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Home My Public Portal About10130 OLIVE ST_Plumbing__ 76A887A ICL* 617e) -4/77 � f APPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE] BUILDING NUMBER FIXTURE OR ITEM ® FEE ADDRESS 10130 E. Olive WATER CLOSET LOCALITY Temple City NEAREST BATH TUB CROSS ST. SHOWER OWNER Dan Branch LAVATORY MAIL ADDRESS 10130 E. Olive SINK CITY Tem le City TEL.No-444-0664 DISHWASHER CONTRACTOR Bryant Heat. & Air Cond. Inc. ,' CLOTHES WASHER ADDRESS 1350 E. Las Tunas Drive SWIMMING POOL RECEPTOR CITY San Gabriel TEL.NO. 286-1141 LAWN SPRINKLER SYSTEM WATER HEATER STATE LIC. LICENSE NO 221751 CLASS C 2 0 1 DISTRICT NO. GROUP ZONE PR C ED BY GAS SYSTEM OUTLETS 3 0 0 n C! OUTLETS OVER 5 PER SYSTEM INDUSTRIAL WASTE APPROVAL Q INSPECTION RECORD y Plan check fee PLUMBING PERMIT ISSUING FEE$ 7 00 TOTAL FEE 10 00 [GA Plan check applicant APPROVALS DATE INSPECTOR'S SIGNATURE Name SLAB WORK Address PLUMBING City Tel.No. PING 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATEENT THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. ATER HEATERIHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED ASING FIXTURES REQUIRED BY LOS ANGELES C UNTY AND STATE OF CALIFORNIA OR THAT I AM THEST f MiaLEGAL OWNER OF.ANDINT O RESIDE IN THE ABOVE DESCRIBED RESIDENTIALe ePROPERTY. - FCONOTIFIED ASIGNATURE �J OFPERMITTEE �'�"•"'Z� �'' PLAN CHECK VALIDATION CK. M.O. CASH to C PERMIT VALIDATION CK. M.O. CASH ,o C7 . . r• r �y �'• ♦ . WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I have a certificate of consent to self in- 20-0026 DPW a/87 f� sure,or a certificate of Workers'Compensation Insurance,or a 76A667A CE 817(REV 8/86) certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. �7 FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM ADDRESS / department. @ FEE LOCALITY Date Applicant WATER CLOSET(TOILET) NEAREST cvtfls 9 CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE OWNER SHOWER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- mit is issued, I shall not employ any person in any ma er so SINK CITY ""- �, TEL. NO as to become sub•ect t Workers'Compensatio s. DISHWASHER y / CONTRACTOR O- App Date licant / �Ir CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY e�__ TEL NO sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATELIC ed. WATER HEATER LICENSE NO. Q CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO ESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS ` O f`J 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER ^• �G -5-. and Professions Code, and my license is in full force and gf- 5 PER SYSTEM FINAL VALIDATIO >_ fect. / // DATE4 ` tL License Number Lam-'Lic. Class _ V i FIN Contractor ,9�� C� Date BY O I am exempt under Sec. W T 0. B.BP.C. for this reason Plan check fee DO PLUMBING PERMIT ISSUING FEE$ O j� Signatur TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and Professions Code): Address ❑ I, as owner of the property, will do the work and the City Tel. No. 