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Home My Public Portal About6229 OAK AVE_Plumbing__ PBS-177 10.e6 APPLICATION FOR PLUMBING PERMIT . 98.I DIVISION OF BUILDING AND SAFETY - Department of County' Engineer County of Los Angeles BUILDING JOHN A.LAMBIE, COUNTY ENGINEER ADDRESS 05 CASSATT D,GRIFFIN,SUPW OF BUILDING LOCALITY I r � P L 6 C 1 f V FOR APPLICANT TO FILL IN I NEAREST _ ry �/ CROSS ST. OWNER ,(af Y/G'. Fo R 1�1►•c�P DISTRICT NO. GROU ZONE REAbY FOR INSPECTION ADDRESS l gf /7.s 9'V!i S' D Q. .I /T I INDUSTRIAL CITY CITY I FER F`F= CI.r Y TEL.NO.' WASTE APPROVAL PLUMBER P I=L I Z O n/ PLypj /j 1,01c INSPECTION RECORD ADDRESS 4 4 'E 14 S Y 13 VR /�/ -4 Va CITY C 0 y Ij�TEL.NO. U• 4 I. LICENSE NO. 06 O moi/o �; �1L-ai '1�Gl1/�r��/�[1 NUMBER UMER TYPE OF FIXTURE OR ITEM FEE 4� �� d 81,61 }&S el/— [ ) WATER.CLOSET-(TOILET) @ $1.00 $ �7 D� �T' fin%1. d BATH TUB @ $1.00 , 4 'Oq' / .HIRPJ,PAEf -pVIN&-A SHOWER @ $1.00 n��n LAVATORY (WASH BASIN) @ $1.00 E KITCHEN SINK @ $1.00 I DISHWASHER @ $1.00 42'�'".S LAUNDRY TUB OR TRAY. @ $1.00 CLOTHES WASHER @ $1.00 49 `z fQ WATER HEATER @ $1.00 I 0- / F P GAS SYSTEM @ $1.00 APPROVALS ' DATE INSP%CTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING ]. �.r `• S dede6' v, GAS PIPING TOTAL FEE Gas VENT �I �jI 1�'� I HEREBY ACKNOWLEDGE THAT.I 'HAVE-READ THIS APPLICATION 'l HOT WATER HEATER ! �t 'Y AND STATE THAT THE ABOVE IS•CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE' LAWS REGULATING PLUMBING FIXTURES PLUMBING. / I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST % Ii � LICENSED AS REQUIRED BY -LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE.' UTILITY CO.NOTIFIED •� - / •di�d�. D G DESCRIBED RESIDENTIAL PROPERTY. , SIGNATURE OF PERMITTEE FINAL OHN A.LAMBIE,COUNTY ENGINEERVALIDATION ROBERT A.WOOD.,CHIEF PLBG. INSPECTOR CH. M.G. CASH � 3 7 0 44S; acT2.4 3 8 00 , 76A667-CE#817 6-65 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ADDRESS �y JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS. SUPT OF BUILDING LOCAL FOR APPLICANT TO FILL IN NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE OWNER � WATER CLOSET $1.25 MAIL BATH TUB 1.25 ADDRESS SHOWER 1.25 CITY TEL. NO. LAVATORY 1.25 CONTRACTOR C, SINS 1.25 ADDRESS DISHWASHER 1.25 CITY TEL. NO. STATE LIC LAUNDRY TUB 1.25 LICENSE No.Acw t16 a CLASS& CLOTHES WASHfif 1.25 DISTRICTNC. Gr�OUP ZONE P CUSSED BY 1.50 Q >- GAS STEM OUTLETS "'a INDUSTRIALWASTE VAL � O OUTLETS OVER 5 PER SYSTEM .80 INSPECTION RECORD U V W 0- APPROVALS APPROVALS DATE INSPECTOR'S SIGNATURE PERMIT a 2 00 UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER PLUMBING. 1HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DEBCRIDED RESIDEN I PROPS UTILITY CO.NOTIFIED SIGNATURE PERMS VJ/j� OF PERMITTEE' Ewa FINAL ` o VK. ALIDATION M.O. CASH LjjGu 6 8 7 8:o WT 16 5 D 3.5 0- v COUNTY OF IAS ANGELES ' DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT LEGAL ID: ON FILE ASSESSOR INF 5385-001-018 TAI, FIONA (626) 283-1932- 1842 S CALIFORNIA ST SAN GABRIEL CA 91776 TEL. NO: AS OWNER - LIC. NO ENOINEEK: TEL. NO: UN, STEVE (626) 262-9668- 028 ROSEMEAD BLVD. #35 LIC. NO: ICO RIVERA CA 90660 NONE PERMIT EXPIRES 180 DAYS IF 1) WORK DOES NOT COMMENCE, OR 2) WOAK IS SUSPENDED OR ABANDONED, OR 3) FAILS TO OBTAIN CODE REQUIRED INSPECTION 20. 