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Home My Public Portal About5233 MCCLINTOCK AVE_Plumbing__ 78A887'-CE#817 2-82 TEMPLE E CgTV APPLICATION FOR PLUMBING PERMIT COUNTY OF'LOS ANGELES DEPARTMENT OF COUNTY.ENGINEER BUILDING AND SAFETY DIVISION rD'&Da'G JOHN A. LAMBIE. COUNTY ENGINEER 5243 Ch Ei. Z WILLIAM A.JENSEN, SUPT OF BUILDING C_40.000/0 in-74W FOR APPLICANT TO FILL IN � NUMBER FIXTURE OR ITEM EACH FEE WATER CLOSET 51.25 z s OWNER MAIL I. BATH TUB 1.25 ADDRESS ' SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 2 % CONTRACTOR V d A P, & SINK 1.25 5 ADDRESS C I DISHWASHER 1.25. CITY C TEL.NO.t y,?- 1C JV Q LAUNDRY TUB 1.25 CONTRACTOR' STATE REGISTRATION NO. �r �J 2. COUNTY ❑ CLOTHES WASHER 1.25 DISTRICT _ �7 NROUP ZONE PROCESSED BY A-/WATEB HEATER 1.50 D GAS SYSTEMOUTLETS- 1.50 ,e � INDUSTRIAL TRIVAL OUTLETS OVER 5 PER.SYSTEM .80 INSPECTION RECORD ° e .y• low ---------------- tl y L Op APPROVALS DATE 14SPECT.011ip SIGNATURE �J1 PERMIT 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE Sd GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS-VENT STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALPLUMBING. COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER A Vo. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST Z. 1 CALIFORNIA OR THAT 1 AM.THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIB RESIDENTIAL PROPERTY. UTILITY CO.;NOTIFIED .SIGNATURE OF PERMITTEE FINAL �Z 3a- LIDATION ROBERT A.WOOD CK. M.O. CASH SUPERVISING MECHANICAL ENG'R 1 6 Z5 JUL 3 0 5 D 8.5-01- 9 7ea667A,IC120e 1713)•11/76 • APPLICATION FOR PLUMBING PERMIT L� BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING J� 1 NUMBER FIXTURE OR ITEM ® FEE ADDRESS �( WATER.CLOSET LOCA BATH TUB NEAREST CROSS ST.. SHOWER OWNER LAVATORY MAIL A DRIES SINK CITY TEL.NO. DISHWASHER CONTRACTO CLOTHES WASHER ADDRESS - SWIMMING POOL RECEPTOR e_ CITY �� TEL.NO3��d J LAWN SPRINKLER SYSTEMSTATE pp WATER HEATER LICENSE NO. ��2 2 J� CLASS GAS SYSTEM OUTLETS DISTRICT NO NE NE OCESSED BY OUTLETS OVER "'- O v 9. 5 P SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD ININ Plan check fee PLUMBING PERMIT ISSUING FEE$ TOTAL FEE U :5�0 Plan check applicant Name APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK Address ROUGH PLUMBING City Tel.No. GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT THAT THE ABOVE IS CORRECT AND MPLY WITH ALL COUNTY ORDINANCES HOT WATER HEATER AND STATE LAWS REGULATING MBING. I HEREBY CERTIFY T T 1 AM PROPERLY EGIS. ED AND/OR LICENSED AS PLUMBING FIXTURES REQUIRED BY LOS ANGELE COUNTY AND STA F CA FORMA OR THAT I AM THE GAS TEST LEGAL OWNER OF,AND IN END TO RESIDE H AS E DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERM ITT EE Y FINAL PLAN CHECK VALIDATION Loz�A CASH PERMIT VALIDATION K. M.O. CASH 6 0 8 SEP 2 2 D 1 0.5 0 oz,s ` - ®s WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT 20-0026 DPW 4/90 I hereby,affirm that I have•b teFfificate of,,eonsent to self in- 76A667A .. surd;ora certificate of Workers'Compensation Insurancg,or a certified copy thgreof,(Sec. 3800, Lab. C.) Policy No• Company s COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS F1 Certified copy is hereby furnished. Certified co is filed with the count building p FOR.APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING