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Home My Public Portal About10129 NADINE ST_Plumbing__ 76A085617 APPLICATION FOR PLUMBING PERMIT 1 DB817 fDVISION OF BUILDING AND SAFETY Deportment of County Engin w County of Los Angeles A LAMBIE COUNTYENGINEER q ADDRESS �oI� (O CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST OWNER .&rll DISTRICT NO GROUP I ZONE I READY FOR 1NSPECT1oN MAIL I ADDRESS /9)/// INDUSTRIAL CI TEL NO _:Q 3 WASTE APPROVAL PLUMBER OF t�t INSPECTION RECORD ADDRESS / (P CITY , TEL NO Jr& 4f—//J LICENSE NO //,/S".I B NUMT�HfiR TYPE OF FIXTURE OR ITEM FEE �c+ WATER CLOSET (TOILET) @ $t 00 $ BATH TUB @ $100 SHOWER @ $S 00 r LAVATORY (WASHBASIN) @ $100 KITCHEN SINK @s1 00 DISHWASHER @ f1 00 LAUNDRY TUB OR TRAY @ $100 CLOTHES WASHER@ $1 00 WATER HEATER @ a1 00 GAS SYSTEM @ $100 0 ve APPROVALS �' DATE INSPECTOR S SIGNATURE UNDBR'� n WORK rw� PERMIT $ 1 00 ROUGH PLUMBING TOTAL FEE GAS PIPING i �� Gas VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER 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 I AM PROPERLY REGISTERED AND/OR GAS TEST wwu LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF v CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED / DESCRIBED RESIDENTIAL P OPERTY SIGNATURE OF PERMITTEE ��+++ FINALr- JOHN A LAMBIE COUNTY ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR CK Y 0 CASH L&708611;, AM 11 3 1100 In <�RKERS COMPENSATION DECLARATION 76AS67A I hereby affirm that I have a certificate of consent to self Cs 817(:66) APPLICATION FOR PLUMBING PERMIT insure or a certificate of Workers Compensation Insurance or a certified copy thereof(Sec 3800 Lab ) 40 COUNTY OF LOS ANGELES BUILDING AND`SAFETY Policy No Company C PL19 Cil 0 Certified copy is hereby furnished FOR APPLICANT TO FILL IN (PRINT OR TYPE) ObUILDING /��{� ADDRESS ( L Ap 1 I yt Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE department WATER CLOSET LOCALITY Date Applicant NEAREST 11i � J(Yr BATH TUB CROSS ST OIIJI� CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE SHOWER OWNER p DI n y� r� Y1 (This section need not be completed if the work involved MAIL LAVATORY ADDRESS OIS9 ! IADI ng by the permit n for one hundred dollars ($100) or less) V SINK CITY .( TEL NO87OAC— I certify that to the performance of the work for which this DISHWASHERO permit is issued I shall not employ any person in any manner CONTRACTOR so as to become subject to the Workers Compensation Laws CLOTHES WASHER ADDRESS ' dV Date Applicant W SWIMMING POOL RECEPTOR a NOTICE TO APPLICANT If after making this Certificate of CITY TEL NO ({Q y Exemption you should become subject to the Workers LAWN SPRINKLER SYSTEM STATE LIC z Compensation provisions of the Labor Code you must forth WATER HEATER LICENSE NO et+� CLASS with comply with such provisions or this permit shall be DISTRICT NO P CESSED Y deemed revoked GAS SYSTEM OUTLETS LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Bust FINAL ALIDATI N ness and Professions Code and my license is to full force and DATE r Z-Z,a —&I effect I OM FNAL t License Number �Tt_�_ Ltc Class F `+��-•��i Contractor PT Date I am exempt from the licensing requirements as I am a Plan check fee G7 licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ W acting to my professional capacity (Section 7051 Bus mass and Professions Code) TOTAL FEE Cp Lie or Reg No Date Plan check applicant HOME OWNER BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractors Address License Law for the following reason (Section 7031 5 Bust City Tel No ness and Professions Code) I as owner of the property am exclusively contracting 3 4(�,�a with licensed contractors to construct the project (Section 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY �• • I hereby affirm that there is a construction lending agency $. ®� 1� A L � �� 2' 1 O O O for the performance of the work for which this permit is (''a�++�'+� 17 l' !�*3 '' � �� •�• • � issued(Sec 3097 Civ C) Y am�.,,tl i9 Lender s Name 1219-80 Lender s Address I certify t I have read is ap It anon and state that the above f ton s cor ct agr a comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordt enc s a S to wit egu it g Plumbing and he by out ort ep ese ti s o tht C unty to enter po the ab ve tt ed ty r to tion purposes I tgnature o P rmtttee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0607120005 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285 0488 EST LEGAL ID FEES PAID BUILDING ADDRESS TR 22438 IT 27 10129 NADINE ST FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802726 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET DAINES 8586-027 036 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID B3 LOCALITY TEMPLE CITY C 51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20 TENANT TOTAL FEES 43 95 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 07/12/06 JR 01/06/07 OWNER TEL NO FINAL DATE FINAL BY CODE RUO FENG CHOU (626) 401 3778 10129 NADINE ST ;L/3L-64; C52- -TEMP 917802726 DESCRIPTION OF WORK GAS LINE FOR AIR CONDITIONING AND HEATING SYSTEM APPLICANT TEL NO SAME AS OWNER - SPECIAL CONDITIONS CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC NO UNDER SLAB WORK WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER TEL NO ROUGH PLUMBING LIC NO GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CMV GRAY WATER SYSTEM REPORT ID DPR263 ROUTE TO BSO50S