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HomeMy Public PortalAbout10241 LOWER AZUSA RD_Plumbing__ 7 DBS-17,f1 0 55... • APP�L�ICA:T•I.ON :FO.R '-PLU ,BIN.G PER.MIT -- - B5,1 DIVISION OF BUILDING AND SAFETY Pepaitment of County Eagineer County of Los,Angeles BUILDING ®+� O v� .. JOHN A. LAMB1E-,COUNTY ENGINEER ADDRESS' s[ - .CAS_SATT'p.,;GRIFFIN,`SUa'T of BUILDING - - - _ n _ LOCALITY f� FOR APPLICANT TO FILL IN NEAREST . ., �y _ - CROSS•ST.. OG�� ../� '�✓� " , OWNER457 -' �,/ DISTRICT,NOS '.GROUP I ZONE I READY FOR INSPECTION MAIL m ADDRESS. •' " INDUSTRIAL. - •'�. CITY ° TEL.•NO, ' 'WASTE APPROVAL' . ` PLUMBERM ! -e --,•/�-' 71NSPECTION RECORD ADDRESS -� CITYNO LICENSE N0. NUMBER TYPE OF FIXTURE OR ITEM FEE. // �! '; �,,,/�L��./„��-j •,ft ijr-',f��,�/�,' - "WATER CLOSET (TOILET)- @' $-1.00• 'Q�. ,f,,.•I Ln : '' .:`/".T. 'J !/•��l/l_., �i1.,.,..�.: , '-BATH TUB *'^ @ $1.00.. `.SHOWER. r @' .$L.00. . ;; r } . LAVATORY: (WASH_BASIN.)' @ $1.00 '..KITCHEN SINK.....: @' .$1..00 k? > r G DISHWASHER - .-.. . @ $1.00. .LAUNDRY TUB OR TRAY '@„x$1.,00. CLOTHES WASHER @ $1.00 'WATER HEATER -.. _ .: @. 51..00 GAS SYSTEM, :. @. $1.00 APPROVALS DATE{ I�NS!PECTOR S SLGNATURE. � UNDER'SLAB WSRk PERM_IT_, .RO•U,GH:PLLiMBING '.:.,. _. "A'B.,"�'d, „/.�i,-,,-•�..f�r,,..,.y„1j'_ ,. GAS PIPING - '.TOTAL FEE .' ��' GAS'V.ENT I HEREBY,ACKNOWLEDGE.THAT•,I .HAVE. READ THIS-APPLICATION 'HOT WATER HEATER i - AND STATE THAT THE�ABOVE IS CORRECT AND- AGREE TO COMPLY WITH ALL .COUNTY. ORDINANCES 'AND-,STATE-.LAWS, -REGULATING pLUMBINGFIXTURES i s PLUMBING..,.:. . It HEREBY CERTIFY. THAT 1 -'AM PROPERLY, REGISTERED AND/OR GAS TEST LICENSED•,AS:.REQUIRED-BY'"LOS ANGELES COUNTY,AND STATE. OF •�CALIFORNIA OR THAT•l .AM THE; -LEGAL' OWNER, OF THE ABOVE UTILITY CO..,NOTIFIED ' DESCRIBED RESIDENTI�PROPRTY, •.. ..' :. : ,.., - -'-" •. _•• -- � -` -- � ' :SIGNATURE r OF PERIvIITTEE. FINAL, 4- JOHN A LAMBIE.'COU-NTY ENGINEER' „-, VALIDATION ROBERT Al'WOOD,CHIEF PLBG.INSPECTOR , CK. 61.0 CASH ci - vl i ` r J CE#817 9/63 APPLICATION FOR - PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF'COUNTY ENGINEER f ILDING BUILDING AANNB SAFETY DIVTY ISION ER DRESSWILLIAM A. JENSEN, SUPT OF BUILDING CALITY•FOR APPLICANT TO FILL IN ARESTOSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.25 MAIL BATH TUB 1,25 ADDRESS �sl(�� a SHOWER 1.25 CITY TEL NO. . v LAVATORY 1.25 CONTRACTOR a CI y SINK 1.25 ADDRESS ,/&!!y DISHWASHER 1.25 CITY TEL. NO , WCT LAUNDRY TUB 1.25 EGISTRAT O NO. 1&'1_'vlY5 COUNTY ❑ CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PROCESSED BY WATER HEATER 1.50JFJ It GAS SYSTEM OUTLETS 1'50 a. WASTE AI PROVAI1'L.O �� O OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RE RD V U W a Z t u 16-G d- /� e APPROVALS DATE INSPECTOR'S, IGNATURE PERMIT $ 2 00 UNDER SLAB WORK ,— ROUGH PLUMBING TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE 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 1 AM P PERLY R ]STEREO AND/OR PLUMBING FIXTURES 4, �/>n LICENSED AS REQUIRED BY LO ANG ES COU AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE AL WNER O AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED E E L PRO UTILITY CO. NOTIFIED SIGNATURE i- OF PERMITTE I' FINAL IV VALIDATION ROBERT A. WOOD M.O. CASH SUPERVISING MECHANICAL Ei1G'R 4 5 5 8 OCT 5 5 0 1 8.7 5. WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT i hereby,'affirm that I have a certificate of consent to self in= 20-0026 DPW a/87 fl 76A667A sure, or a certificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) certified cony thereof (Sec. 3800, Lab. C.) ' Policy No. ,/ Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS 'SC54tified copy is hereby furnished. ` C� FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection ADDRESS !L/ Y I GfJ i-iJJ department. NUMBER FIXTURE OR ITEM Qa FEE LOCALITY WATER CLOSET(TOILET) Date Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by the permit is for.one hundred dollars ($100)or less.) LAVATORY MAILADDRESS 1 certify that in the performance of the work for which this per- _ mit is issued, I shall not employ any person in any manner so CITY TEL. NO. 3 SINK `jvNl��s`� '7 9� C as to become subject to the Workers' Compensation L ws. DISHWASHER !! 