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Home My Public Portal About10104 OLIVE ST_Plumbing__ DEPARTMI$NT OOF BUILDING AND SAFSTY APPLICATION FOR PERIM COUNTY OF LOS ANGELES PLUMBING 1 +{ WK.J. FOX.CHIEF ENGINEER NATURE O ST UIN DIMMICT NO. GROUPI ZONE PERMIT NO. ROUGH FIXTURES COMPLETE _ R[ [D■ READY FOR HEATER CESSPOOL SEPTIC TANK G� FIRST INSPECTION DAT[ISSUED HMISCELLANEOUS 3-/�–`>` APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY v? 7c7(:Sjow / K NAME ADORE" Z_ B ADDRESS LOCALITY / D — ela fiA6:F Gw RVEY CITY EL MONTE. CALIF.` TEL.NO. NEARS ST.EST ,L/ sL COUNTY CERT.No. tXPIRES NAME jj, s �,L L LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL NORTH O ADDRESS CITY TEL.No. 1 AM THE LEGAL POSS R OF THE ABOVE LOS ANGELES COUNTY CERTIFIC OF QUALIF BION. 00, PLVUMMEM I AM THE LEGAL OWNER OF THE PROPERTY DESC ■[D ABOVE. OWNER CORRECTIONS BOOTH J DESCRIPTION OF WORK z z HATH TUB FURNACE - Lj Qr ROWER DISHWASHER Q LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE IN R's NAME / WATER HEATER DENTAL LAVATORY I I ROUGH PLUMBING ETER a—GAS SODA FOUNTAIN OUn GAS PIPING GAS VENT I r CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK I / I CESSPOOL 8EPTICTANK SEWER I s D UTILITY-CO.NOTIFIED TOTAL FEE FINAL 's D.e.s.-17 25"SETS 11-46 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY ��'�� 1 COUNTY OF LOS ANGELES Wm. J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE � MAT O+.��,, ROUGH FIXTURES 1:� COMPLETE /READY FORHEATER CESSPOOL SEPTIC TANK R 61V,�D BY ATi ISSUED G//��_--� FIRST INSPECTION � 7a �. GAS� MISCELLANEOUS APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY AME JOB W NAME ADDRE8Y1 �� n ADDRESS ' 7% - LOCALITY J - ✓ ^•":,. NEAREST .J CITY 'TEL.No. CROSS ST. COUNTY CERT.No. EXPIRES W NAME LOCATION OF SEPTIC TANK, OR CESSPOOL 2 MAIL 3 ADDRESS NORTH O CITY TEL.No. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF gUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED y� ABOVE. W > 3 OWNER CORRECTIONS SOUTH J DESCRIPTION OF WORK Z BATH TUB FURNACE (Y SHOWER DISHWASHER O LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING METER-GAS SODA FOUNTAIN GAS PIPING OUTL GAS VENT11111111111111011 I I CESSPOOL I TOTAL NUMBER OF FIXTURES SEPTIC TANK I _ 4 -CESSPOOI SEPTIC TANK SEWER S TOTAL FEE UTILITY CO.NOTIFI[D I FINAL r�li }, rrrt•WORKER'S COMPENSATION DECLARATION 7°sas 7A Pw9/ a9 APPLICATION FOR PLUMBING PERMIT yll'IIIf 'l�rtiey a�fithaYl have a certificate of consent to self Insure, or alsrtiffcate of Worker's Comperrsat`IonNpsurance, or.a•ce?tified copy thereof(Ssc.®800 Lab.15.)" • COUNTY DF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No.. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ADDRESS/ 19 ❑ Certified copy is filed with the county building inspection department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET NEAREST _ CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST., COMPENSATION INSURANCE BATH TUB ASSESSOR MAP BOOK PAGE PARCEL (This section need not be completed if the work Involved by the SHOWER � permit is for one hundred dollars($100)or less.) OWNER I certify that in the performance of the work for which this permit I ILLAVATORY Is issued. I shall not employ any person in any manner so as to SINK ADDRESS /p p OL ez� S7 become subject to the Workers'Compensation Laws. DISWASHER CITY ^ TEL.NO. 4� Date Applicant CLOTHES WASHER CONTRACTO I ) NOTICE TO APPLICANT: If, after making this Certificate ofil� Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS' provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION WATER HEATER CITY TEL.NO. a I hereby affirm that lam licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business and STATE LIC. Professions Code,and my license is in full force and effect. GAS SYSTEM OUTLETS LICENSE NO. CLASS OUTLETS OVER DISTRICT NO. PROCESSED BY 5 PER SYSTEM License Number Lic.ClassFINAL O O DATE VALIVA5ION nW. Contractor Dater El5A15lyr i'Y O f_�I L I am exempt under Sec. BY AL *74 � ITEMS B.