HomeMy Public PortalAbout8701 LONGDEN AVE_Plumbing__ 76AS67 (CE-817)
APPLI.CATION FOR PLUMBING PERMIT
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING
ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS
/
NUMBER FIXTURE OR ITEM @ FEE CROSS ST �!j
OWNER
WATER CLOSET 200
MAIL
BATH TUB 2.00 ADDRESS
r
SHOWER 2.00 CITY TEL. NO.
LAVATORY mpg d,y CONTRACTO
SINK 2.00 f� 'ADDRESS
DISHWASHER 2.00
CLOTHES WASHER 200 y �/
SWIMMING POOL RECEPTOR 2 00 LICENSE O (/ Y fP CLASS
DISTRICT NO. ROUP ZONE ROCESSE,D BY
LAWN SPRINKLER SYSTEM 2,00 �p A �_ �—� �.
WATER HEATER 200 INDUSTRIAL •l'`
WASTE APPROVAL
GAS SYSTEM OUTLETS 2.00a
INSPECTION RECORD
OUTLETS OVER t U
5 PER SYSTEM .30 iJ
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N
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
_ APPROVALS DATE IN9 PE C_T,OR 9 91GNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
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 j PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REOUIL
RE BY OS 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
SIGNATURE /J/J� �,^`
OF PERMITTEE/i" - �� G6�/�
PERMIT VALIDATION cK M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
F'a
76A667A - - -
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APPLICATION FOR .LUEY BiNG PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS 7O O av r'g„
NUMBER FIXTURE OR ITEM @ FEE e.— I
WATER CLOSET :LOCALITY
NEAREST
BATH TUB CROSS ST A-7 esM
SHOWER JA
WNERL.1 4Ad
G
LAVATORY AIL
DDRESS
SINK ITY YAI`Q NO
DISHWASHER CONTRACTOR
CLOTHES WASHER u ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL NO
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER LICENSE NO CLASS
t
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT
&2
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST
Plan check fee UTILITY CO NOTIFIED A
PLUMBING PERMIT ISSUING FEE$ 1 e
TOTAL FEE � (, —�
FINAL
Plan check applicant PLAN CHECK VALIDA-UON J �,
Name �i!(,�a ►pfC), A,7YR AG oa��V O �'N,
Address Y• # o o o o o 5 '
City Tel No 2 0 0 1-0.00
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES O O O 1. (100M
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS 1005-78/10 O �'7 O
O
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE / .
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY (/•
V
SIGNATURE
OF PERMITT
DISTRI NO PROCESSE
S_0
INDUSTRIAL
WASTE APPROVAL
76A667A 1
CE 6174REV 6/791 '
&S
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPEI BUILDINGi✓�L—
ADDRESS o
NUMBER FIXTURE OR ITEM ® FEE
m2 a�u
WATER CLOSET LOCALITY
NEAREST �($_
BATH TUB CROSS ST N'�01'1
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY TEL NO
DISHWASHER CONTRACTOR
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL NO
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER - LICENSE NO CLASS
GAS SYSTEM OUTLETS
APPROVALS DATE INSPECTOR 5 SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST �
Plan check fee UTILITY CO NOTIFIED
PLUMBING PERMIT ISSUING FEE$ h o
TOTAL FEE `L7 j FINAL 1 ` 7 `y
Plan check applicant PLAN CHECK VALIDATION
Name '? /11+/shi
Address zr,-v yr/ L/,-
City orifi'G Tel NO Z SC -tL�; /
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ;2 5.5 1.4 A
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS # O O O O O 5
REQUIRED 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 //�� 2 0 0 10,00
SIGNATURE O O O 1,0,
OF PERMITTEE
11
DISTRI NQ PRO SSED BY
0717-V' 79O O f-J
INDUSTRIAL
WASTE APPROVAL
76A667-CE#817 2-66
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILOHNDANLAMBIEG AND SCouNTr EAFETY INGINOEER ING
ADDDRESS 8701 Longden Ave.
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY ,rjaTl Gabriel
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER IV. R. Graham
MAIL
WATER CLOSET $1.25 O
BATH TUB 1,25 ADDRESS 87.01. Longden Ave.
SHOWER 1.25 CITY Sari Gabriel TEL. NO. 285 1.354
LAVATORY 1.25 CONTRACTOR Vall-ey 21xt Heating Cbtp .
SINK 1.25 ADDRESS305 E Valhey Blvd.
DISHWASHER 1.25 Circ Sah Gabriel TEL. NO. 288 681.2
STATE LIC
LAUNDRY TUB 1.25 LICENSE NO 1.47899 CLASS C 20'
CLOTHES WASHER 1.25 DISTRICT NO. GRqj.W ZONE PROCESSED BY
WATER HEATER 1.50
1 GAS SYSTEM 1. OUTLETS "S0 1_ 0; INDUSTRIAL
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 U
INSPECTION RECORD
O
H
U
W
� N
Z
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT 5 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE 31 56,1 GAS PIPING
I HEREBY ACKNOWLEDGE THAT IHAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY EGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGEL COU Y AND STATE OF GAS TEST
CALIFORNIA OR THAT I THE LEGA OWN O AND END TO
RESIDE IN,THE ABOVE CCRIBED R ENTI P PERT UTILITY CO NOTIFIED
SIGNATURE
OF PERM ITTE t
FINAL
LIDATION JACK R. ALLEN
cK M o CASH SUPERVISING MECHANICAL ENG'R.
t: ! A(`�•5 1=.3:9 .tom 2 8 5 V 34 Q a
i.t.
