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HomeMy Public PortalAbout10124 NADINE ST_Plumbing__ 7GA88= (CE 817) 4/72 APPLICATIO FOR P MBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO BUILDING r ADDRESS HARVEY T BRANDT COUNTY ENGINEER LOCALITY L FOR APPLICANT TO FILL IN (PRINT OR TYPE) CROSS ST S NUMBER FIXTURE OR ITEM ® FEE WATER CLOSET 1 75 OWNER MAIL BATH TUB 1 75 ADDRESS �L SHOWER 1 75 CITY Celt TEL NO LAVATORY 1 75 CONTRACTO SINK 1 75 ADDRESS DISHWASHER 1 75 CITY L NO CLOTHES WASHER 1 75 STATE /R7 2)If" LIC LICENSE NOCLASS 1 SWIMMING POOL RECEPTOR 1 75 LAWN SPRINKLER SYSTEM 1 75 DISTRICT NO GROUP ZONE C€SSE BV WATER HEATER 1 75 INDUSTRIAL WASTE APPROVAL g' GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD OUTLETS OVER 30 5 PER SYSTEM Lu O.. N Z Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ 3 00 TOTAL FEE APPROVALS GATE INSPECTOR 4 SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel NO ,� GAS VENT I HEREBY A NOWLEDGE T I HAVE READ THI APPLICATION HOT WATER HEATER AND STATE T T THE ABOV S CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL LINTY ORDIN CES AND STATE LAWS REGULATING PLUMBING 0 GAS TEST I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESC IBED RESIDENTIAL PROPERTY FINAL SIGNATU RE OF PERMITTEE f' PERMIT VALIDATION cK M 0 CASH PLAN CHECK VALIDATION CK M 0 CASH 1 df 1 1 1 X73 tiAY 14 5 D 4 75— a °A°°7APPLICATION FOR PLUMBING PERMIT OestYtoa 1 D ISION OF BUnD]NG AND SAFETY O /;a d Department of County Engineer JOHN County MB ELos COUANTg1f�ENGINEER ADBUILDING DRESS �O��Z , CASSATT D GRIFFIN SUP T OF BUILDING • LOCALITY FOR APPLICANT TO MI IN NEAREST CROSS ST OWNER DISTRICTN G UP I ZONE I BEADY FOR INSPECTION MAILADDRESS .c3o 4 1 rA7 INDUSTRIAL I CITY TEL NO T 3 / WASTE APPROVAL PLUMBER /p1 INSPECTION RECORD ADDRESS 61 (I CI I CITY �+ TpEL NO ffk of' .I LICENSE NO ��•� 3a NUMBER TYPE OF FIXTURE OR ITEM FEB bi Z WATER CLOSET (TOILET) Q $1 00 $ BATH TUB Q $1 00 qq/ SHOWER Q $100 AI LAVATORY (WASH BASIN) Q $100 / KITCHEN SINK Q $1 00 DISHWASHER Q $100 LAUNDRY TUB OR TRAY Q $100 / CLOTHES WASHER Q $100 WATER HEATER Q $100 GAS SYSTEM Q $100 APPROVALS DATE INSPECTOR S SIGNATURE UNDE S'&b WORK PERMIT $ 1 00ROUGH PLUMBING J TOTAL FEE I•L 00 GAS PIPING GAS VENT 1 HEREBY ACKNOWLEDGE THAT t HAVE READ THIS APPLICATION HOT WATER HEATER Q AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PLUMBING FIXTURES 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST J LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF _ CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED DESCRIBED RESIDENTIAL PROPERTY SIGNATURE �� PAAAK � OF PERMITTEE FINAL � JOHN A LAMBIE COUNTY ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR CK N 0 CASH 5634; fEB27 3 1200 '� WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I berelly affirm that I have a certificate of consent to self 20 0026 DPW 6/67 Fmsure, &a certificate of Workers Compensation Insurance 76AS67A ,9r a certified copy thereof(Sec 3600 Lab C ) COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS .policy bo Company Certified copy is hereby furnished El Certified APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING )/�1Z Certified copy is filed with the county building mspec ADDRESS f Vt hon department NUMBER FIXTURE OR ITEM FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER OWNER t (This section need not be completed if the work involved by Med AIL the permit is for one hundred dollars($100)or less) LAVATORY ADDRESS 1 certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner SINK QU CITY On TEL NO .