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Home My Public Portal About10203 NADINE ST_Plumbing__ 76A607 D8817 1150 APPLICATION FOR PEBMi DEPARTMENT OFING AND SAFETY PLUMBING COIINTY OFF LOS LOS ANGELES WILLIAM J FOX, CH1[F ENGINE[R 0101TRICT NO BRO PERMIT mu FOR APPLICANT TD FILL IN f Z9C� PLUMBER O READY FOR EIVED SY FIRST INSP[CTION OATr ' Udo �/APDREBB ILDINO CITY TELNo ADDR[BS oada COUNTY—LICENSELOCALITY 1 8 NEAREST PERMIT FEES CROSS BT NOMBlR TYPE OF FIXTYR[OR ITBM FEE OWNER MAIL WATER CLOSET(TOILET) can • ADDREBB BATH TUB ago CITY TEL SHOWER ago 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) ago APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK ago AND STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT 1 POMEM THE ABOVE VALID LOB LAUNDRY TUB OR TRAY Ono ANGELES COUN ICENBE R 1 AM THE 4LEMAL OWNER BAS SYSTEM OUTLETS 0 060 OF THE RCRIDl!TI PRO DESORIBED ASCVE. E Or WATER HEATER ago SIGN CRMRITT[ BLOP BINK 1@ ago INSPECTION RECORD FLOOR SINK Ono FLOOR DRAIN ® ago DISHWASHER ® OBC DRINKING FOUNTAIN CSO URINAL ago HOUSE SEINER 41 ago Z MISCELLANECUB O APPROVALS DATE INSPECTOR 8 NAM[ ROUGH PLUMBING GAS PIPING BAB VENT CESSPOOL 100 CEB8PCOL Z SEPTIC TANK BEPTIC TANK DRAIN ( ) PIT ( ) IOD SEWER PERMIT IDD BAB TEST In .,2 UTILITY CO NOTIFIED TOTAL FEE FINAL �y ay7l, 78A687 CE#817 2 82 t APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGIlMER aonDnlc B oII EMG AAM�StFETOUNY EIMION NGINEER ADD /47,203 — WILLIAM A JENSEN SUPT OF BUILDING LOCALITY izEmme Gi FOR APPLICANT TO FILL IN CROSS S NUMBER FIXTURE OR ITEM EACH FEE OWNER NIZ S WATER CLOSET $125 �. Km BATH TUB 175 AS +CITY TEL NO SHOWER 175 ! �rZVIeerV LAVATORY 125 CONTRACTOR D SINS 125 ADDRESS DISHWAs11ER 125 cITY,% TEL NO Q..,f 2 TE LAUNDRY TUB 125 REGIS�TRATTIION NO p COUNTTY CLOTHES WASHER 125 DIICT P NO Z NE BED BY WATER NEATER 150 —/ GAS SYSTEM OUTLETS 150 WASTEAPPROVAL —fOUTLETS OVER 5 PER SYSTEM 30 MSPEC�TION RECOR�Dz 1 O ag Allen - r � Z APPROVALS DATE INSPECTOR 8 sir.PA.TVRE PERMIT s 2 OO UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE O GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ T 18 APPLICATION GAS VENT AND STATE THAT THE ABOVE 18 CORRECT AMC AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REgU1RED BY LOS ANGELE8 COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE SCRIBED RE8IDENTIAL�PROPERTY UTILITY CO NOTIFIED SIGNATURE OF PERMITTEE FINAL ALIDATION ROBERT A WOOD cK M O CASH SUPERVISING MECHANICAL ENG R LAC67766% DEC 3 5 D 850- q s TGA667 17 s as® APPLICATION FOR PERM DEPARTNNIENT OF BUILDING AND SAFETY PLUMBING ��' COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL 1N DISTRICT O GROUP ZO E PERMIT NO PLUMBER RECBIV READY FO DATE ISSURo 7/7 FIRST INSPECTION e f BUILD ADDRESS CC �T , IN CITY TEL NO ADDRESS r COUNTY LICENSE N EXPIRES LOCALITY NEAREST PERM FEES CROSS ST NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER _P r MAIL d WATER CLOSET TOILET O SO ADDRESS BATH TUB 050 CITY EL. NO ROWER O SO 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY WASH BASIN) O SO APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK O SO STATE LAWS REGULATING PLUMBING 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY O SO ANGELES COUNTY LI OIL OR 1 AM THE LEGAL OWNER OF THE RESIDENTI WOPERTY DESCRIBED ABOVE. GAS SYSTEM ouTLETB O SO SIGNATURE F r WATER HEATER O SO SLOP SINK a O SO �SPECTION RECORD FLOOR SINK O SO i FLOOR DRAIN O SO DISHWASHER O SO DRINKING FOUNTAIN 41 O SO URINAL 030 .� HOUSESEWER 050 Z MISCELLANEOUS (J a O APPROVALS DATE INSPECTOR 8 NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL loo CESSPOOL SEPTIC TANK SEPTIC TANK l DRAIN ( ) PIT ( ) @1 00 SEWER /� PERMIT 1100 ST 0 GAS TE UTILITY CO NOTIFIED TOTAL FEE � FINAL WSAS67 In s as® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING 1 COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT O GROUP ZONE PERMIT NO PLUMBER G/Y! /�,. K,S r G �� RECEIVE READY OR ATE ISSUED FIRST INSPECTION ADDRESS yY0 G Y `� CITY TBL NO BUILDING r� r ADDRESS d + COUNTY CSN S NO EXPIRES "43D LOCALITY NEAREST �Qq � PERMIT FEES CROW ST r NUMBER TYPE OF FIXTURE OR ITEM FE6 OW ER r MAIL WATER CLOSET TOILET 0501, ADDRESS BATH TUB 050 CITY IBL. NO ��7 HOWER 050 1 HERE ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY WASH BASIN) 050 APPLICATION AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK 050 STATE LAWS REGULATING PLUMBING I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB LAUNDRY