CE 81,7(REV B/�TB) - -
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APPLICATION FOR PL.UMBIIVG PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
•ADDRESSE G�� ✓ (�
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET LOCALITY
•NEAREST _` '
BATH TUB CROSS ST
SHOWER OWNER CN 140t R 4 Af J.�
LAVATORY MAIL t
ADDRESS
SINK CITY TEL NO
DISHWASHER CONTRACTOR'
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL NO
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER LICENSE NO'• CLASS
GAS SYSTEM OUTLETS 0- APPROVALS DATE INSPECTOR 5 SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT
HOT WATER HEATER p0
PLUMBING FIXTURES 8 D
GAS TEST' 1�A
PI'ah check fee UTILITYCO NOTIFIED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL "
Plan check applicant PLAN CHECK VALIDATION
Name J _ ;906 7 SA
Address # o o o o o 5
City Tel No L o p 1000
I HEREBY ACKNOWLEDGE'THAT I HAVE READ THIS APPLICATION AND STATE lap" , �2
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ' O O O 1,0 O O V
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS _ _ •� - I O',O 6 /�/
8
REQUIRED 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
SIGNATURE
.OF PERM ITTEE
DISTRICT NO PROCE S BY
INDUSTRIAL "
WASTE APPROVAL
' 'r WORKERS' COMPENSATION DECLARATION A PPUC TION FOR (SLUM o��N l�f�R/,�� T
I 'hereby' affirm that I have a rertificate of consent to self 76A667A /rvu /r�1 llv u v QJ Il�[la ®vu U
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 BUILDING AND SAFETY
Policy No Company
Certified copy is hereby furnished
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
❑ Certified copy is filed with the county building inspec- ADDRESS
tion department NUMBER FIXTURE OR ITEM Qa FEE LOCALITY �� G
Date Applicant WATER CLOSET NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST
COMPENSATION INSURANCE OWNER V
IC
(This section need not be completed if the work involved by SHOWER
the permit is for one hundred dollars($100)or less.) LAVATORY MAIL
ADDRESS
I certify that in the performance of the work for which this
permit is issued, I shall not employ any person in any manner SINK- CITY 7 � TEL NO 7�J
so as to become subject to the Workers'Compensation Laws HWASHER 7 J
CONTRACTOR
Date (6-22--93 Applicant 960&y A
r)' Lei 1�X/� CLOTHES WASHER �� ADDRESS PL ,
NOTICE TO APPLICANT If, after making this Certificate of Sr4• t2
Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR or�v
Compensation provisions of the Labor Code, you must forth- 1 7J TEL N0�41
CITY ! 6
LAWN SPRINKLER SYSTEM I!
with comply with such provisions or this permit shall be STATE LIC
deemed revoked WATER HEATER LICENSE NO CLASS
LICENSED CONTRACTORS DECLARATION DISTRICT 0 P ESSED BY
I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS
(commencing with Section 7000) of Division 3 of the Business OUTLETS OVER d
and Professions Code, and my license is in full force and effect 5 PER SYSTEM FINAL
DATE VALIDATION u
'f License Number 3 7 ELI :3 !� Lic Class =
FINn - � " AL O
Contracto`T4'QY BY
�
❑ I am exempt under Sec
Vf
B 8P C for this reason
Plan check fee -
Dote `Z'�3
PLUMBING PERMIT ISSUING FEE$
Signature
TOTAL FEE
SINGLE FAMILY
Plan check applicant
'
HOME OWNER-BUILDER DECLARATION Name 141 a3 A
I hereby affirm that I am exempt from the Contractor's License Address
Law for the following reason (Section 7031 5, Business and o o o o e 5
Professions Code) City Tel No 2'- -'2'8"'C
❑ j, as owner of the property, will do the work and the
structure is not intended or offered for sale (Section '0'0 a 2 R,5 p
7044, Business and Professions Code)
CONSTRUCTION LENDING AGENCY 0802-83
j 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 State jaws regulating Plumbing, and hereby
authorize representatives of this County to enter upon the
above-me boned propert for inoection purposes
SEE REVERSE FOR EXPLANATORY LANGUAGE
Sign ture o ermittee ' Date J
r
w 7 We'ORKERS' SAYION DECLARATION APPU AMN FOR PLUMBING PERM?
