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Home My Public Portal About10124 OLIVE ST_Plumbing__ '76As07-JCEe17 1040 APPLICATION FOR. -PLUMBING PERMIT COUNTY OF LOS ANGELES = DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING .JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS me WILLIAM A. JENSEN, SUPT OF BUILDING r-^ LOCALITY FOR APPLICANT TO'FILL IN — a NETOSS . NUMBER FIXTURE OR ITEM OWNER WATER CLOSET ADDRESS 0 BATH TUB CITY TEL NO. SHOWER _ CO OR •�` � •- LAVATORY ' SmK _ ADDRESS DISHWASHER CITY 't TEL.NO. CO CTOR'S STATE ❑❑ LAUNDRY TUB COUNTY p CLOTHES WASHER DISTRIC'mN0. 'GROUP NE 'P SSED BY. WATER HEATER yy GAS.SYSTEM INDIIS \ .. wAs%s�a_iPPaOVAi • r �- :r=/ INSPECTION;RECORD O 12, ------------------------------------------------ .! .$1.00 PER ITI y� OR FIS m $ i At J/ L1S�= D TES INSPE fDR�B'SLGNATUItB PERMIT $ .'9160 UNDERL6-4 WORK` �cy�Tr/b .�?,/f✓;G;y� TOTAL FEE ROUGH PLUMBING q/l, An. -GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ TH18 APPLICATION t _ AND STATE THAT THE ABOVE 18 CORRECT AND AGREETO COMPLY GAS VENT r� t `•,_. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING Ir s "• ".`^" PLUMBING. HOT WATER HEATER I HEREBY CERTIFY THAT 1 AM PROPERLY. REGISTERED AND/OR PLUMBING FIXTURES ,. • LICENSED AS REQUIRED BY LOS ANGELES C AND STATE OF GAS TEST CALIFORNIA OR TH 1 AM,THE L A►.. N OF THE ABOVE DESCRIBED RESIDE_ f L PROPERTY. UTILITY CO.NOTIFIED SIGNATURE I �' OF FERMITT G. FINAL / ?' rrlir..sFr' fl LIDATION- ' ROBERT A.WOOD . OC -M.D. CASH SUPERVISING MECHANICAL•ENWR 2 5 1. 2 AUG- •3. 5 D 5.7 5'� WORKERS'COMPENSATION DECLARATION affirm a APPLICATION FOR PLUMBING PERMIT I hereby arm that I have a'�c'ertificat� of consenCC 81t to self c6 ear (z-eo) insure,•or a certificate of Workers'Compensation Insurance,or ; a certified copy.thereof(Sec.3800,Lab.C.) COUNTY OF LOS ANE LES BUI G—A'NB-SMETY .Policy No. Coinpany ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) ILDING Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE LOCALITY ADDRESS �'ilry department. �;;.ti � G •yij Date Applicant WATER CLOSET NEAREST .� . �� ?� CERTIFICATE OF BATH TUB CROSS ST /J0�l EXEMPTION FROM WORKERS'- r OWNER COMPENSATION INSURANCE SHOWER (This section need not be completed if the work involved �i LAVATORY MAIL ADDRESS } by the permit is for one hundred dollars ($100) or less.) i SINK CITY ` TEL.NOL JU)0 I certify that in the performance of the work for which this DISHWASHER V permit is issued, I shall not employ any person in any manner CONTRACTOR � so as to become subject to the Workers'Compensation Laws. CLOTHES WASHER OO ADDRESS Date Applicant SWIMMING POOL RECEPTOR W NOTICE TO APPLICANT: If, after making this Certificate of CITY TEL.NO. CL Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM Compensation provisions of the Labor Code,you must forth- STATE LIC. z with comply with such provisions or this permit shall be WATER HEATER LICENSE NO. CLASS _ deemed revoked. GAS SYSTEM OUTLETS. DISTRICT NO. .O ESSED Y+ LICENSED CONTRACTORS DECLARATION OUTLETS OVER ' a I hereby affirm that I am licensed under provisions of Chapter, 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL 3 -7—g-3. �,`-� VALIDA ION ness and Professions Code, and my license is in full force and DATE effect'. FINAL License Number Lic.Class BY Contractor Date 0 I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ 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 I hereby affirm that I am exempt from the Contractor's Address License-Law for the following reason (Section.7031.5, Busi- City Tel.No. ;2 0 1 a 1 A ness d Professions Code): I, as owner of the property, am exclusively contracting 0 0 0 0 0 57 with licensed contractors to construct the project (Section 7044,Business and Professions Code). 