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Home My Public Portal About9419 LOWER AZUSA RD_Plumbing__ 76AG67-CE#817 10-62 7LUMEBING APPLICATION FOR PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRES WILLIAM A.JENSEN, SUP'T OF BUILDING LOCALITY El Mont FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.251-49 MAIL BATH TUB 1.25 Jr ADDRESS SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 d V CONTRACTOR f SINK 1.25 ADDREss2jk07N . Lee Ave DISHWASHER 1.25 CrrySo o El Monte TEL.N LAUNDRY TUB 1.25 REGISTRATION NO. C 36 206367 COUTNTY ❑ CLOTHES WASHER 1.25 DISTRICT NO. GRnup, ZONE P SED BY WATER HEATER 1.50 GAS SYSTEM OUTLETS 1.50 INDUSTRIAL / B>. WASTE'APPROVAL OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD u 0 I— QuD In cut z APPROVALS D TE I INSPECTOR'S SI N ,ARE PERMIT $ 2 00 UNDER SLAB WORK TOTAL FEE I ROUGH PLUMBING GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN.THE ABOVE DESCRIBED RESIDENTIAL PROPERTY: UTILITY CO.NOTIFIED tt SIGNATURE ` l i1i !Yl i'G•+"f.�f111 OF PERMITTEE FINAL 1 14+v /-YALIDATION ROBERT A.WOOD CK M.0. CASH SUPERVISING MECHANICAL ENG'R LALo 0 6. 5 0 Q SEP 2 5 5 D 13.7 5" / 76A667 (CE-817)=8-71 / .- `/-/ APPLICA`/ 1911 FOR L WA�. PE10 COUNTY OF LOS ANGELES . DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ABUILDING DDRESS• LOCALITY FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST CROSS ST. • d NUMBER FIXTURE OR ITEM 0 FEE . OWNER /LL WATER CLOSET 1.75 MAIL BATH TUB 1.35 ADDRESS 4d ' 4 SHOWER 1.75 CITY Z - TEL. NO. LAVATORY 1.75 •CONTRACTOR SINK 1.75 ADDRESS / DISHWASHER 1.75 CITY TEL. NO. / CLOTHES,WASHER 1.75 STATE LIC �.� SWIMMING POOL RECEPTOR 1.75 LICENSE NO. CLASS DISTRICT GROUP ZO E PPITD B. LAWN SPRINKLER SYSTEM 1.75 D WATER HEATER 1.75 17rINDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD V OUTLETS OVER 30 5 PER SYSTEM m V W d ` Vl Z Plan check fee See reverse. PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE 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 15 CORRECT AND AGREE TO COMPLY 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 REQUIRED BY LOS ANGELES COUNTY ND STATE OF r ` CALIFORNIA OR THAT I AM THE LEGAL OWNER OF ND IN TO _ file RESIDE IN THE ABOVE DESCRIS RESIDE AL P O ERTY. FINAL SIGNATURE OF PERMITTEE. ' PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH I Ia"' As44.75~ CQ �) WORKERS'COMPENSATION DECLARATION 4 FF errb �affi.rm that I helve a certificate of consent to self76A •AP:PL;ICATION�FOR PLIJMBI.NG PERMIT insgre, ora certificate'of Workers'Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof(Sec. 3800, Lob. C.) .COUNTY OF LOS ANGELES 1 I' BUILDING AND SAFETY Policy No. • Company 1 Certified copy is hereby furnished. 9 I 7! FORA PLICA T TO FILL IN(PRINT OR TYPE) BUILDING DD ESS G� El Certified copy is filed'with the county building inspect tion department. NUMBER FIXTUREOR ITEM @ FEE LOCALITY / Date A li ant WATER CLOSET NEAREST PP 4. � . CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB gROS5 ST. COMPENSATION INSURANCE I SHOWER OWNER (This section need not be completed if the work involved by IL p the permit is for one hundred dollars-($100)or less.) LAVATORY ADDRESS �IrIG I certify that in the performance of the work for which this; I permit is issued, I shall not employ any person in any manner) SINK CITY �� % TEL.NO. so as to'be ome subject to the Workers'Compensation Laws. I DISHWASHER CONTRACTOR Date E n licant e✓+'�'Vv CLOTHES-WASHER ADDRESS 3 NOTI O APPC ANT: If, after making this Certificate of I, Exemption, you should become subject 'to the Workers' SWIMMING POOL RECEPTOR ' Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY 1/4A. TEL. with comply with such provisions or this permit .shall be STATE LIC. deemed revoked. ' WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION } DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS I610 �( (commencing with Section 7000) of Division 3.of the Business i OUTLETS OVER —•• v U and Professions Code,and my license is in full force and effect. ' 5 PER.SYSTEM 'FINA VALI TION V 0 License Number 71 2y.�Lic. Class / DATE. �j IFIN Contractor :Date " BY U W ❑ �0954A PA I am.exempt under Sec. N B.&P.C. for this rea on Plan check fee # 0 0 0 0 0 5 t : PLUMBING PERMIT ISSUING FEE$ Signature 'I o o 1 &50 TOTAL FEE. o o'o 1 6505 Plan check applicant SINGLE FAMILY •( Q24-84 HOME OWNER:BUILDER DECLARATION Name i 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. ❑ I, as-owner of the property, will do the work and the I' 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 I , Lender's Address I certify that I have read this application and state t o,e' f at'- ec gMou oom I�v4 nt �p p5 "fytPr e tk n to .enter Upon the above- ti pro erty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE � Si nature of P mittee Urafe C i • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 I PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9809090005 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PA DING A DIES : TR: 13329 LT: 22 BL: .001 -9411 LOWER AZUSA RD FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 'TEMP CA 917804220 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: CLOVERLY 8590-021-027 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 1.00 FIX 16.20 i TENANT: 47 WATER HEATER(S) 1.00 WTH 16.20 ISSUED ON: PROCESSED : PLAN BY: EXPIRES 0 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 09/09/98 UT 09/09 TOTAL FEES 76.35 OWNER: TEL. NO: I FINAL DATE FINAL BY: CODE: REAL TOMASA D - 9419 LOWER AZUSA RD TEMP 917804220 DESCRIPTION Of WORK PLUMBING FOR BATHROOM REMODEL AND ELOCATE WATER HEATER APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: � `�!� n APPR9VALS DATE INSPECTOR SIG SAME AS OWNER - LIC. NO UNDER SLAB WORK WATE, SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. N0: }- ROUGH PLUMBING LIC. N0: i I I� `1` •� _ GAS PIPING GAS VENT ��j Ij U C w 1]n e� OT WATER EATER LUMBING FIXTURES c,) AW 'SPRI ERS GAS TEST COMPA—ffYV07 FIED L '�� _ ' c v -- GRAY WATER SYSTE REPORT ID: DPR263 ROUTE TO: BS0508