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 r above information is correct. I agree to comply with all County 1 ordinances and State laws regulating Plumbing, and hereby authorize re resent iv thi ounty to enter upon the above- ne ro spegti urposes. + SEE REVERSE FOR EXPLANATORY LANGUAGE tr ature of Permittee Date 1 COUNTY`OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1404020015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: ITR: 10558 LT: 23 I [ 10130 OLIVE ST I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917803344 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: BALDWIN 18585-002-013 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY CAI I 107 BATHTUBS/SHOWERS 1.00 FIX 16.20 1 [TENANT: 111 CLOTHESWASHER(S) 1.00 FIX 16.20 (ISSUED ON: PROCESSED BY: PLAN BY: 1 I 125 LAVATORIES/SINKS 1.00 FIX 16.20 104/02/14 SR I [ 145 WATER CLOSET/URINAL 1.00 FIX 16.20 1 I (OWNER: TEL. NO: I TOTAL FEES 92.60 1FINAL A FINAL Y: CODE: 1 IJANKLY JOHN B;ROSA (626) 442-2862- 1 [ 110130 OLIVE ST I I I ITEMP 917803344 1 IDS 2 T ON OF WORK I I 1SHOWER ONLY, LAVATORIE, WATER CLOSET FOR NEW BATHROOM ADDIT11 I I [ON AND CLOTHESWASER FOR THE LAUNDRY I (APPLICANT: TEL. NO: I I 1 ICHAVEZ, HECTOR (661) 212-7928- [ [ 1 144500 FENHOLD ST [ ISPECIAL CONDITIONS: I ILANCASTER CA 93535 I I I [ I 1CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I ICHAVEZ PLUMBING (661) 212-7928- I UNDER SLAB WORK I I 144500 FENHOLD ST LIC. NO I I I I ILANCASTER CA 93535 845982 * [ 1 I I [ IWATER SERVICE I [ [ 1 [ IPLASTIC YIN METAL YIN I I 1 [ARCHITECT OR ENGINEER: TEL. NO: 1 I I I I - I IROUGH PLUMBING I, I LIC. NO: I I 1GAS PIPING �1 IGAS VENT I \ I [ [ IHOT WATER HEATER I [ I [ [ IPLUMBING FIXTURES I I [ I [ ILAWN SPRINKLERS 1 [ I I [ I I I I I [ (GAS TEST 1 I (UTILITY COMPANY NOTIFIED( CWV [ I [GRAY WATER SYSTEM I I I I I I 1 I I I I I I I I [ 1* ADDITIONAL DATA ON FILE I [ I I IREPORT ID: DPR263 ROUTE TO: BS0508 [ I I [ I I I [ I I t 1 t COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1404210030 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID I BUILDING ADDRESS: 1 TR: 10558 LT: 23 I 1 10130 OLIVE ST 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT-1 TEMP CA 917803344 I (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: BALDWIN 18585-002-013 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY CAI 1 113 DISHWASHER(S) 1.00 FIX 16.20 I I (TENANT: 125 LAVATORIES/SINKS 1.00 FIX 16.20 IISSUED ON: PROCESSED BY: PLAN BY: 1 I I TOTAL FEES 60.20 104/21/14 SR 10WNER: TEL. NO: I (FINAL DATE FY: CODE: IJANKLY JOHN B;ROSA (626) 442-2862- 1 I 110130 OLIVE ST I IN [ ITEMP 917803344 I I PTION OF WORK I I IREPLACE KITCHEN SINK AND DI HER I (APPLICANT: TEL. NO: I I I IAQUINO, JAIME (626) 810-0946- 12419 PAULINE ST I ISPECIAL CONDITIONS: I IWEST COVINA CA 91792 I I I I I I (CONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE I IM M RAMOS CONSTRUCTION INC. (818) 224-2422- I 1 I 138519 2TH STREET LIC. NO 1 (UNDER SLAB WORK I I IPALMDALE CA 93550 500772 I 1 I I IWATER SERVICE IPLASTIC YIN METAL YIN (ARCHITECT OR ENGINEER: TEL. NO: I I I I 1 - I IROUGH PLUMBING LIC. NO: I I I I I IGAS PIPING I 1 [ 1 I IGAS VENT 1 [ I IHOT WATER HEATER I I IPLUMBING FIXTURES I I I I I I (LAWN SPRINKLERS I I I IGAS TEST I I [ I (UTILITY COMPANY NOTIFIED( I I I I ICWV I I I [GRAY WATER SYSTEM I I I I I I I I [ I I I I I I I I I I 1 I 1 [REPORT ID: DPR263 ROUTE TO: BS0508 I