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HomeMy Public PortalAbout10561 OLIVE ST_Plumbing__ ION WORKER'S I have a certificate of consent to 76A665DPw9189 APPLICATION FOR PLUMBING PERMIT I her@by affirm that I have a certificate of consent to self insure, 75Afi57A or_a certificate of Worker's Compensation Insurance,or a certified copy thereof(Sec.3800 Lab.C.) I COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. PolicyCompany ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINGn-,- ❑ Certified copy is filed with the county building inspection ADDRESS l© -6I' 6{/-V e 4oe . 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 ���S� PAGE Qom- PARCEL ZZO permit is for one hundred dollars($100)or less.) OWNER Iver I certify that in the performance of the work for which this permit LAVATORY Is issued, I shall not employ any person in any manner so as to SINK ADDRESSMAIL Nie become subject to the Workers'Compensation Laws. DISWASHER Applicant •y CLOTHES WASHER CITY TEL.NO. �J Date a�+ 7'113 CONTRACTOR Q NOTICE TO APPLICANT: If, after making this Cor.'cate of Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code,you must forthwith comply with such ADDRESS • 1 3a provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM t LICENSED CONTRACTORS DECLARATIONWATER HEATER CITY Ltd C• EL. O. ��/�1—��b� a I hereby affirm that I am licensed under provisions of Chapter 9 STATE C (commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS CENSE NO. �� �"n CLASS Professions Code,and my license Is In full force and effect. DISTRICT NO. PROCESSED BY OUTLETS OVER � c� C 5 PER SYSTEM License Number Lic.Class I- ' FINAL yAUffA�'ION IL Contractor F`9' �'� � Data J ` r DATE J I 33 x�3 { '- a JJUJ i TT 15��a.�•.r ❑ I am exempt under Sec. BY FINAL 1 1 1 E�{' ? B.&P.C.for this reason Date: } T�1�. 196-35 Plan check fee ' Signature PLUMBING PERMIT ISSUING FEE$ CHECK 191, ? TOTAL FEE CHANGE AIV ❑ SINGLY Plan check applicant 3 ' { HOME OWNER-BUILDER DECLARATION Name 1 ��—U � L/1 f0 I hereby affirm that I am exempt from the Contractor's License Law r ., �;t for the following reason(Section 7031.5, Business and Professions Address _ 3 a 1.332 1 r'M 11 o•'-"-' Code): ❑ city C ye.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 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-mentioned property for Inspection purposes. p SEE REVERSE FOR EXPLANATORY LANGUAGE D.H.S.17 25M SETS 12.44 APPLICATION FOR- EDIL�DAR11PT DRFARtMENT OF BUILDING. AND SAFETY sSeYb1/M81 COUNTY. OF LOS ANGELES Fri"LT WM.J. FOX. CHIEF ENGINEER - NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMITO. ROUGH X FIXTURES X COMPLETE . RECEIVED BY READY FOR• DATE 188U HEATER X CESSPOOL SEPTIC TANK ED FIRST INSPECTION e: GAS X MISCELLANEOUS ✓. r '7` r *�'! �,';' Rpt F{C, i;^� APPLICANT FILL IN HEAVILY OUTLINED POTI®N ®NLY a NAME Gii OLlurtl'�. tLUY+:tSlivlr AooRESS 2949 Olive Street Iu - ADDRESS 1010 East Garvev LOCALITY T rnn C" •1� e,�NEAREBT p"1, _ CITY .1_11 Monte TEL.No. BU 8-03 ICROSSST. COUNTY 1 NAME T! J. Brock e Dila e CERT.No. 50-�41 EXPIRES .�U �-0�`8 LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL- NORTH O ADDRESS j p. M CITY T o. ASr e l e s TEL.No. j 1 AM THE LEGAL POSSESSOR OF_THE ABOVE LO `I ANGELES COUNTY CERTIFICATE OF QUALIFICATI H. 16 PLUMMER 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. " OWNER 1 C®RRECTI®NS l CC Vii''((%"C. f-� fr','_ 'Cl. a„f•r I _ �� ��,tn.