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Home My Public Portal About9965 LOWER AZUSA RD_Plumbing__ 76A667A CE 817(REV 6/781 ®s APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY Bowe� ALus9 FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM ® FEE ADDRESS LOCALITY WATER CLOSET NEAREST BATH TUB CROSS ST SHOWER OWNER LAVATORY MAIL ADDRESS ,$ SINK CITY t TEL NO DISHWASHER CONTRACTOR AA P CLOTHES WASHER ADDRESS j _ SWIMMING POOL RECEPTOR OOF CITYTEL NO LAWN SPRINKLER SYSTEM TATE LIC WATER HEATER LICENSE NO /D 7 CLASS B GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE OUTLETS OVER UNDER SLAB WORK S PER SYSTEM ROUGH PLUMBING GAS PIPING Q GAS VENT V HOT WATER HEATER 0 PLUMBING FIXTURES GAS TEST Plan check fee UTILITY CO NOTIFIED _ PLUMBING PERMIT ISSUING FEE$ TOTAL FEE FINAL PLAN CHECK VALIDATIQN Pion check applicant Nome � �2��8a� Address Clry Tel No 8 6 • • • 5 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE 2 8 • , Q O O THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES l AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION 119 6 e 1 Q Q 0 0 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE 04.05-79�,O C5 r7 9n LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL V / PROPERTY SIGNATURE CIFPERMITTEE DI LOCT J>JO�.f ROC BY INDUSTRIAL U a WASTE APPROVAL 76A467A jCR 8178) -4/77 APPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) ABUILDDDRESING 61 2`S NUMBER FIXTURE OR ITEM ® FEE WATER CLOSET LOCALITY NEAREST + BATH TUB CROSS ST SHOWER OWNER LAVATORYMAIL Q U ADDRESS SINK OT .3 D CITY TEL NO DISHWASHER _J 00 CONTRACTOR CLOTHES WASHER ADDRESS d4,4-610240 SWIMMING POOL RECEPTOR CITY TEL NO 6?ft�ZGI LAWN SPRINKLER SYSTEM STATE ^ n LIC WATER HEATER a LICENSE NO�-�6 c CLASS�^ GAS SYSTEM OUTLETS Igo. DISTRICT NO GROUP ZONE PROCESSED BY OUTLETS AVER V 'O4? 5 PER SYSTEM INDUSTRIAL WASTE APPROVAL ' �`� ` " 0 0 INSPECTION RECORD CD LLJ ace n-0 �Ez78 Nor&-4-o t'!W v G. N Z Plan check fee PLUMBING PERMIT ISSUING FEE$ p(� TOTALFEE Plan check applicant APPROVALS DATE IN OR S SIGNAT E Name UNDER SLAB WORK Address ROUGH PLUMBING City Tel No GAS PIPING Ll,ry REBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES HOT WATER HEATER LAWS REGULATING PLUMBING REBY CERTIFY THAT I AM PROPERLY REGISTERED AND/ LICENSED AS PLUMBING FIXTURES BY LOS ANGELES CO AND STATE OFC RNI R THAT 1 AM THEGAS TEST Z � MeNER OF AND INTEND RESIDE IN THE D RIBED RESIDENTIAL4 UTILITY CO NOTIFIED REM PTTEE FINALX4 J ATIga 4At 7 N JUL ISRMITlAkIDATION L jigs cAs LICY HOLDER., LICY NUMBER; /-W-"-00 - 36 '79/d ORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT r• i her fl�rm that 1 have a certificate of consent to self 76A667A inSQ: rZ a certifwtate of Workers'Compensation Insurance, CE 817(REV 10/81) Qr a certified copy thereof(Sec 3800, Lab C) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished F1 Certified APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS 2-A tion department NUMBER FIXTURE OR ITEM (� FEE LOCALITY Date Appligant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST Co COMPENSATION INSURANCE SHOWER OWNER%J+Ct -a (This section need not be completed if the work Involved by MAIL M•permit Is for one hundred dollars($100)or less) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued,I shall not empl any person in any manner SINK .r CITY TEL NO so as to bec me subject to the kers'Co n ion La DISHWASHER CONTRACTOR )�L Date pplican CLOTHES WASHER