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Home My Public Portal About10405 LOWER AZUSA RD_Plumbing__ 76A667 DBS 17 11-SO _APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER DISTRICT O. GROUP I ZONE RMI NO. ,F❑ APPLICANT ILL IN PLUMS E I RECE D BY READY FOR DATE ISSUED FIRST INSPECTION ADORERS ® O 1 BUILDING 0® -79 CITY TEL.NO.Opt &I 4 ADDRESS t GDUNTY J�p� /��y�y� ` LICENSE NO. 7/t!� _Q' -Y EXPIRES ®°�� LOCALITY NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL 77— WATER CLOSET(TOILET) @ 0.50 $ ADDRESS BATH TUB @ 0.50 CITY TEL.. No. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS / LAVATORY (WASH BASIN) @ 0.50APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POSSESS ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, ) THE LEGAL OWNER ® TI E GAS SYSTEM OF THE REBID UTLETS @ 0.50 SIGNATURE OF a' WATER HEATER @ 0.50 PR PER SCRIBED ABOVE. PERMITTE SLOP SINK @ o.50 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.50 DRINKING FOUNTAIN @ 0.50 URINAL .@ 0.50 Q HOUSE SEWER @ 0.50 ? MISCELLANEOUS [7 O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 7.00 SEWER PERMIT I 1,00 GAS TEST UTILITY CO.NOTIFIED '8i .Ge sS4 TOTAL FEE $ FINAL WORKERS'COMPE445ATIOAti.DECLARATION APPLICATION FOR PLUMBING PERMIT I r,reby, Zr itrjm that I have a certificate of consent to self in- 76A6667A PW 4/90 sures'or a cer ficate of Workers'Compensation Insurance,or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company u F]. Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING r Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET.(TOILET) NEAREST �s CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. 221 COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK mit is issued,.I shall not employ any person in any manner so CITY /) AlMay NO. / :242 as to become subject to the Workers'Compensation Laws. DISHWASHER c1�s '✓ CONTRACTOR Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESS emption,you should become subject to the Workers'Compen- SWIMMING POOL RECEPTOR CITY TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. / WATER HEATE O LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETSD 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect. HOSE BIB DATE 1 Z�--G >_ License Number Lic. Class tL FINAL O U Contractor Date BY I am exempt under Sec. 3303 43,40 B.&P.C. for this reason 1 ITE 1 U Plan check fee , IL Date: PLUMBING PERMIT ISSUING FEE$ TOTAL 43 o 40 3 Signature TOTAL FEE CHECK 43.40 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant CHANGE ,Qi] I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and 0000'001 � � � � Professions Code): Address eAI, as owner of the property, will do the work and the City Tel. No. 2663 1 AM 9:53 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 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 laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-me tinned prop rty f r inspection purposes. / 0,21�Vll ! SEE REVERSE FOR EXPLANATORY LANGUAGE iA'nature of ermittee 15ate COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS 4P_L-0508-9708190015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BULL-DING-ADDRESS.: TR: 13645 LT: 80 BL: .001 10405 LOWER AZUSA RDS FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP-CA-91.7803470 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET$ 8585-017-018 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C5 LOCALITY: TEMPLE CITY 21 HOSE BIBB(S) 2.00 FIX 32.70 TENANT: 25 LAVATORIES/SINKS 1.00 FIX 16.35 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 45 WATER CLOSET/URINAL 1.00 FIX 16.35 08/19/97 TC 08/19/98 TOTAL FEES 93.15 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: CHINES JOHN G, CHANG C (626) 575-8330- Q 10405 LOWER AZUSA RD 1,5-q8 5-q V 7� TEMP 917803470 DESCRIPTION OF WORK PLUMBING FOR HOUSE CONVERTED TO NIVIFRY FOR COMMERCIAL USE APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO UNDER SLAB WORK WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. N0: ROUGH PLUMBING LIC. NO: GAS PIPING GAS VENT i HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: 8S0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0301150008 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 13645 LT: 80 BL: .001 10405 LOWER AZUSA RD FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803470 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: HALLOWELL 8585-017-018 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C5 LOCALITY: TEMPLE CITY 05 BACKFLOW DEVICE(S) 1.00 DEV 16.20 TENANT: 21 HOSE BIBB(S) 2.00 FIX 32.40 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 25 LAVATORIES/SINKS 1.00 FIX 16.20 01/21/03 JK 07/20/03 TOTAL FEES 92.55 OWNER: RMICHELLE TEL. NO: FINAL DATE l FINAL Y CODE: >c' DESCRIPTION OF WORK PLUMBING FOR T.I. APPLICANT: TEL. NO: FREEMAN HAN (626) 796-5899- 9051 E VALLEY BL SPECIAL CONDITIONS: ROSEMEAD 91770 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE TAM AND WANG CONSTRUCTION (626) 429-1884- 416 AVONDALE STREET LIC. NO �'; UNDER SLAB WORK MONTEREY PARK, CA 91754 771180 B WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. N0: HAN, FREEMAN (626) 796-5899 - ROUGH PLUMBING 9051 VALLEY BLVD. #104 LIC. N0: ROSEMEAD, CA 91770 C21976 j i I 1 GAS PIPING - GAS VENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508