� AA)�JA•.1' .w�l�ly,�r.,,-��l/ r. .'i- I SOUTH i DESCRIPTION OF WORK x ATH TUB FURNACE 1 ~ -SHOWER DISHWASHER LAVATORY REFRIGERATOR. ITCHEN SINK WATER SOFTENBR LOOR SINK SAND TRAP LOP SINK eLOOR DRAIN 1 WASH TRAY URINAL APPROVALS-- WATER CLOSET DRINKING FOUNTAIN INSPECTOR'S NwNAMEPE DATE INS ,- WATER HEATER DENTAL LAVATORY N 1 ROUGH PLUMBING I �6` L/r�lJ� 1 METER2 GAS SODA FOUNTAIN OUTL GAS PIPING GAS VENT I I ' ' CESSPOOL I TOTAL NUMBER OF FIXTURES SEPTIC'TANK I CESSPOOV- SEPTIC TANK SEWER 8 1%T UTILITY CO.NOTIFIED I TOTAL FEE I FINAL �•"�,� /,_ D.B.S.17 28M SETS 12.44 - APPLICATION FOR 1fEII11i8YI1 DEPARTMENT OF BUILDING AND S" COUNTY OF LOS ANGELES PLUMBIWgab WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION ®sol ICT No. GROUP ZONE- - PERMIT No. ROUGH FIXTURES COMPLETE �~ ' 9,;7 _ HEATER CESSPOOL I-I SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED n�+ FIRST INSPECTION '` 2 �� GAS MISCELLANEOUS - I— APPLICANT FILL IN HEA�?ILY O�TTLINED PORTION ONLY NL JOB C NAME NL ',Iti `' '1��" a ADDRESS .Z ADDRESS j.dre: �':ri (-�lr?;,.��•b• 3r LOCALITY L/ �r.24 (,r4✓fi`W/ 71q j1l'�I p•,+fr'i� NEAREST .J CITY id`s;:-1_ _:� :}1 =T$f::NO:" 9 CROSS ST. COUNTY --- - r y•---- CERT.No. EXPIRES W NAME �i' N G!/�Ls• j LOCATION OF SEPTIC TANK,-OR CESSPOOL z MAIL y ADDRESS NORTH O CITY TEL.NO. I AM THE LEGAL POSSESSOR OF' THE ABOVE LOB ANGELES COUNTY CERTIFICATE OF.QUALIFICATION. PLUMBER I AM THE LEGAL OWNER OF THE PROF E TY DESCRI13RD ABOVE. � I- w ' OWNER CORRECTIONS SOUTH DESCRIPTION OF WORK —BATH TUB FURNACE . O SHOWER DISHWASHER LAVATORY REFRIGERATOR .KITCHEN SINK WATER SOFTENER FLOOR SINK BAND TRAP GLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE IMBPECTOR'B MAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I i METER GAS SODA FOUNTAIN GAS PIPING I I OUTL GAS VENT I CESSPOOL I f k V p1p L NUMBER OF FIXTURES SEPTIC TANKk�;�I� 9j�1 ILL POOL SEPTIC TANK SEWER I i t: I / <! } R UTILITY CO.NOTIFIED i Af I TOTAL FEE I FINAL t ION WORKER'lh have a certificate of consent to 26AS57 DPW 9189 APPLICATION FOR PLUMBING PERMIT I herby affirm that I have a certificate of consent to self insure, 76A687A ` or, certifica(e of Worker',s Compensation Insurance, or a certified copy thereof(Sec.3800 Lab.C.) J COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policyr-to. Company ❑, Certified copy is hereby furrifted. BUILDINGnn..,,__ E] Certified copy is filed with the county building inspection FOR APPLICANT TO FILL IN(PRINT OR.TYPE) ADDRESS W-61' '� 11_Q 4w. , department. NUMBER FIXTURE.OR ITEM G FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST. L COMPENSATION INSURANCE , BATH TUB AMAP SSESSOBOOK PAGE PARCEL G � R ��� .(This section need not be completed if,.the work.Involved by the SHOWER Sa Qom- permit is for one hundred dollars($100)or less.) OWNERf. I certify that In the performance of the work for which this permit LAVATORY Is Issued, I shall not employ any person In any manner so as.to SINK 1 MAIL a4 aQ become subject to the Workers'Compensation Laws. e ■ DISWASHER CITY TEL.NO. Date 00'— 17�3Appiicant CLOTHES WASHER CONTRACTOR N arL(d .67aNOTICE TO APPLICANT: If, after making this Cer icate of Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR YUCCA provisions of the Labor Code,you must forthwith comply with such ADDRESS 3_ , 1„ provisions or this permit shall be deemed,revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION aq� CITY G1 TyEL. I hereby affirm that I am licensed under provisions of Chapter g WATER HEATER' (commencing with Section 7000 of Division 3 of the Business and STATE LI . ( 9 ) LICENSE NO. 'r D CLASS (J Professions Code,and my license is in full force.and effect. GAS SYSTEM OUTLETS OUTLETS OVER - DISTRICT.NO. PROCESSED BY Vr f� �. 