The URL can be used to link to this page

Home My Public Portal About9506 OLEMA ST_Plumbing__ 76AS67A ICE 817191-11/76 `APPLICATION FOR PLUM ING PERMIT dddbbb BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM ® FEE ADDRESS J WATER CLOSET LOCALITY NEAREST BATH TUB CROSS ST. SHOWER OWNER LAVATORY MAIL001, Q ADDRESS SINK, CITY �I TEL. DISHWASHER CONTRACTO CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR + j CI TEL.NO. LAWN SPRINKLER SYSTEM STA E i'J�j/ LIC. WATER HEATER LICENSE NO. pCOC CLASS GAS SYSTEM OUTLETS DISTRICNO. GROUP ZONE P BY OUTLETS OVER !SED tia 5 PER SYSTEM INDUSTRIAL WASTE APPROVAL 0 INSPECTION RECORD a ut Plan check fee PLUMBING PERMIT ISSUING FEE$ JQ TOTAL FEE O Plan check applicant APPROVALS DATE INSPECTOR'S SIGNATURE Name UNDER SLAB WORK Address ROUGH PLUMBING City Tel.No. GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES HOT WATER HEATER AND STATE LAWS REGULATING PLUMBING. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/ LICENSED AS PLUMBING FIXTURES REQUIRED BY LOS LES COUNTY AND STATE OF CALIFORNI NAT I AM THE GAS TEST LEGAL OWNER ,AND NTEND TO RESIDE I HE ABOVE DES R ESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OFPERMI E FINAL Z—Z•�—.7'�' .� er.�.,•� PLAN CH ALIDATION CK. M.O. CASH CPERMIT VALIDATION J UI CK. M.O. ASH) ®s V:k;;�cFfts COMPENSATION DECLARATION QpdOCAU ®H FOR PLUMBING PERMIT I �. I nc';n' j i rT i"At I have a certificate of consent to self /6A667A in 11i4� e r u certificate of Workers'Compensation Insurance, CE 817(REV 10/81) or a certified copy thereof(Sec. 3800, Lab. C. COUNTY OF LOS.ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING a T Certified copy is filed with the county building inspec- ADDRESS /-y ,. Lt. tion department. NUMBER FIXTURE OR ITEM (rc FEE LOCALITY (� /? �:✓ Date Appligant_, - R'= y WATER CLOSET r NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST. COMPENSATION INSURANCE ��' SHOWER (/� OWNER ;',��r�- f.' r'�✓jo, (This section need not be completed if the vrork involved by MAIL the permit is for one hundred dollars($100)or loss.) % LAVATORY ® ADDRESS ' I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR "T Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR y CITY 7� .".7 TEL. N9. Compensation provisions of the Labor Code, you must forth- with comply with such provisions or this permit shall be LAWN SPRINKLER SYSTEM STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT Np� PR SSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS Lf "✓S (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER :0- and and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VAUI now I. y, DATE 0 License Number Lic. Class-74 Contractor -i � ��. Date BY /!' ❑ I am exempt under Sec. B.&P.C. for this reason 2Z Plan check fee Ij� / �a� tG PLUMBING PERMIT ISSUING FEE$ ) __ G 7 a I h Signature TOTAL FEE S� 0 0 0 0 0 5 SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name C C I hereby affirm that I am exempt from the Contractor's License Address 0 0 0 (I r Law for the following reason (Section 7031.5, Business and 0 `�L c' Professions Code.): City Tel. No. 08 16 "&5 ❑ I, 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 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 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.