ADDRESS NOTICE PLICANT If, after ma mg th. Certificate of el Y Exemption, you should become subj the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY h) f� TEL NOSZsf•, with comply with such provisions or this permit shall be STATEUC deemed revoked , WATER HEATER LICENSE NO 36316D� CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO D BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS --- 4 (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER .J } and Professions Code,and my license is in full force_cnd effect 10 5 PER SYSTEM .r+ I/ S/ FINAL VALID N O DAT W License N er Lic FIN 09 O Contracto BY V EDr I am exempt un Sec N B&P C for this reason tL , X 1 4 7.7 A Z Plan check fee Date # • • • • •5 PLUMBING PERMIT ISSUING FEE$ Signature 1 * 14250 TOTAL FEE Plan check applicant - . 1142505 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 0 0 2 3—8 5 1 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 structure is not intended or offered for sale (Section No. 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 No.above information is correct I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby /tkuthorize representatives of this County to enter upon the a ve-ment d property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of ermittee Date COUNTY OF LOS ANGELES TEMPLE CITY 0 0508 ING P DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS k-aVL99061fiM BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID TR 9848 LT: 80 BL: .001 9LVW155MILOWE D FEE DESCRIPTION: QUANTITY. UOM: AMOUNT: T 7804041 ASSESSOR INFORMATION NLIMBEIU.- NEAREST CROSS STREET: BALDWIN 8589-025-038 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE: 597 GRID: 85 LOCALITY: TEMPLE CITY 17 FLOOR DRAINS) 1.00 FIX 16 20 /� TOTAL FEES 43 95 ` e" - 06/16/99 . UT 12/13/99 Z�� N TEL. NO: / FINAL DAT FINAL BY. CODE: locNLEfXNCONEUND 16 LTD (407) 422-1574- 400 SOUTHSTOP 6E� APPLICANT: TEL. NO: ALL FL S 8 J VENTURES, INC. (909) 276-9700- 3175 KLUX LANE SPECIAL CONDITIONS: RIVERSIDE, CA CONTRACTOR: APPROVALS DATE INSPECTOR SIGNATURF-- S AND J VENTURES, INC. (909) 276-9700- 3175 KLUX LANE LIC NO UNDER SLAB WORK RIVERSIDE, CA 555878 B fWATER SERVICE ARCHITECT OR ENGINEER: TEL. NO: % PLASTIC Y/N METAL Y/N LIC. NO GAS VENT warlaTorluffmr- PLUMBING FIXTURES GAS TEST CWV GRAY WATER SYSTEM * ADDITIONAL DATA ON FILE REPORT ID: DPR263 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 9901060008 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS TR 9848 LT 80 BL: 001 9965 LOWER AZUSA RD FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917804041 ASSESSOR INFORMATION NUMBER. NEAREST CROSS STREET: BALDWIN 8589-025-038 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID 65 LOCALITY TEMPLE CITY 47 WATER HEATER(S) 1 00 WTH 16 20 TOTAL FEES 43.95 ISSUED ON PROCESSED 01/06/99 UT 01/06/00 OWNER: FINAL DATE FI CNL INCOME FUND 16 LTD (407) 422-1574- 92_ 400 SOUTH ST UUMMON OF WORKF RELOCATE GAS HOT WATER HEATER TO OUTSIDE APPLICA T TEL. NO. KO PLUMBING INC (626) 338-1181- 1453 "H" VIRGINIA AV SPEC TIO S: BALDWIN PARK, CA CONTRACT-OR TEL. NO APPROVALS DATE INSPECTOR SIGNATUWF- KO PLUMBING, INC (626) 338-1181- 1453 H VIRGINIA AVE LIC NO UNDER SLAB WORK BALDWIN PARK, CA 91706 493048 C20 WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL NO LIC. NO. GAS PIPINGHOT WATER HERTER LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM * ADDITIONAL DATA ON FILE REPORT ID DPR263 ROUTE TO BS0508