HomeMy Public PortalAbout10508-10512 OLIVE ST_Plumbing__ 76ABBAPPLIGATI-ON �F'OR PLU11 RING PERMIT 1
>rE B„B-gR
BUILDING AND SAFETY DIVISION
Department of County Engineer
County of Los Angeles BUILDING 6 OLS U C rf Q CC.
JOHN A.L.AMBIE,COUNTY ENGINEER ADDRESS
CASSi4TT 0,GRIFFIN,SUPT OF HUILDIN6 LOCALITY TC m L 6F C ;7
FOR APPLICANT TO FILL IN NEAREST JIF
CROSS ST.
MAIL
OWNER DISTRICT NO GROUP ZONE/ READY FOR INSPECTION
ADDRESS I •- '� J/ I
INDUSTRIAL
CITY TEL.NO. WASTE APPROVAL
P IANA PLUMBING CONTRACTORS J. INSPECTION RECORD
ADDRESS ?ADDRESS123?9 E EclarStreet
CI % Calif. TEL.Q.- 7-7226
LICENSE* 96496
NUMBER TYPE OF FIXTURE OR-ITEM FEE �.( K+•�„L/ �.A•LeY
WATER CLOSET (TOILET) @ $1.00 $ t
BATH TUB @ $1.00
SHOWER @ $1.00 ” S '
LAVATORY (WASH BASIN) @ $1.00 -AM
KITCHEN SINK @ $1.00 'C=9�
DISHWASHER@ $1.00 ��. _ U tm Q%
LAUNDRY TUB OR TRAY @ $1.00 X V.
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
ATH INSPE ORAS SIGNATURE
UNDER SLAB WORK 7 AA
PERMIT $ 00 ROUGH PLUMBING
GAS PIPING. /ti/4�' r• r .�
TOTAL FEE GAS VENT
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION FIOTW2.TERHEATER
AND STATE THAT THE ABOVE 1S CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. • PLUMBING FIXTURES p
I .HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST 1 / isS�. Sr7
LICENSED AS-REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT AM THE LEGAL OWNER THE ABOVE UTILITY CO.NOTIFIED - `tS• _ _
DESCRIBED RESIDENTI •PROP TY'.
:._
SIGNATURE -1 S
OF PERMITTEE FINAL
ROBERT A.WOOD,
JOHN A.LAMBIE..COUNTY ENGINEER ALIDATION SUPERVISING MECHANICAL ENG,R
y DR. =2. 3 4 Al F® 2 5 5 A 9.00 M
O r
Y , _
' WOthal IS have
aceSATIONate of consent to 766AB67A PW 9189 APPLICATION FOR PLUMBING PERMIT
I hereby affirm that I have a certificate of consent to self insure,
or a certlficaty of Worker'b Compensation Insurance, or a certified
copy thereof(Sec.3800 kpWbC.)
COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV.
Policy No. Company
❑ Certified copy is hereby furnished. BUILDING c `,,//
FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS �7J [•L L�� �-
❑ 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' BATH TUB CROSS ST.COMPENSATION INSURANCE ASSESSOR
(This section need not be completed If the work Involved by the SHOWER MAP BOOK PAGE PARCEL
permit Is for one hundred dollars($100)or less.) LAVATORY OWNER ���
I certify that in the performance of the work for which this permit
is issued, I shall not employ any person in any manner so as to SINK ADDRESS
become subject to the Workers'Compensation Laws.
DISWASHER CITY TEL.NO.
Date 2' Applicant CLOTHES WASHER CONTRACTOR
NOTICE TO APPLICANT: If, aft making this Certificate of T' z
Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS ll
provisions of the Labor Code,you must forthwith comply with such S✓V-
provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM ,
LICENSED CONTRACTORS DECLARATION CITY� �� !��-QN• TEL'S&
I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER STATE LIC.n /'
(commencing with Section 7000)of Division 3 of the Business and p GAS SYSTEM OUTLETS LICENSE NO. .SC7 �Q CLASS ` -3� U
Professions Code,and my license is in full force and effect. /
��--• OUTLETS OVER DISTRICT NO. PROCESSED BY
5 PER SYSTEM Q
License Number z(<� Lic.Class v� ~
U
FINAL/ - 2_CLU
� 3 DATE VALIDATION
Contractor Date
❑ FINAL ,... 8 Z
I am xempt under Sec. BY .1 Wih
,v
B.&P.C.for this mason
Plan check fee __
Date: =!
Signature PLUMBING PERMIT ISSUING FEE$ ...:T �
❑ J -
TOTAL FEE /, Q t
i'
Plan check applicant CHECK =f 1.3".
SINGLE FAMILY M=
HOME OWNER-BUILDER DECLARATION Name -
I hereby affirm that I am exempt from the Contractor's License Law
for the following reason(Section 7031.5, Business and Professions Address
Code):❑ .3 _111
1010
i 414/5-7
I,as owner of the property,will do the work and the structure - , ,;.
Is not intended or offered for sale(Section 7044, Business 100. :14� Al t_■i I._
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 Pol.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
propert fo inspecti urposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Alclitature of Permittee Date
% COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0303140004
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL I S PAID BUILDING ADDRSSS:
TR: 11290 LT: 8 BL: B 10508 OLIVE ST
FEE DESCRIPTION: QUANTITY: LION: AMOUNT: TEMP CA 917802864
ASSESSOR INFORMATION NEAREST CROSS STREET: HALIFAX
8585-021-013 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY
11 CLOTHESWASHER(S) 1.00 FIX 16.20
TOTAL FEES 43.95S : PROCESSED : P 8 P ON:
03/14/03 JK 09/10/03
OWNER: TEL. NO: FINAL TE FINAL BY: CODE:
SPATA ALEXANDER;CATHERINE;JOHN (626) 350-1054-
10512 OLIVE ST o'
TEMPLE CITY 91780CR I 0 OR
PLUMBI G FOR LAUNDRY
APPLICANT: TEL. 0:
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO UNDER SLAB WORK
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: L. 0:
- ROUGH PLUMBING
LIC. NO:
GAS PIPING
S VENT
q ( ✓ 0 WA
C��$ u3
PLUMBING FIXTURES
Lok LAWN SPRINKLERS
II �� GAS TEST
T CO P 0 D
CWV
GRAY-WATERSYST99—
REPORT ID: DPR263 ROUTE TO: BS05O8