5 PER SYSTEM 0� License Number l� It 8� Lic.Class FINAL 1 V1�1C A-tION t t Ci W Contractor:. �Qin !''W Date t l t r ✓� DATE � ° �' ❑ I am exempt under Sec. BY AL � 1 ITEC S - B.&P.C.for this reason Date: Plan check fee 001. ITAL196.35 Signature .. K 1967 PLUMBING PERMIT ISSUING FEE$ CHEC °`'%, f TOTAL FEE CHANGE ■00 E] SINGLE FAMILY Plan check applicant 3S ' HOME OWNER-BUILDER DECLARATION Name UL� — �iC�� �� �fL ; I hereby affirm that I am exempt from the Contractor's License Law r ° for the following reason(Section 7031.5, Business and Professions Address �� olt� ■ 13,2 1 AM11■311 Code): ❑ City e.No. I,as owneF of the property,will do the work and the structure r 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.3091,- Civ. 087;Civ.C.) Lendees'Narn 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-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Slanature.of Permitt a Data COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1209170023 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: (LEGAL ID: I FEES PAID I BUILDING ADDRESS: I TR: 7690 LT: 7 UN: .002 I 1 10561 OLIVE ST I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917802865 1 1 ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: PAL MAL 8586-029-003 101 PERMIT ISSUANCE FEE 27.80 1 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, Cl 1 107 BATHTUBS/SHOWERS 1.00 FIX 16.20 I I TENANT: I TOTAL FEES 44.00 (ISSUED ON: PROCESSED BY: PLAN BY: I 109/17/12 SR IIOWNER: TEL. NO: I (FINAL DATE FINAL BY: CODE: 1 HOUN MENG OUI;PHET HOUANG (626) 448-7127- 1 1 /j�� I 110561 OLIVE ST I I (TEMP 917802865 1 ID SCRIPTION OF WORK 1 I I ICHANGE BATHTUB TO SHOWER ONLY FOR BATHROOM REMODEL (APPLICANT: TEL. NO: I I SAME AS OWNER I (SPECIAL CONDITIONS: ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE I [SAME AS OWNER - I I I I LIC. NO I (UNDER SLAB WORK I I (WATER SERVICE 1 1 I I I (PLASTIC Y/N METAL Y/N 1 I I (ARCHITECT OR ENGINEER: TEL. NO: I I I - 1 (ROUGH PLUMBING LIC. NO: IGAS PIPING 1 I I 1 I (GAS VENT I I 1 1 I IHOT WATER HEATER 1 I 1 I I (PLUMBING FIXTURES 1 1 1 1 I (LAWN SPRINKLERS 1 1 1 [ IGAS TEST I 1 I (UTILITY COMPANY NOTIFIED( 1 I I 1CWV I I I 1 I (GRAY WATER SYSTEM 1 I I I I I I I I I I I [REPORT ID: DPR263 ROUTE TO: BS0508 1 I [ I I I I I I I COUNTY OF IAS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1209130018 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: ITR: 7690 LT: 7 UN: .002I 10561 OLIVE ST I I IFEE DESCRIPTION: QUANTITY: UOM: AMO TEMP TEMP CA 917802865 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: PAL MAL 18586-029-003 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, Cl 113 DISHWASHER(S) 1.00 FIX 16.20 1 1 TENANT: 125 LAVATORIES/SINKS 1.00 FIX 16.20 (ISSUED ON: PROCESSED BY: PLAN BY: 1 TOTAL FEES 60.20 109/13/12 SR (OWNER: TEL. NO: I IF NAL DATE FI BY: CODE: I NOUN MENG OUI;PHET HOUANG (626) 448-7127- 110561 OLIVE ST I I ITEMP 917802865 1 IDESCRIPTION OF WORK 1 I IREPLACE DISHWASHER AND SINK FOR KITCHEN REMODEL 1 (APPLICANT: TEL. NO: I I I ISAME AS OWNER I I ISPECIAL CONDITIONS: 1 ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1 ISAME AS OWNER - I I I I LIC. NO I 1UNDER SLAB WORK I I I 1 1 (WATER SERVICE I I I I 1PLASTIC YIN METAL YIN I I I (ARCHITECT OR ENGINEER: TEL. NO: I I I I - IROUGH PLUMBING I LIC. NO: I I IGAS PIPING 1 I I I IGAS VENT I I I I I IHOT WATER HEATER I I I I I I IPLUMBING FIXTURES ILAWN SPRINKLERS I I I 1 1 IGAS TEST I I I I I 1 1 (UTILITY COMPANY NOTIFIED( I 1 I I ICWV I I I IGRAY WATER SYSTEM I I I I I I I 1 I I 1 I 1 I I I I I 1 I I I I I I I I I I I I I I I I I I I 1REPORT ID: DPR263 ROUTE TO: BS0508 I I I I I I I I