE
' UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE
2 OO GAS PIPING ^
GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM, PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE
OF PERMITTEE FINAL
JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR
CK. Et 0. CASH
° g 5 A 2:: 0
WORKERS'COMPENSATION DECLARATION /p� gPPUC/ T\ OH FOR PLUMBING
PERMIT
`=i hereby affirm that I have a certificate of consent to self 76A667A u-uu u u v PERMIT
insure, or a certificate of Workers' Compensation Insurance, CE 817(REV 10/81)
or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES T BUILDING AND SAFETY
Policy No Company
Certified copy is hereby furnished BUILDING
FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS
Certified copy is filed with the county building inspec-
tion d art nt. NUMBER FIXTURE OR ITEM @ FEE
�, LOCALITY
Date Apphcan WATER CLOSET �' NEAREST
CE FICATE OF EXEMPTIO FROM ORKERS' BATH TUB CROSS ST
r�
COMPENSATION INSURAN E OWNER
SHOWER
(This section need not be completed If the work Involved by MAIL
the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS
I certify that in the performance of the work for which this
permit is issued, I shall not employ any person in any manner SINK CITY TEL NO,
so as to become subject to the Workers'Compensation Laws DISHWASHER
CONTRACTOR
Date Applicant CLOTHES WASHER ADDRES
NOTICE TO APPLICANT If, after making this Certificate of O
SWIMMING POOL RECEPTOR
Exemption, you should become subject to the Workers' CITY
Compensation provisions of the Labor Code, you must forth- ' LAWN SPRINKLER SYSTEM EL NO d r
with comply with such provisions or this permit shall be STATE LIC `
deemed revoked WATER HEATER LICENSE NO CLASSe-Ze7—C b
LICENSED CONTRACTORS DECLARATION DISTRICT NO PR ESSED BY
I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS
(commencing with Section 7000) of Division 3 of the Business OUTLETS OVER
and Professions Code,and my�license is in full force and effect 5 PER SYSTEM FINAL ,/ VALIDATION
S / 4 /J "�7 �r- DATE �� Z -�J U
License Nu ber� Lic Class��
FINAL �
Contract DateZ�Z FIBY O
i-•
F-1I am xem under Sec /�j3 �( LU
V
IL
B &P C for this reason H
Plan check fee
Date PLUMBING PERMIT ISSUING FEE$
Signature
TOTAL FEE
Plan check applicant
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Name
I hereby 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 o•C 5 9' 2'A
❑ j, as owner of the property, will do the work and the o o o o o 5
structure is not intended or offered for sale (Section 2o d L u 5
7044, Business and Professions Code)
CONSTRUCTION LENDING AGENCY a R oS.J O U
I hereby affirm that there is a construction lending agency for a
the performance of the work for which this permit is issued o 7.0 9,—8 4
(Sec 3097, Civ C )
Lender's Name
Lender's Address
I certify that I ha re d this application and state that the
above informal s c rect I agree to comply with all County
ordinances a tate aws regulating Plumbing, and hereby
authorize r esent Ives of this County to enter upon the
abov ne or inspection pur ses�
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signatur rmittee ate
c
s COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1110170034
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL IO 1 FEES PAID I BUILDING ADDRESS
1 ON FILE I 1 8639 LONGDEN AV 1
1 1FEE DESCRIPTION _ QUANTITY UOM AMOUNT SGAB CA 917751811
IASSESSOR INFORMATION NUMBER 1 I NEAREST CROSS STREET LEMON
15381-016-001 101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID G2 LOCALITY TEMPLE CITY, Cl
1 145 WATER CLOSET/URINAL. _ .l 00 FIX 16 30
ITENANT 1 TOTAL FEES 44 10 11SSUED ON PROCESSED BY PLAN BY 1
1 1 110/17/11 SR 1
I I I I
10WNER TEL NO 1 IFINAL DATE F AL BY CODE 1
IWONG, JAMES (626) 246-8848- 1 1 1
18639 LONGEN AVE 1
1SAN GABRIEL CA 91775 1 IDESCRIPTION OF WORK 1
I I IRELOCATE WATER HEATER
1 1 1 1
1APPLICANT TEL NO I I
ILIU, MICHAEL (626) 641-8208- 1 1 1
12550 W MAIN ST 211 1 1SPECIAL CONDITIONS 1
ALHAMBRA, CA 91801 1
I I I I
CONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE
ILI, GUANG JIN (626) 672-8360- 1 1 1
1522 W WINNIE WAY LIC NO (UNDER SLAB WORK 1
IARCADIA, CA 91007 688406 B 1 I 1
1 1 1WATER SERVICE I 1
I IPLASTIC Y/N METAL Y/N 1 1
(ARCHITECT OR ENGINEER TEL NO I I I I
- I IROUGH PLUMBING I I
LIC NO
IGAS PIPING 1 I
1
IGAS VENT 1 I
1 I
I I 1HOT WATER HEATER 1 1 1
1 1 1PLUMBING FIXTURES I I
1 1 1LAWN SPRINKLERS 1 1
I I IGAS TEST I 1
II - 11 1
1 1 1UTILITY COMPANY NOTIFIEDI 1
I I cWV 1 I
IGRAY 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
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(REPORT ID DPR263 ROUTE TO BS0508