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Home My Public Portal About9933 NADINE ST_Plumbing__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0711190003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: JLEGAL ID: FEES PAID 1 BUILDING ADDRESS: JTR: 17002 LT: 16 , J 9933 NADINE ST 1 ;I FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:) TEMP CA 917802623 I JASSESSOR INFORMATION NUMBER: I 1 NEAREST CROSS STREET: 1 18588-018-007 ,101 PERMIT ISSUANCE FEE 27.75 J THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, C 164 WATER PIPNG <= 1 1/2 1.00 LIN 16.20 1 TENANT: I TOTAL FEES 43.95 JISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I I'll/i9/07 SR 05/17/08 (OWNER: TEL. NO: 1 JFI DATE FI CODE: 1 IFORBES (626) 358-0135- 19933 NADINE ST ITEMP 917802623 I IDESCRIPTION OF WORK 1 I IREPLACE EXISTING WATER SERVICE W/1" COPPER WATER SERVICE I I I ]APPLICANT: TEL. NO: DACE PELIZON PLUMBING (626) 331-0701- I I I 1120 E. BADILSA ST. J ISPECIAL CONDITIONS: 1 ICOVINA, CA 91723 1 I I I I I I I ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1 TACE PELIZON PLUMBING (626) 331-0707- I 1 ] 1120 E. BADILLO LIC. NO J (UNDER SLAB WORK I ] ICOVINA CA 93.722 800472042 + I I I I I IWATER SERVICE 1 I I I PLASTIC YIN�/N 11 (ARCHITECT OR ENGINEER: TEL. NO: I I I I I - IROUGH PLUMBING I I I J LIC. NO: I I I I I IGAS,PIPING 1 GAS VENT j i II I ] (HOT WATER HEATER ] I I I I I I I I IPLUMBING FIXTURES I I I I I I I I I I ILAWN SPRINKLERS I I ] ] 1 1GAs TEST ] I 1 JUTILITY COMPANY NOTIFIED I I I I I� I ICWV I I I ! ] IGRAY WATER SYSTEM II 1 I I I I I I 11 I I ] I I J I I I I I I J '1. ADDITIONAL DATA ON FILE I I I I 1 1 1 I I I (REPORT ID: DPR263 ROUTE TO: BS0508 76►SS7 17 5-40® APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ��' � � 1 COUNTY OF LOS ANGELES WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICTJVO. GROUP ZONE �'PER�MIT NO. S � 00 PLUMBER VALLEY BOULEVARD PLUMBING CO. RECEIVED BY READY FOR DATEISSUCD FIRST INSPECTION Z`r ADDRESS AST VALLEY BLVD. BUILDING Sa CITY ROSEMEAD TEL. NO. AT. 2-2719 ADDRESS COUNTY N 93M EXPIRES 6-30-,S1- FOCALITY NEAREST PER CROSS CROSS ST. NUMBER TYPQ OF FIXTURE OR ITEM FEE OWNER MAIL —000,ffdgmwgmjg—�m—; WATER CLOSET TOILET 0.50 S 1 SQ ADDRESS .17 s9 BATH TUB @ 0.50 C TY l EL NO. " LJ. SHOWER 0.50 1 HEREBY ACKNOWLEDGE 'THAT I HAVE READ THIS LAVATORY WASH BASIN 0.50 6 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK 0.50 Q STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY 0.50 ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER OF THE RESIDENTIALfPIJOPERTY DESCRIBED ABOVE.. GAS SYSTE OUTLETS 0.50 D SIGNATURE OF WATER HEATER 0.50 PERMITTE SLOP SINK 0.50 INSPECTION RECORD FLOOR SINK 0.50 FLOOR DRAIN 0.80 DISHWASHER 0.50 DRINKING FOUNTAIN 0.50 URINAL Q 0.50 J HOUSE SEWER 0.50 MISCELLANEOUS U O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING r► GAS VENT CESSPOOL ® 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT . 1.00 GAS TEST UTILITY CO. NOTIFIED r t. TOTAL FEE FINAL 7SX667 n 5-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING. ' WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRI T NO. GROUP ZONE PE MIT NO. FADDRESS MBER RECEIVED BY READY FOR DATE ISSUEg w FIRST INSPECTION 1 v � J� o 14 BUILDING CITYTEL. NO. ADDRESS COUNTY LOCALITY LICENSE NO. EXPIRES NEAREST PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET TOILET 0.50 ADDRESS BATH TUB @ 0.50 CITY TEL. NO. SHOWER 0 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK 0.50 STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY ® 0.50 ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER OF THE RESIDENTIAL PROPERTY OESCRI ED ABOVE. GAS SYSTEM OUTLETS a 0.50 SIGNATURE OF WATER HEATER (a 0.50 PERMITTEE SLOP SINK a 0.50 INSPECTION RECORD FLOOR SINK a 0.80 FLOOR DRAIN 0.50 . DISHWASHER 0.50 DRINKING FOUNTAIN 0.50 URINAL qp 0.50 ..1 HOUSE SEWER ® 0.50 4 z_ MISCELLANEOUS a 0 APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) 1.00 SEWER PERMIT . 1.00 GAS TEST UTILITY CO. NOTIFIED TOTAL FEE FINAL t r' 0 !J - WORKERS'COMPENSATION DECLARATION I hereb APPLICATION FOR PLUMBING PERMIT /87 y,.affirm that I have a certificate ofconsent to self in- 20.0026 DPW 4 76A667A sure,or-o c�eertificate of Workers'Compensation Insurance,or a CE 817(REV. 8/86) cer ified cdp thereof (Sec. 3800, Lab. C.) • Policy No. 'Z-Company t ( COUNTY OF LOS.ANGELES DEPT. OF PUBLIC WORKS /�_ � Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) AA qqAog /i I� lj� Certified copy is filed with the county building inspection ADDRESS /1/ -m — de m nt: NUMBER FIXTURE OR ITEM ® FEE LOCALITY Cft Date 14 Applicant WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER s� (This section need not be completed if the work Involved by lJ MAIL the permit is for one hundred dollars($100)of less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- ` mit is issued, I shall not employ any person in any manner so SINK CITY /r TEL. NO. as to become subject to the Workers'Compensation Laws. DISHWASHER • CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject'to the Workers'Compen- CITY TEL. NO. 1141-t-36 ` L sotion provisions of the Labor Code, you must forthwith comp- LAWN SPRINKLER SYSTEM p ly with such provisions or this permit shall be deemed revok- STATE /1 UC. ed. WATER HEATER LICENSE NO. (/ CLASS / LICENSED CONTRACTORS DECLARATION D TRICT N OCE B I hereby affirm that Fam licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL fect. ALIDATION l DATE d License Nu ber Lic. Class O ^r U (�/. �� 8 FINA(VI tS Contractot� Date BY O t— Fj I am exempt under Sec. W B.BP.C. for this eas n • Plan check fee ► _ Dater L� _ PLUMBING PERMIT ISSUING FEE$ -ho 5 0 Signature TOTAL FEE SINGLE F LY. HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and i �T At Professions Code): Address 28 I, as owner of the property, will do the work and the City Tel. No. 7 "� ` structure is not intended or offered for sale(Section 7044, _. 1 ITERS Business and Professions Code), , TGT . 28 r 50' CONSTRUCTION LENDING AGENCY_ I hereby affirm that there is a construction lending agency for CHECK . 50 the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address W 1 AM $:36 I.certify that I have read this application and state that the abovi ation is correct. I agree to comply with all County ► ordina ces nd Stat laws regulating Plumbing, and hereby author a re resent ves of this County to enter upon the above, enti nedp arty for inspection purp ses ir SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Dot