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Home My Public Portal About9361 LOWER AZUSA RD_Plumbing__ S 76A667 08817 11-50 • APPLICATION FOR PERMIT - DEPARTMENT OF BUILDING AND SAFETY PLUMBING 1 e COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER R G RO P ZONE PERMIT . FOR APPLICANT TO FILL IN � ,��1 J PLUMBER �5..7{ �� r orf,• ! RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION -7-�� IADCRESS F�.� � vl' •r ¢��G a /. �.G 3�� CITY . . „�5= �/•/.� Lr�TEL No. ( BUILDING / 6 V7/�® U .� .¢�� /_-' ADDRESS �i /�,r/� 7 Y//1 COUNTY _ LOCALITY LICENSE NO. EXPIRES NEAREST PERMIT FEES CROSS ST. /� NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER .- F ,fir /= I 1 !w V' / b� {q MAIL WATER CLOSET(TOILET) 0.50 111 ADDRESS p �y V.4 �� Y ag y 6 BATH TUB 0.50 CITY ( _ {�,s=�{ TEL NO. I SHOWER 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS / LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK 0.513 AND STATE LAWS REGULATING PLUMBINO. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY 0.50 ANGELES COUNTY LICEN8E, OR 1 AM THE LEGAL DINNER OF THE RESIDEW IAL P 0 RTY DESCRIBED ABOVE. GA9 SYSTEM CUTLETS 0.50 SIGNATURE OF, WATER HEATER 0.50 P,ERMITTEF C SLOP SINK 0.50 INS ECTION RECORD FLOOR SINK @ 0.50 A FLOOR DRAIN 0 0.50 DISHWASHER 0.50 DRINKI'NG FOUIiTA1N 0.50 OA. URINAL db 0.50 i Q HOUSE SEWER @ 0.50 Jam' 2 �a ,� .�� ao- 04-- 7-u Z MISCELLANEOUS vTIL�Y C p , rrQQL�d -�� m O APPROVALS DATE INSPECTOR'S/NAME .ROUGH PLUMBING ►�"/� r GAS PIPING - GAS VENT CESSPOOL @ 1.1313 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER A PERMIT . 1.00 GAB TESTJ UTILITY CO.NOTIFIED ,� /F-�� :��.,.•'+a �' � \ / TOTAL FEE " FINAL 76AG67 DBB 17 11-s0 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY r . COUNTY OF LOS ANGELES PLUMBING 1 WILLIAM J. FCX CHIEF ENGINEER FOR'APPLICANT �T�O/FILL IN PLUMBER ♦Cf I 1,(Zy q t' " J RECEIVED BY READY FOR DATE ISSUED h ` / FIRST INSPECTION a ADDRESS r r /� �� SUILDINBq / ` ��' war ` ADDRESS / �1/J/ .7n1"�� CITY �(/'=� J,; 1 TEL.No. COUNTY - LOCALITY \Ve��L?! Iii i .f.+✓ =` LICENSE N04� EXPIRES MCA I PERMIT FEES CROSSST. :�w/J�/."rte NUMBER / TYPE OF FIXTURE OR ITEM FEE OWNER �J�,C•r'��,P�//f�/V ,d�IV''''�1✓ ✓ /�/t1( // /+/� MAIL WATER CLOSET(TOILET) 0.50 M ADDRESS '�)�`�'�)�✓�f1/F /i! ��G BATH TUB @ 0.50 CITY \ '� %[G�// TEL No. SHOWER 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL CQUNTY ORDINANCES KITCHEN SINK 0,50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POBBEBB THE ABOVE VALID LOS S COUNTY LICENSE. OR 1 AM THE-LEGAL OWNER LAUNDRY TUB 13R TRAY a.so ANSELE GAB SYSTEM-1—OUTLETS 0.50 OF THE RESIOENTIA P PE DESCRIBED ABOVE. SIGNATURE OFi WATER HEATER 0 0.50 PERMITTEE / SLOP SINK 0 0.50 II7SPECTION RECORD FLOOR SINK @ 13.50 FLOOR DRAIN O.SO DISHWASHER ® 0.50 DRINKING FOUNTAIN 0.50 URINAL 0.50 A HOUSE SEWER 0.50 Z MISCELLANEOUS 13 R' O -r e cl APPI'LOVALS \\ AnTE INBPEOTOR-B NAME ROUGH PLUMBING ` lam— tv l" BAB PIPING GAS VENT CESSPOOL 1:00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT 1.013 GAS TEST TOTAL FEE III / UTILITY CO.NOTIFIED FINAL WORKERS'COMPENSATION DECLARATION 20-0026 DPW 4/87 APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I have a certificate of coi5sent to self•iri- 76A667A sure,dr a certificP?e oPWorkers'Campensatien Fnsurance,•or a CE 817(REV.8/86) 'fl certified copy thereof(Sec. 3800, Lab. C.) ' i Policy No 6273789Q4smpany PACIFIC COMP. I COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy is hereby furnished. I FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ® Certified copy is filed with the county building inspection NUMBER ADDRESS 9361 LOWER AZUSA RD. department. FIXTURE OR ITEM @ FEE LOCALITY TEMPLE CITY, CA. Date 3-12-90 Applicant OWM PLBG. 4 WATER CLOSET(TOILET) 3Q.00 NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' 4 BATH TUB 3 .00 CROSS ST. COMPENSATION INSURANCE SHOWER OWNER BERNIE MIZRAHI (This section need not be completed if the work involved by MAIL the permit Is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any manner so 1 SINK 7.50 CITY LA CANADA, 'CA 91011TEL. NO.790-8662 as to become subject to the Workers'Compensation Laws.. DISHWASHER .50 CONTRACTOR PLUMING CO. Date Applicant 1 CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of Ex- ADDRESS 2019 SANTA ANITA AVE. emption,you should become subject to the Workers'Compen- SWIMMING POOL RECEPTOR sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM CITY JT ' NO-443-3384 ly with such provisions or this permit shall be deemed revok- ASTATE LIC. ed. •WATER HE.6TER LICENSE NO. •4551933 CLASS C-36• LICENSED CONTRACTORS DECLARATION ISTRnIP P SED BY )r I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM ' 5 OUTLETS .50 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL Q/% AL ATION d feet. DATE License Number 451933 Lic. Class C-36 0 tNContractor. OWEN PLBG. Date FIN 3-12-90 BY A 1 am exempt under Sec. LAA B.BP.C. for this reason5 Plan check fee I,- ► g Date: PLUMBING PERMIT ISSUING FEE$ ACCT -TL Signature 13• 0 1•':00 I �� 155°5O TOTAL FEE 15 �5O 4 1 ITEMS SINGLE FAMILY Plan check a HOME OWNER-BUILDER licant DECLARATION pp i TOTAL 1�5®50 I hereby affirm that I am exempt from the Contractor's License Name CHECK 1 °� Law for the following reason (Section 7031.5, Business and Professions Code): Address CHANGE ° 00 I, 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). oil. 3/279/90 CONSTRUCTION LENDING AGENCY97�b 1 A�'I11031 1 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 repres ntatives o County to enter upon the above- do d pro rt or' spection purposes. --�p SEE REVERSE FOR EXPLANATORY LANGUAGE Sbrx6re of Permittee Date