- I �eraby d# I have irtn that have a certificate of consent to self 76A667A 1p/7Ja�
insure, or a WrtiUrofte of Workers' Compensation Insurance, CE 817(REV 10/81)
or a certifiA4.copy thereof (Sec 3800, Lab C ) A=/6 y
Z
/�` COUNTY OF LOS ANGELES BUILDING ARID SAFETY
Policy No d 3 Company
❑ Certified copy is hereby furnished
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING t
Certified copy is filed with the county, Id ng ms ec- ADDRESS 7z5i /
tion department NUMBER FIXTURE OR ITEM @ FEE
LOCALITY �
Date Applicant WATER CLOSET NEAREST''-
CERTIFICATE OF EXEMPTION FROM WORKERS' 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 ($100)or less.) LAVATORY MAIL
ADDRESS
I certify that in the performance of the work for which this ?
permit is issued, I shall not employ any person in any rrlanner SINK CITY TEL ORP� `J
so as to become subject to the Workers'Compensation Laws DISHWASHER
CONTRACTOR
Date Applicant CLOTHES WASHER ADDRESS /
NOTICE TO APPLICANT If, after making this Certificate of
Exemption, you•should become subject to the Workers' SWIMMING POOL RECEPTOR
Compensation provisions of the Labor Code, you must forth- CITY TEL NO
LAWN SPRINKLER SYSTEM '
with comply with such provisions or this permit shall be STATE LIC
deemed revoked / WATER HEATER LICENSE NO Y CLASS C"s
LICENSED CONTRACTORS DECLARATION DISC O� PROCESSED BY
I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS
(commencing with Section 7000) of Division 3 of the Business OUTLETS OVER Q .v
and Professions Code,and my license is in full force and effect 5 PER SYSTEM " O
�'` � rF VALIDATION License Numb r J I s Class cis g
L O
Contracto ate V
El
nu
I am exempt under Sec y
B 8P C for this reason Plan check fee Z
Date D
PLUMBING PERMIT IS EE$
Signature
TOTAL FEE /� _� 9 Q 1,5 A
SINGLE FAMILY Plan check applicant t'o o'o o o 5
HOME OWNER-BUILDER DECLARATION Name ? u,o 1 6'5 0
j hereby affirm that I am exempt from the Contractor's License Address
Law for the following reason (Section 7031 5, Business and C, 0 0 1 / Q
Professions Code) City Tel No I
❑ j, as owner of the property, will do the work and the o L 1 6-84
structure is not intended or offered for sale (Section D
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 D
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-menti ned 2�yfor inspection purposes '
SEE REVERSE FOR EXPLANATORY LANGUAGE
a .—do
Signature of Permittee Date
a
COUNTY.OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
• DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0703190009
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT.
ILEGAL ID I FEES PAID I BUILDING ADDRESS I
ON FILE 8701 LONGDEN AV 1
IFEE DESCRIPTION QUANTITY. UOM AMOUNT:( SGAS CA 917751813 I
(ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET- ROSEMEAD 1
15381-022-020 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE- 596 GRID G2 LOCALITY- TEMPLE CITY, Cl
1 107 BATHTUBS/SHOWERS 2 00 FIX 32.40 I 1
ITENANT 117 FLOOR DRAIN(S) 1 00 FIX 16 20 (ISSUED ON PROCESSED BY- PLAN BY EXPIRES ON:
1 125 LAVATORIES/SINKS 3 00 FIX 48 60 103/19/07 JK 09/15/07
I 145 WATER CLOSET/URINAL 2 00 FIX 32 40 1 I
1OWNER: TEL. NO- 147 WATER HEATER(S) 1 00 WTH 1620 IFI AL DATE FI CODE 1
ILIU, TINA (626) 780-4694— 160 DWV REPAIR OR ALTER 3.00 SYS 48 60 1 1 �t 1
18701 E LONGDEN AVE I TOTAL FEES 222.15 1 1
ISAN GABRIEL CA 91775 1 IDEMCRIPTION OF WORK I
I I IPLUMBING FOR KITCHEN AND BA HROOMS
(APPLICANT- TEL NO- 1 I I
SAME AS OWNER - 1
I (SPECIAL CONDITIONS:
I
I
ICONTRACTOR TEL. NO I 1APPROVALS DATE INSPECTOR SIGNATURE 1
I SAME AS OWNER — I s� r - I 1
I LIC- NO 1 1UNDER SLAB WORK I I I
I I IWATER SERVICE I
I =I IPLP.STIC YIN METAL YIN I I I
1ARCHITECT OR ENGINEER TEL NO. 1 I 1 I I
1 — I (ROUGH PLUMBING
LIC. NO: 1 I
IGAS PIPING- I I I
1 I IGAS VENT I 1 1
IHOT WATER HEATER I 1 I
1 I IPLUMBING FIXTURES I I I
I 1 ILAWN SPRINKLERS 1 1 1
1 1 IGAS TEST I I I
1 I 1UTILITY COMPANY NOTIFIEDI I 1
CWV
- (GRAY WATER SYSTEM 1 I 1
I I I I I
I I I_ I
I IRT ID DPR263 ROUTE TO BS0508 I I 1
I (REPO 0 I I I