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Home My Public Portal About5755 OAK AVE_Plumbing__ �` c' PLUMBING 1 DEPARTIIQ+11iT OF COUP= (iINEER DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS "GELEB BUILDING WILLIAM J FOX COUNTY Eaa1MEEN ADDRESS FOR APPLICANTTO FILL IN LOCALITY + Ci BUILDING /� NEAREST ADDRESS r '�' CROSS ST DISTRICT GROUP ZONE PERMIT NO LOCALITY / i �G NEAREST 1Y CROSS ST RECEI BY Ready for InspftUoo DATE ISSUED OWNER 7-9 MAIL INDUSTRIAL ADDRESS WASTE APPROVAL CITY TEL NO INSPECTION RECORD PLUMBERVALLEY BOULEVARD PLUMBING M ADDRESS 8300 EAST VALLEY BLVD CITY ROSEMEAD TEL NO AT 2 2719 Cl25 STATE LICENSE NO &COUNT% J PERMIT FEES z NUMBER TYPE or FIXTURE OR ITEM rEE Q WATER CLOSET(TOILET) ! 080 = O BATHTUB ! 080 SHOWER 080 LAVATORY(WASH BASIN) 0 0 80 KITCHEN SINK 0 0 h0 LAUNDRY TUB OR TRAY ! 080 SLOP SINK 0 080 FLOORSINK ! 080 FLOOR DRAIN 41 080 DISHWASHER ! 080 DRINKING FOUNTAIN ! 080 URINAL ! 080 GAS SYSTEM OUTLETS 0 100 WATER H EATER ! 100 MISCELLANEOUS APPROVALS DATE INSPECTOR S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING TOTAL FEE Q, GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI GAS VENT CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER — -- TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBI PLUMBING FIXTURES 1 HEREBY CERT THAT 1 A PROPERLY REGISTERED AND/OR LICENSE REQUIRED AN COUNT GAS TEST 21 — EB OF THE A130OF V BOR $T TETE IEGAY OW UTILITY CO NOTIFIED Q J $yP SIGNATURE OF PERMITTEE _ — _ _ __._ _ _ _ _ FINAL it 76AUT DBS 17 1/68 WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT Thereby 8ffirm that I have a certificate of consent to self in 7ADPW 4/90 sure or 9 certtfigne of Workers Compensation Insurance or a certified copy thereof(Sec 3800 Lab C ) Policy No Company COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS r Certified copy is hereby furnished ' FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING E] Certified copy is filed with the county building inspection ADDRESS department NUMBER FIXTURE OR ITEM ® FEE LOCALITY WATER CLOSET(TOILET) Dote Applicant • NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars(:100)or less) LAVATORY ADDRESS A203 y 1 certify that in the performance of the work for which this per mit is issued I shall not employ any person in any manner so SINK CITY 2, TEL NO Joe d3+B as to become subject to the Workers Compensation Laws DISHWASHER CONTRACTOR Date` Applicant CLOTHES WASHER NOTICE TO APPLICANT If after making this Certificate of Ex ADDRESS SWIMMING POOL RECEPTOR emption you should become subject to the Workers Comport sation provisions of the Labor Code you must forthwith com CITY TEL NO LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revo STATE LIC ed WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSEb BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS yfop 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER 4 and Professions Code and my license is in full force and of 5 PER SYSTEM FINAL �`� VALIDATION fest HOSE BIB DATE License Number Lic Class C FINAL V Contractor Date BY Q I am exempt under Sec � s 29 {y-+i:tFO B 8P C for this reason V Plan check fee , go Date PLUMBING PERMIT ISSUING FEE$ Z TOTAL FEE Signature SINGLE FAMILY Plan check applicant HOME OWNER BUILDER DECLARATIONITEM I hereby affirm that I am exempt from the Contractor s License Name 9.890Law for the following reason (Section 7031 5 Business and ME Professions Code) Address (I as owner of the property will do the work and the City Tel No 0000—ooQi 6/79/05 structure is not intended or offered for sale(Section 7044 Business and Professions Code) Eta 4 -49 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ C ) Lender s Name Lender s Address i 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 repre tatives f is my to enter upon the above,mwWo'ne-d proper i coon pur o t� SEE REVERSE FOR EXPLANATORY LANGUAGE nature of Permittee D,�td 7- � � 4 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0501200011 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285 0488 EXT LEGAL 10 FEES PAID BUILDIN TR 6561 LT 734 5755 OAK AV FEE DESCRIPTION QUANTITY LION AMOUNT TEMP CA 917802431 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LIVE OAK 8587 005 012 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J3 LOCALITY TEMPLE CITY, C 47 WATER HEATER(S) 1 00 NTH 16 20 TENANT TOTAL FEES 43 95 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 01/20/05 JK 07/19/05 OWNER TEL NO FINAL tlt:L:AL Y CODE FONG, STUART (323) 821 3604 5755 OAK AV TEMP 917802431 DESCRIPTION OF WORK WATER HEATER CHANGE OUT APPLICANT TEL NO TEKAWA (310) 515 1311 17111 S BROADWAY E S GARDENA CONTRACTOR TEL NO ACTION CONTRACTORS (310) 515 1311 P S 17111 SOUTH BROADWAY LIC NO UNDER SLAB WORK GARDENA, CA 90248 652535BC36 r WATERER 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 NOTIFIM CWV GRAY WATMr3MM REPORT 1D DPR263 ROUTE TO BS0508