20. TEMPLE CITY � 1N(i AllllRESB: # 0508 9701 LAS TUNAS 1 6229 OAK AV AMOONT:I TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: 34.40 THOMAS PAGE: 596 GRID: S2 LOCALITY: TEMPLE CITY 60.60 FEES PAID FEE DESCRIPTION: QUANTITY: DOM: O1 PERMIT ISSUANCE FEE 40.40 07 BATHTUBS/SHOWERS 3.00 FI% 13 DISHWASHER (S) 1.00 FIX 21 HOSE BIBB(S) 2.00 FIX 25 LAVATORIES / SINKS 4.00 £IX 45 WATER CLOSET/URINAL 3.00 FIX 47 WATER HEATER(S) 1.00 WTH 51 LAW PRS GAS LES OUTS 1.00 SYS 64 WATER PIPNG <= 1 1/2 2.00 LIN TOTAL FEES ID: DPA263 ROUTE T0: BSO508 PLUFID ING PERMIT PL 0508 1604270014 '.0 Y/N�yME',pw zyN PLUME ING �J DATE � 1N(i AllllRESB: 1 6229 OAK AV AMOONT:I TEMP CA 917801656 NEAREST CROSS STREET: 34.40 THOMAS PAGE: 596 GRID: S2 LOCALITY: TEMPLE CITY 60.60 20.20 ISSUED ON: PROCESSED BY: PLAN BY: 40.40 104/27/16 SR 80.80 60.60 FINAL DA/IE FINAL B CODE: 20 /j 5/��/Gb 20 /ll 40.40 ]DESCRIPTION F WORK 377.80 BATHTUBS/SHOWERS, DISHWASHER, HOSE BIBBS, LAVATORIES, SINK WATER CLOSETS, WATER CLOSET, GAS LINE AND WATER MAIN '.0 Y/N�yME',pw zyN PLUME ING �J DATE OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code): Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): (, I, as owner of the property, or my employees with wages as their sole compensation, will do (✓) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the Owner - Builder will have the burden of proving that it was not built or improved for the purpose of sale.). (� I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ": I am exempt fr om licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year priorito completion[ of the improvements covered by this permit, Ignnot legally sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of'the Business and Professions Code, is available upon request when this application is submitted or at the following Web site: http://www.leciinfo.ca.gov/calaw.htni. ate: rf�—e-)' "— h 0 Signature of Propert y Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License Date Contractor WORKERS' COMPENSATION DECLARATION WAF�NING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self - insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Policy No. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Garnier Policy Number Expiretion Date Name of Agent Phone Number I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions � �Oen.,L� �, � 27-�i6 Signature of 40plicant Date LOBBYIST ORDINANCE CERTIFICATION Complete this section for permits in Unincorporated Los Angeles County only This is to certify that I, as permit applicant, am familiar with the requirements of Los Angeles County Code Chapter 2.160 at seq., (relating to the Los Angeles County Lobbyist Ordinance) and that all persons acting on behalf of myself complied and will continue to comply therewith through the application process. Applica nt (Print Name) Applicant Signature Company Name Date JOB ADDRESS LOCALITY HAZARDOUS MATERIAL DECLARATION WiII the applicant or future building occupant handle a hazardous material or a mixture containing a hazardous material equal to or greater than the amount specified on the hazardous materials information guide? Will the intended use of the building by the applicant or future building occupant require a permit for construction or modfication from the South Coast Air Quality Management District (SCAQMD)? See permitting checklist for guidelines. Yes El o El I have read the hazardous materials information guide and the SCAQMD permitting checklist, I understand my requirements under the Los Angeles County Code Title 2, Chapter 320' Sections 220.100 through 220.140 concerning hazardous material reporting and for obtaining a permit from the SCAQMD. ASBESTOS NOTIFICATION ❑ Notification letter sent to AQMD and/or EPA ❑ I declare that notification of asbestos removal is not applicable to addressed project. DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lenders Name Lender's Addre ss By my signature below, I certify to;each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building consVuction. I authorize representatives of this county to enter the above -identified property for inspection purposes. Signature of Propert y Owner or Authorized Agent