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Home My Public Portal About9428 LOWER AZUSA RD_Plumbing__ r 7GA4677 r GE B7 7",1REV.8/781 ®S � APPLICA ON F R PLUM N PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM ® FEE ADDRESS WATER CLOSET LOCALITY NEAREST BATH TUB CROSS ST. SHOWER OWNER dlaviz 41z- MAIL LAVATORY ADDRESS 99-429 LGwer- Azusa SINK CITYTem le City TEL.N0.�85-2073 DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS 1350 E. Las Tunas Drive SWIMMING POOL RECEPTOR CITY Sari Gabriel TEL.N2.86-1141 LAWN SPRINKLER SYSTEM TE LIC. 5 WATER HEATER CENSE NO. 22L751 CLASS C20 Z GAS SYSTEM OUTLETS 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING GAS VENT @S HOT WATER HEATER PLUMBING FIXTURES GAS TEST —1 ul Plan check fee UTILITY CO.NOTIFIED V PLUMBING PERMIT ISSUING FEE$ 00 TOTAL FEE 10 00 FINAL 99 Plan check applicant PLANK CHECK VALIDATION Name �� Address City Tel.No. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES F Q 0,2 AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS y o 0 0 0 0 REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE OWNERLEGAL OF.AND INT TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. G a 0 C r -d SIGNATURE o o l l l,�,' OFPERMITTEE �7'✓ �•'L C.62 1 C "DISTRICT Nom„ P CESS Y v/JOv r JI INDUSTRIAL WASTE APPROVAL COUNTY OF LOS ANGELES APPLICATION FOR PERMIT Department of County Engineer DIVISION OF BUILDING & SAFETY PLUMBING ' WILLIAM J. FOX. County Engineer FOR APPLICANT TO FILL IN DISTRICT O. GROUP I ZONE PERMIT Jr 6�3 PLUMBER READY FOR RECEI ED BY DATE ISSUED FIRST INSPECTION _ ADDRESS y✓BUILDIN � CITY Pasadena TEL NOSY 2-5379 ADDRESSCOUNTY !7', 1 LICENSE NO. 2825M EXPIRES 6-30-53 LOCALITY C' NEAREST PERMIT FEES CROSS ST. �j NUMBER TYPE OF PIXTURE OR ITEM FEE OWNER /-f_A0Zl/,S/ys MAIL WATER CLOSET(TOILET) a 0.50 M ADDRESS -� BATH TUB ® 0.50 CITY TEL. NO. SHOWER 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS J_AVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT �r AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN BINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT E THE ABOV ID LOB LAUNDRY TUB OR TRAY D.50 ANOELE9 COUNT CEN R EG OWNER OF THE REBI TIA OPE RISE BOVE. GAS SYSTEM OUTLETS ® 0.50 LIT --r SIGNATOROF WATER NEATER @ 0.50 PERMI SLOP SINK a 0.513 INSPECTION RECORD FLOOR SINK 0.50- FLOOR DRAIN a 0.50 DISHWASHER Q 0.50 V DRINKING FOUNTAIN 0.50 URINAL 0.513 aJ`7�'1~.M / --I HOUSE SEWER 0.50 ss• a+ +� Z MISCELLANEOUS 2 APPROVALS DATE IN13PCOTRWB NAME ROUGH PLUMBING GAB PIPING GAS VENT CESSPOOL Q l;00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) 1.1301 1 SEWER PERMIT 1.00 GAS TEST UTILITY CO.NOTIFIED s. TOTAL FEE M FINAL TOA607 DBS.#17 10/58 / WORKERS'COMPENSATION DECLARATION+ a d' hereby affirm that I have a certificate of consent to self I APPLICATION FOR PLUMBING PERMIT �6A667A insure, or a certificate of Workers'Compensation Insurance, E 817(REV. 10/81) or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES / ` BUILDING AND SAFETY Policy No. Company I Certified copy is,hereby furnished. BUILDING ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS. Certified copy is filed with the county building inspec- tion department. NU BER FIXTURE OR ITEM @ FEE LOCALITY ` WATER CLOSET Date Applicant CNEAREST ROSS ST (� CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE OWNER • WVt)n' Z- (This section need not be completed If the work involved by SHOWER MAIL (�L1 f�I ,Q the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS �C !J� C�I pc I certify that in the performance of the work for which this ermit is issued, I.shal•I not employ an person in an manner SINK CITY • TEL.NO.� .a P.. P Y YP Y law. G>1' 0�:3 so as to become subject to the Workers'Compensation Laws. I DISHWASHER aw,. CONTRACTOR KDQ�te'11-1-2p 2 Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making .this Certifica o SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers CITY TEL.NO. Compensation.provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be ; STATE LIC. deemed revoked. f WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. P. cESSED BY� . I hereby affirm that I am licensed under provisions of-Chapter 9 JQrGAS SYSTEM all OUTLETS (commencing with Section.7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5PER SYSTEM FINAL Q '- VALIDATION - V DAT License Number Lic. Class Z OG r~ FI M. Contractor Date B W ❑ I am exempt under Sec. ' y B•BP.C. for this reason .3 Plan check fee Date:. PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE 10 Plan check applicant SINGLE FAMILY HOME.OWNER-BUILDER DECLARATION Name I hereby affirm that I am.exempt from the Contractor's License � Address Law for the following reason.(Section 7031.5, Business and 'G 7 5 J,7 A : I Professions Code ❑ ) city TeL No. I,.as owner of the.property, will do the work and the I `t o o. o o o 5 structure is not intended or offered for sale (Section. l , 2'0 0 (j Q 7044, Business and Professions Code). ti CONSTRUCTION LENDING AGENCY oro o (L 0.c 0 40. 1 hereby affirm that there is a construction lending agency for _ the performance of the work.for which this permit is issued l 1. 1 2—8 2. (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-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature-of PermItW Date , COUNTY OF LOS ANGELES TEMPLE CITY # 0508 �U!r-RG PERMI-T--) DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0007-170006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILD NG—ADDRESS TR: 12998 LT: 39428 LOWER AZUSA RD FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP—CA 9178042 O ASSESSOR INFORMATION NUMB : NEAREST CROSS STREET: CLOVERLY 8592-003-025 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED : P A BY: EXPIRES ON: 07/11/00 UT 01/08/01 OWNER: TEL. N0: FINAL DATE FIN BY: CODE: GALAVIZ ANTONIO;MARGARET 9428 LOWER AZUSA RD TEMP 917804219 DESCRIPTION OF WOR GAS LINE FOR NEW FIREPLACE APPLICANT: TEL. NO: DIMA CONSTRUCTION (626) 369-5397- 304 S. 5TH AVE. SPECIAL CONDITIONS: LA PUENTE, CA CONTRACTOR: TEL. NO: E C®�/� APPROVALS DATE INSPECTOR SIGNATURE DIMA CONSTRUCTION (626) 369-5397— 304 S. 5TH AVE. LIC. NO UNDER SLAB WORK LA PUENTE, CA 91746 772254 WATER SERVICE ARCHITECT OR ENGINEER: EL. N0: PLASTIC Y/N METAL Y/N ROUGH PLUMBING , LIC. NO / X11111111 LGAS PIPING L GAS VENT G D II C TY O�K""-S) OT AER EATER LLL�� LI Ll PLUMB NG FIXTURES c G o °"` LAWN SPRI LERS O ❑ ? �6 GAS TEST ElUTILITY COMPA 0 I ED ❑ n1 46/j V V0� CW C `service"T'ba� GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508