-gientioned,propert)f for inspection purposes. / SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date d WORKERS'COMPENSA-'ON DECLARATION 76AS67A I hereby affirm that I have a' ertiti of consent to self cls e17(z-ao) A% A\\ B 6 ®�j�P. U,MBING PERMIT insure,or a certificate of Workers'Compensation Insurance,or . '1�/_, �bJ /W a certified c�y thereof 3800, ab.C.p / "`' /Jl/v. '� d COUNTY OF LOS ANES � BUILDING AND SAFETY Polic ompany Certified copy is hereby furnishe FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING O/ ADDRESS (0 co y isfiled with th cou y bt ing inspection NUMBER FIXTURE OR ITEM 0 FEELOCAL• eeprtifti etWATER CLOSET Applicant NEAREST CERTIFICATE OF EXEMPTION FROM WORK S' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER JOWNER e (This section need not be completed if the work involved LAVATORY MAIL ADDRE >_by the permit is for one hundred dollars ($100) or less.) SINK C TY TEL.NO. CL I ceobem the performanc o he ork f r which this DISHWASHER U pershall not emp y an p.rson ' any manner CONTRACTO , so aubject to the s' .417 om nation Laws. CLOTHES WASHER ADDRESS . �/z O DatApplicant •YT V SWIMMING POOL RECEPTOR NOLICANT: If, after making this Certi ca of CITY �,�y TEL.N 3 W CL Exemption, You should become subject to the Wor ers' LAWN SPRINKLER SYSTEM STATE LIC. V) Compensation provisions of the Labor Code,you must forth- LICENSE N d CLASS zvZ with comply with such provisions or this permit shall be WATER HEATER deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. PRO ESSE � LICENSED CONTRACTORS DECLARATION OUTLETS OVER � ,Or/ I hereby affirm that I am licensed under provisions of Chapter 5 PE YSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL � VALIDATION ness and Professions Code, and my license is in full force and DATE effect. FINAL License Nu rt Lic.Clas BY Contractote F1 I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic.or Reg.No: Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name -- 1790A I hereby affirm that I am exempt from the Contractor's Address License Law for the followingreason Section 7031.5 Busi- # 0 0 0 0 0 ( + City Tel.No. ness and Professions Code): 2 o o 1 6.00 F1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project 0 0 0 1 6.0 0:= (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY 0818-80 1 hereby affirm. that there is a construction lending agency for the perform e. of the ork which this .permit is issued(Sec.3097 � `moo--'�j1r— Lender's Name Lender's.Address S I certify that I hav . d this application and state that the above inf n' Corr t.I agree to Comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordinan es and ate. Is regulating Plumbing, and hereby suthori a repr atives f this County to enter upon the above- ent' ed p pert y ora pectio pArses. Signet of Permittee a COUNTY OF LOS ANGELES TEMPLE !:I i i # [��!S !=!LIMBING PERMIT DEPP°TUIFMT OF PUBLIC WORKS 9701 LAS T°UHAS 0508 0410180019 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: ( 1t;5-0488 EXT: LEGAL 1D; ____ - FEES PAID BUILDING ;=ESS: TR: 14533 LT: 18 9506 OLEMA ST _ FEE DESCRIPTION: QUANTITY: UOM: A14C!INT: TEMP CA 917801343 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: OAK 5382-020-038 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAZ7: 596 GRID: J2 LOCALITY: TCMPLE CITY, C 07 BATHTUBS/SHOWERS 1.00 FIX 16.20 TENANT: 25 LAVATORIES/SINKS 1.00 FIX 16-.20 ISSUED : PROCEISCD 3.: PLAN BY: EXPIRES ON: 45 WATER CLOSET/URINAL 1.00 FIX 16.20 10/18/04 JK 04/16/05 OWNER: TEL. NO: TOTAL FEES 76.35 FINAL DATE FINAL BY: CODE: LIAO, DAVID (626) 278-1809- 9506 OLEMA ST ? -y S TEMP 917801343 DEbUKIPTIUN OF WORK REPLACE BATHTUB, LAVATORIE, AND WATER CLU?sEf. !APPLICANT: TEL. NO: (SAME AS OWNER - SPECIAL CONDITITlNb= CONTRACTOR: TEL. NO: APPROVALS DATE INSPELTOR SIGNATURE SAME AS OWNER - LIC. NO UNDER SLAB WORK '- ,WATER SERVICE — ARCHITECT OR ENGINCER: TEL. N0; PLASTIC YIN METAL YIN LIC.-NO: ROUGH PLUMBING GAS PIPING + I I -- - —I GAS VENT - dOT WATER i I ! iPt'fBI9G—FlX!MRES i L WN SPRINK FRS—_-- i - ----' I GAS TEST — - ---- ! iUT IL I TY CO NY7i0'iIFIED - CNV GRAY-WATER SYSTEM REPORT ID: DPR263 ROUTE TO: SS0508