TUB OR TRAY 050 AN66LE9 COUNTY LICENSE, OR I AM THE LEGAL OWNER OF THE RESIDENT PROPERTY DESCRIBED E. ` GAS SYSTEM�OUTLETS Q 050 SIGNATURE OR 45W WATER HEATER O 50 PERMITTE SLOP SINK 050 INSPECTION RECORD FLOOR SINK 050 FLOOR DRAIN 41 050 DISHWASHER 050 DRINKING FOUNTAIN 050 T URINAL db 050 J HOUSESEWER 050 Z MISCELLANEOUS C9 a 0 APPROVALS DATE INSPECTOR 9 NAME ROUGH PLUMBING GAS PIPING r• GAS VENT CESSPOOL too CESSPOOL SEPTIC TANK SEPTIC TANK DRAIN ( ) PIT ( ) ® 100 SEWER PERMIT 100 GAS TEST 7 UTILITY CO NOTIFIED TOTAL FEE 8ory FINAL C� y� 1 WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I herel�y'offirm tAot I have a certificate of consent to self 76A667A insure or a certificate of Workers Compensation Insurance CE 817(REV 10/81) or a certified copy thereof(Sec Seo b C) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No L�Company Certified copy is hereby furnished ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec ADDRESS0� F tion department LOCALITY NUMBER FIXTURE OR ITEM FEE LOCALITY`—' /Z11 J II T`ate Apphcant WATER CLOSET NEAREST Date " - CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by ft�� MAIL the permit is for one hundred dollars($100)or less) LAVATORY ADDRESS �kME I certify that 1n the performance of the work for which th's a ti permit is issued I shall not employ any person in any manner SINK CITY 1 TEL NO p so as to become subject to the Workers Compensation Laws DISHWASHERCONTRACTOR C7 Date applicant CLOTHES WASHER ADDY! NOTICE TO APPLICANT If after making this Certificate of SWIMMING POOL RECEPTOR Exemption you should become subject to the Workers CITY TEL NO Compensation provisions of the Labor Code you must forth LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATELIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO ROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS L` (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code and my license is in full force and effect 5 PER SYSTEM DAT FINAL VALIDATION License Num[bberr J173 81 Lic Class--a FINA Contractor ��T O BY -- ❑ O I am exempt under Sec H• B&P C for this reason d Plan check fee N Date PLUMBING PERMIT ISSUING FEE$ Q Signature �. TOTAL FEE 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 Professions Code) City Tel No ❑ 1 as owner of the property will do the work and the structure is not intended or offered for sale (Section , 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY A 5 85 8 A I hereby affirm that there is a construction lending agency for _ the performance of the work for which this permit is issued # • • • • • 5 (Sec 3097 Civ C ) I • • 2&50 Lender s Name - - • • • 2 a 5 O 5 Lender s Address 1104-86 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 enti ned property fo inspection purposes �� ^� SEE REVERSE FOR EXPLANATORY LANGUAGE s - -- Signature of Permittee Date • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0710310011 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285 0488 EXT ILEGAL ID I FEES PAID I BUILDING ADDRESS 1 ITR 15862 LT 22 I I 10203 NADINE ST I I IFBS DESCRIPTION QUANTITY UOM AMOUNTI TEMP CA 917602728 1 (ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET 1 18586 027 022 101 PERMIT ISSUANCE FEE 27 75 1 THOMAS PAGE 597 GRID B3 LOCALITY TEMPLE CITY 1 107 BATHTUBS/SHOWERS 1 00 FIX 16 20 I ITENANT 25 LAVATORIES/SINKS 1 00 FIX 16 20 (ISSUED ON PROCESSED BY PLAN BY EXPIRES ON i I 145 WATER CLOSET/URINAL 1 00 FIX 16 20 110/31/07 SR 04/28/08 I 1 TOTAL FEES 76 35 1 I (OWNER TEL NO 1 IFINAL DATE Y CODE I IJACOBS RAYMOND D NANCY L (626) 575 0728 1 1EXPI I 110203 NADINE ST 1 I ITEM 917802728 [ DESCRIPTIONOP WORIC [ IBATHROOM REMODEL BATHTUB LAVATORIE AND WATER CLOSET 1 1APPLICANT TEL NO I I I [MORAD (818) 519 7706 1 I I 112348 MAGNOLIA BL i ISPECIAL CONDITIONS 1 [VALLEY VILLAGE 91607 1 I ICONTRACTOR TEL NO 1 (APPROVALS DATE INSPECTOR SIGNATURE 1 1AMERICAN HOME IMPROVEMENT INC (818) 348 7020 1 1 I 120335 VENTURA BLVD STE 422 LIC NO 1 (UNDER SLAB WORK I I I [WOODLAND HILLS CA 91364 835537B * 1 I I I I [ I IWATER SERVICE I I I 1 I IPLASTIC YIN METAL YIN I I I (ARCHITECT OR ENGINEER TEL NO 1 I I I I IROUGH PLUMBING I I I LIC NO I' 1 IGAS PIPING I 1 1 II IGAS VENT I I I 1 1 IHOT WATER HEATER I I I 1PLUMBING FIXTURES I I 'LAWN SPRINKLERS I I I IGAS TEST I I I (UTILITY COMPANY NOTIFIEDI 1 1 CWV IGRAY WATER SYSTEM I I I I I I I I I I I I 1 I I I I I 1• ADDITIONAL DATA ON FILE I I I I 1 IREPORT ID DPR263 ROUTE TO BS0508 I I I I I I