&P.C.for this reason f •_ �� Date Plan check fee Poo- , IL — Signature PLUMBING PERMIT ISSUING FEE$ 'CHECK !' °V ❑ - TOTAL FEE ° CHANGE .00 SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name 013-0101_00131 3/13/9F I hereby affirm that I am exempt from the Contractor's License Law _ for the following reason (Section 7031.5, Business and Professions Address L'i; °'?C, Code): r-'•a.. �. (^i:t �J'°�•. City Tel.No. 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 1 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-mentioned property for ins os a. SEE REVERSE FOR EXPLANATORY LANGUAGE Sinn inra of Parmitiaa �at9 COUNTY OFJOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF POBLIC WORKS 9701 LAS TUNAS PL 0508 0006300024 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUMING ADDRESS: TR: 10558 LT: 20 10104 OLIVE ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803344 ASS SSOR INF R A 0 NUMBER: NEAREST CROSS STREET: BALDWIN 8585-002-020 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY 13 DISHWASHERS) 1.00 FIX 16.20 TENANT: 47 WATER HEATER(S) 1.00 WTH 16.20 ISSUED ON: PROCESSED B LA BY: EXPIRES ON: 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 06/30/00 UT 12/27/00 TOTAL FEES 76.35 OWNER: TEL. NO: FIN4 DATE FINAL BY: CODE: SHUI MICHAEL (626) 582-8235- 10104 OLIVE ST TEMP 917803344 DESCRIPTION OF WORK PLUMBING FOR LAUNDRY FACILITIES, WATER HEATER AND GAS LINE APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: [;ELES Co CONTRACTOR: TEL. N0: �� APPROVALS DATE INSPECTOR SIGNAT E SAME AS OWNER LIC. NO ` UNDER SLAB WORK WATER PLASTICEY/NCEMETAL Y/N i ARCHITECT OR ENGINEER: TEL. N0: S ROUGH PLUMBING LIC. NO / u !L 1111111 GAS PIPING GAS VENT G�U � (( �n�O I lC I C-�J HOT WATER EATER I � LJ 11 LJ v L MB G FIXTUR S O13 a,, 5�,� LA N SPRINKLERS O �❑-II } !� 't«• G S ESM UTILITY COMPANY NOTIFIED 48��c CWV �ervi�ce Thai GRAY WATER SYS E REPORT ID: DPR263 ROUTE TO: BS0508 COUNTY OF-LOS ANGELES TEMPLE CITY # 0508 PLUMBING P M�� DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PC-0'-08 9905210028 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL I ES PAID BUILDING AD S: TR: 10558 LT: 20 10104 OLIVE ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803344 SSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BALDWIN 8585-002-020 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY 25 LAVATORIES/SINKS 1.00 FIX 16.20 TENANT: 45 WATER CLOSET/URINAL 1.00 FIX 16.20 ISSUED 0N: PROCESSED By PLAN BY: EXPIRES ON: TOTAL FEES 60.15 05/21/99 UT 11/17/99 OWNER: TEL. NO: � FINAL DATE FIN BY: CODE: SHUI MICHAEL (626) 582-8235- 10104 OLIVE ST TEMP 917803344 DESCRIPTION 0 PLUMBING FOR A ITIQN OF GARAGE AND WORK SHOP T SAME AS OWNER - SPEC AL ONDITIO CONTRALTO TEL. N0: / G� LE S CO��A APPR ALS D SPECTOR SIGNATURE SAME AS OWNER LIC. NO UNDER bewwoRK ATER SERVICE d� AST�IC Y/N M AL Y/ ARCHITECT OR ENGINEER: E O: RSVGH PLUMYRG LIC. N0: f 11111 GAS PIP AL , PUQ UC V V CTa G V I R t UM I IX LA75PRINKLT \ " Pill.,. S TES C ® ��5UTILITYPPANY NOTIFIED 48��C t CW ServirGRAY R SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508