e copy y g ins ection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE / ` LOCALITY f Date Applicant WATER CLOSET(TOILET) NEAREST L CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER yl 41S OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK CITY TEL.NO. mit is issued,.1 shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. Oh DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- emption,you should become subject to the Workers'Compen- CITY TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE LIC.- ed. CLASS WATER HEATER LICENSE NO. LICENSED CONTRACTORS DECLARATION GAS SYSTEM OUTLETS DISTRICT NO.O e4;CLASS__ BY � y I hereby affirm that I am licensed under provisions of Chapter N 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER _ and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect. HOSE BIB DATE ! License Number Lic. Class a FINAL �i Contractor ........ Date BY O I am exempt under Sec. O V B.&P.C. for this reason / W k f h Plan check a • ► w Date: PlPLUMBING PERMIT ISSUING FEE$ a D Z SignatureTOTAL FEE D �� 9 SINGLE FAMILY PP a licant rr HOME OWNER=BUILDER DECLARATION � Plan check I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and Accra Professions Code): Address "2303 173.90 I, as owner of the property, will do the work and the City Tel. No. 1 ITEMS structure is not intended or offered for sale(Section 7044, TOTAL ,.2 � Business and Professions Code). ► CONSTRUCTION LENDING AGENCY CHECK 12190 1 hereby affirm that there is a construction lending agency for CHANGE _ the performance of the work for which this permit is issued 00 (Sec. 3097, Civ. C.). Lender's Name 0000-0001 4/29/96 Lender's Address - - 6094 1 PM 5.,10 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 re ulating Plumbing, and hereby Mauepresentatives o t is County to enter upon the toned ro rty o inspection purposes. (1r SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Perm tte Date COUNir OF LOS ANGELES TEMPLE CITY # 0508 - v"lmdii.G PERF4IT DEPARTMENT OF PUBLIC WORKS 9701 LAS TURAS ;'L O508 0409160023 BUILDING AND SAFETY LAND DEVELOPMENT TEMPLE CITY CA 9lidO PHONE: (626) 285-0488 EXT: LEGA ID: FEES PAI — BUILDING A RESS: TR: 13384 LT: 18 5233 MCCLINTOCK AV re•o FEE DESCRIPTION: QUANTITY: UOM: A`-�OUNT: TEMP CA 91780:559 ASSESSO INFORMATION- UM E NEAREST CROSS STREET: 857/0-004-003 01 PERMIT ISSUANCE FEF 27.75 I THOMAS PAGE: :97 GRID: D4 LOCALITY: TEMPLE CITY, C _ 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TENANT: TOTAL FEES 43.95 IS UE . PROCMFJ q AN EXPIRES 00: 09/16/04 JK 03/15/05 �OWNER: TEL. NO: FINAL DATE Fie L B.. ConE: ROBLEDO, ROBERT (626) 222-8619- I523ao MCCLINTOCK AV TEM? 917803559 ;UESCRI N 0 LORI: I� GAS LINE FOR HVAC I! PPLICANT: TEL. NO: JORDANAIR (626) 963-3313- 129 S. HACIENDA SPECIAL CONOITinN5; —� GLENDORA, CA 91741 1 �CONIRACTOR: TEL. N0: - y AA PROVALS DATE—INSPEC AT1i�E JORDANAIR (626) 963-3313- 129 S. HACIENDA AVE LIC. NU UNDER SL B R GLENDORA, CA 91741 5604290?Gb IPATER SERVICE ARCHITECT OR ENGINEER- jPLASIIC Y/N METAL Y/N I ?EL. y^. —'I __- Ii: UOG LIC. t'^ H LBING 'GAS =PG-------�-- ------ GAS VENT -� RUT WATER HEATER PLUl•BI •G FIXTURES LAW l SP I!K ERS - 'GAS FTEST .._ UTILITY COMPANY NO 1FIED CWV `- GRAY WATER SYSTEM i �^ ADDITIONAL DATA ON FILE REPORT ID: DPR263 ROUTE TO: BS0508