2.0 02200 CONSTRUCTION LENDING AGENCY 0'0 0 2 2.0 0 G I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is 0 6 1 0—8 1 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby auth riza repre entatives "f this County to enter upon the abov -m ohe proper for inspection purposes. ( -- + ' ig atur of Permittee Date ' i WORKERS'COMPENSATION DECLARATION 7aA667A APPLICATION FOR PLUMBING P E R M I T I hereby affirm that I have a' certificate of consent to self ca e»(z-eo) insure, or a certificate of Workers'Compensation Insurance,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 o �` Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM A FEE ADDRESS department. LOCALITY Date Applicant WATER CLOSET NEAREST �" "v �v CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. �-,)Ir/ COMPENSATION INSURANCE SHOWER OWNER Y,Z (This section need not be completed if the work involved LAVATORY MAI LADDRESS by the permit is for one hundred dollars ($100) or less.) SINK CITY '� TEL.N51 Y' elo} I certify that in the performance of the work for which this DISHWASHER U permit is issued, I shall not employ any person in any manner CONTRACTOR so as to become subject to the Workers'Compensation Laws. CLOTHES WASHER ADDRESS -,Cd O Date Applicant SWIMMING POOL RECEPTOR U NOTICE TO APPLICANT: If, after making this Certificate of CITY TEL.NO. LL Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. CL Compensation provisions of the Labor Code, you must forth- WATER HEATER LICENSE NO. CLASS with comply with such provisions or this permit shall be deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO. PR ESSED BY p� LICENSED CONTRACTORS DECLARATION OUTLETS OVER -5— L�Q I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL VALIDATION ness and Professions Code, and my license is in full force and DATE effect. P License Number Lic.Class FINAL BY Contractor Date F1 I am exempt from the licensing requirements as I am a Plan Check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ (� acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE J"rj Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section 7031.5, Busi- City Tel.No. ness and Professions Code): I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws egulating Plumbing, and hereby authori a represe tatives this County to enter upon the e- ( abovo d rope". oper for inspection purposes. SiEn-a—Vre of Permittee Date . COUNTY OF LOS ANGELES r TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0012260020 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: GA EES PAID BUILDING ADDRESS: TR: 10558 LT: 22 10124 OLIVE ST FEE DESCRIPTION: QUANTITY: UDM: AMOUNT: TEMP CA 917803344 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BALDWIN 8585-002-012 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 1.00 FIX 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLA EXPIRES ON: 12/26/00 UT 06/25/01 OWNER: TEL. NO: FINAL DATE FIN CODE: HEATER JOHN H;CHRISTINE (818) 444-5111- 2 2Qj 2c� 10124 OLIVE ST TEMP 917803344 DESCRIFTION OF WORK NEW SHOWER PAN APPLICANT: TEL. 0: NICK'S REMODELING (626) 442-7985- 9941 HOWLAND SPECIAL CONDITIONS: TEMPLE CITY -" CONTRACTOR: TEL. N0: :.r%,�• ,�i,:;•,- APPROVALS DATE INSPECTOR SIGNATURE NICK'S REMODELING (626) 442-7985- �a 9941 HOWLAND DRIVE LIC. NO ' ° ER SLAB WORK TEMPLE CITY, CA 91780 409663 B ' r °- �' S' ' 1; •! WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR E G ER: TEL. 0: ROUGH PLUMBING LIC. N0:' GAS PIPING -- - - -------- - - - - GAS VENT _ u L, �.- HOT-WATER HEATER '- - - LANG FIXTURES AWN SPRINKLERS i ! GAS TEST _ UTILITY COMPAWY OTIFIED ^� 1 C V GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508