� so as to be am e ubject to the Wor ation Laws DISHWASHER + CONTRACTOR Date '7 ppbcant / CLOTHES WASHER ADDRESS NOTICE TO APPLICANT If after me ung this Certificate of SWIMMING POOL RECEPTOR Exemption you should become subject to the Workers Compensation provisions of the Labor Code you must forth CITY TEL NO with comply with such provisions or this permit shall be LAWN SPRINKLER SYSTEM P Y P P STATE LIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO ESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETSa B 1 (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code and my license is to full force and effect 5 PER SYSTEM FINAL VALIDATIONS Q 8L , icense Number Lic Class DATE FINAL Contractor Date BY LID G7 ❑ I am exempt under Sec ^`N B 8P C for this reason Plan check fee U) Date PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLE FAMILY Plan check applicant HOME OWNER BUILDER DECLARATION Name �tL I hereby affirm that I am exempt from the Contractor s LicenseZiz �Ys* Law for the following reason (Section 7031 5 Business and Address Q t Ztructure ions Code) City Tel No 7 =7 34.50 as owner of the property will do the work and the 1 ITM is not intended or offered for sale (Section , 7044 Business and Professions Code) MAL 34.50 CONSTRUCTION LENDING AGENCY CKCK 34.501 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued CWM .00 (Sec 3097 Civ C ) Lender s Name 0000-Ml 8/22/89 Lender s Address 5204 1 AM 8312 1 certify that I have read this application and state that the Poo information is correct I agree to comply with all County ordinances and State laws regulating Plumbing and hereby =.fPerm.tteeves f this County to enter upon the for inspection pur�oses SEE REVERSE FOR EXPLANATORY LANGUAGE Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0107190002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285 0488 EXT LEGAL ID FEES PAID BUILDINC ADDRESS TR 22438 LT 9 10124 NADINE ST FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802725 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET DAINES 8586,025 010 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID B3 LOCALITY TEMPLE CITY 11 CLOTHESWASHER(S) 1 00 FIX 16 20 TENANT 25 LAVATORIES/SINKS 1 00 FIX 16 20 ISSUED ON PROCESSED BY PLAN BY ownwar- 45 WATER CLOSET/URINAL 1 00 FIX 16 20 07/26/01 UT 01/22/02 51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20 OWNER 0 TOTAL FEES 92 55 E FIN CODE PARKS DANIEL E,COLLEEN (626) 575 3068 10124 NADINE ST cl (Emag, TEMP 917802725 ON OF WORR,-ol I FINALIZE EXPIRED PER IT 204 APPLICANT TEL NO TORKIAN CONSTRUCTION INC (310) 478 0666 11805 MISSISSIPI LOS ANGELES 90025 5 GEE S c CONTRACTOF----- TEL NO ®(o APPROVALS TORKIAN CONSTRUCTION INC (310) 478 0666 �Aj. 11805 MISSISSIPI LIC NO UUM-9LAB WORK LOS ANGELES 550877,A&B WATER ARCHITECT OR ENGINEER TEL NO PLASTIC Y/NC METAL Y/N ROUGH PLUMBINT- LIC NGAS PIPING GAS VENT 0�/ lllitit L C 7\-,Pl©10-1 PLUMBING FIXTURES LAWN SPRINKLERS J t o ®»1 � GAS NUTIa Uq46be service TVA A REPORT ID DPR263 ROUTE TO BS0508