6G 6f7� CONTRACTOR Date 0 G Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after in is ertificate of Ex- SWIMMING POOL RECEPTOR l�E�.aedrw emption, you should become subject to the Workers'Compen- CITY n sation,provisions of the Labor Code, you must forthwith comp- 11 �«�' TEL. NO./yiZgoy ly with such provisions or this permit shall be deemed revok- LAWN SPRINKLER SYSTEM STATEIC. ed. WATER HEATER LICENSE NO. 1©6S6aGCLASS r3 6 LICENSED CONTRACTORS DECLARATION DISTRICT NO. CESSED BY I hereby affirm-that I am licensed under provisions of Chapter GAS SYSTEMOUTLETS D 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM VALIDATION D fect. License Number �l) Lic. Class r 3 � —AlQ DATE 6 O - V FINAL Contractor eCli���6 Date 0G J BY Q J� I am exempt under Sec. Q U B.BP.C. for this reason Plan-check fee a Date: PLUMBING PERMIT ISSUING FEE$ 1451 -50 —.fiSignature TOTAL FEE SINGLE FAMILY + 'HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason '(Section 7031.5, Business and '- Professions Code): Address c` D1, as owner of the property, will do the work and the City Tel. No. structure is not intended or offered for sale(Section 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 _ n; +7 Lender's Address y - 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 laws regulating Plumbing,.and hereby pool authorize representatives of this County to enter upon the /ab�o mentio d rty fo pection purposes. � SEE REVERSE FOR EXPLANATORY LANGUAGE ofPer e D to WO'kKERS' COMPENSATION DECLARATION C ,L ' UP APPLICATION FOR PLUMBING PERMIT I lebk•cfff,ft that J. hayoe a'certi4icate of consent to self 20-0026 DPW 6/87 insu/te,'or a certificate of Workers' Compensation Insurance, 76A667A or a certified copy thereof (Sec. 3800, Lab. C.) / �Q� COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company (� (( Certified copy is hereby furnished. ❑ )) FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING / `e Certified copy is filed with th dunty build' inspec- ADDRESS tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET Date Applic NEAREST CERTIFICATE OF EXEMPTION F M RKERS BATH TUB CROSS ST. COMPENSATION INSURANCE OWNER (This section need not be completed if the work Involved by MAIL SHOWER the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS r \ / certify that in the performance rf the work fo which this permit is issued, I shall not employ ny person i ny manner SINK CITY » TEL. O. so as to become subject to the Vlor Is Comp sation S. DISHWASHER CONTRACTOR .; e Date Applican CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making t i3 Cert ica a of Exemption, you should become subject t the /orkers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you rn t forth- CITY O l�1 TEL. NO� LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT N PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM iw�UTLETS O (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and m license is in full force and effect. 15 PER SYSTEM 3' FINAL .� 01 VALIDATION /_ DATE License r � L'c' Classes Q FINAL Contrac o Date ' BY ❑ 1 am exempt u der Sic B.&P.C. for this reason ILI Plan check fee ® Cn Date: Signature PLUMBING PERMIT ISSUING FEE$ 6 Sv TOTAL FEE /z, Plan check applicant SINGLE FAMILY 5 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address ACCT. Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. 3307 .. 16°50 ❑ 1, as owner of the property, will do the work and the 1 ITEPS structure is not intended or offered for sale (Section TOTAL 7044, Business and Professions Code). 1 y OPAL 16 m 50 CONSTRUCTION LENDING AGENCY ; 16. 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued CHANE °00 (Sec. 3097, Civ. C.). �yry Lender's Name W—CLACK 5/16/89 Lender's Address 33318 �t ry• I certify that I have read this application and state that the 1 e�711V° above informatipn is correct. I agree to comply with all County ordinances an /State laws regulating Plumbing, and hereby authorize re esentatives of thi ounty to enter upon the above_r4 i ed property fo spection purposes. �/ SEE REVERSE FOR EXPLANATORY LANGUAGE L'7, Signature of Perm' tee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 9903040003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 11148 LT: 1 BL: A 10241 LOWER AZUSA RD FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917804027 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: ARDEN DR. 8585-015-001 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B5 LOCALITY: TEMPLE CITY 47 WATER HEATER(S) 1.00 WTH 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: EL CAPIRO 03/04/99 UT 03/04/zn0 OWNER: TEL. NO: FINAL DATE FINAL BY: ODE: UGARTE ROSA 102 BEVERLY BL MBLO 906404303 DESC99RIPTION OF WfA ORK APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: / \CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO -gra � � UNDER SLAB WORK WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. N0: i ROUGH PLUMBING LIC. NO" GAS PIPING GAS VENT HOT NATER HEATER - PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508