The URL can be used to link to this page

Home My Public Portal About9064 OLIVE ST_Plumbing__ 76 A 667- CE 817 7-68 Temple City APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS: ANGELES B .000897 DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION °'BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS' 9064' Eo Olive COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY Temple Cit FOR APPLICANT TO FILL IN PR NT O TYPE), NEAREST ST. NUMBER FIXTURE OR ITEM EACH FEE M e Ga WATER CLOSET 1..50 OWNER MAIL BATH TUB 1.50 ADDRESS S.t1Y11E SHOWER 1.50 Cts T�yT,E'L'.,,N0. LAVATORY 1.50 CONTRACTOR General bat�tim CO. SINK 1.50 ADDRRSS .6558 West d. Blv DISHWASHER 1.50 CITY Los �eT,,de TEL. NO. CLOTHES WASHER 1.50 STATE LICENSE.NO, C-86. 151839 LIC CLASS SWIMMING POOL RECEPTOR. 1.50 DISTRICT No GROLLP ZONE i P LAWN SPRINKLER SYSTEM 2.00 eL- '� WATER HEATER 1 INDUST]IM WASTE APPROVAL O GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD (� OUTLETS OVER 30 :Ready for Inspeeffon Now O 5 PER SYSTEM WATE$SOPTENEE W H z Plan:check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE $ 00 TOTAL FEE APPROVALS DATE INSPECTOR'S.SIGNATURE Plan check applicant UNDER SLAB WORK. Name ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel. No. HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION PLUMBING FIXTURES AND STATE THAT THE ABOVE IS CORRECT AND AGREE'TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST _ PLUMBING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED "AND/OR UTILITY CO.NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVE DESCRIBED RE NT P Y. FINAL SIGNATURE JACK R. ALLEN, SU ERVISI CHANICAL ENG'R. OF PERMITTEE PERMIT VALIDATION CK. M.0. CASH. PLAN CHECK VALIDATION -CK. M.0. CASH#- •f lam•- 'fCtJG..,2 U'D � 7 Jam' •W.ORKERO'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT • I hereby,affirm that I have a certificate of consent to self 70AS67A insure, or a certificate of Workers'Compensation Insurance, CE 817(REV.8/86) or a certified copy thereof(Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. Company Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING t✓ 64 Certified copy is filed with the county building inspec- ADDRESS v E. 7 v�- tion department. NUMBER FIXTURE OR ITEM FEE � /� LOCALITY Date Appligant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. V COMPENSATION INSURANCE OWNER -7—^ (This section need not be completed if the work Involved by SHOWER MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS kek I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL,NO2,�7- -60S so as to become subject to the Workersf Comp n ation Laws. DISHWASHER el CONTRACTOR Date G pplican �N� T" CLOTHES WASHER NOTIC TO A PLICANT: If, a making this Certificate of O ADDRESS Exemption, you should bec me subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN TEL. NO. LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATERn LICENSE NO. C LICENSED CONTRACTORS DECLARATION V DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER L r and Professions Code,.and m license is in full force and effect. 5 PER SYSTEM Y FINAL VALIDATION DATE License Number Lic. Class FINAL Controctor Date BY 6� I am exempt under Sec. � B.BP.C. for this reason a Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ �? Signature TOTAL FEE S-0 Plan check applicant ;C-7125A SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name # 0 0 0 0 0 5 I hereby affirm that I am exempt from the Contractor's License Address 1 0 0 3 4,5 0 Law for the following reason (Section 7031.5, Business and Zfions Code): City Tel. No. 0 0 0 3 4,5 0 23U, as owner of the property, will do the work and the 0528-87 structure is not intended or offered for sale (Section Poo7044, 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 t ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the 0ignot1'nre!.nf bove mention pr perry for inspection purposes. �� 5 ) , SIE REVERSE FOR EXPLANATORY LANGUAGE IF ate ' 11 WORKERS'COMPENSATION DECLARATION 6 DPW 4/87 APPLICATION FOR PLUMBING PERMIT ,I. hereby'-affirm that I have a certificate of consent to self in 76A666A667A sure,ora cefflificate of Workers'Compensation Insurance,ora CE 817(REV.8/86) certified co y'thereof Sec 3800, Lab. .) • ' P licy No Pa n'p°ny COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS t rCertified copy is hereby furnished. ; BUILDING +� ~ FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspectLgn ADDRESS d U department. NUMBER FIXTURE OR ITEM @ FEE �'w p LOCALITY � a �_/�/v `/i WATER CLOSET(TOILET) Dare Applicant - AV NEAREST BATH TUB CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST. COMPENSATION INSURANCE - SHOWER OWNER 1X1 (This section need not be coinpleted if the work Involved by MAIL c the permit is for one hundred dollars($100)or less.). LAVATORY ADDRESS D ®/l �- I certify that in the performance'of the work for which this per- SINK / �rn mit is issued, I shall not employ any person in any manner so, CITY At Ile. lY 01L6 TEL. NS42— I as to become.subject to the Workers'Compensation Laws. DISHWASHER ` �YYYYJJJJ CONTRACTOR Date Applicant CLOTHES WASHER' n_ , ADDRESS Y NOTICE TO APPLICANT: If, aIN 'after making this Certificate of Ex- SWIMMING POOL RECEPTOR4.11 f emptibn,you should become subiect to the Workers'Compen- CITY le &e' TEL. NO. sation'provisions of the Labor Code,you'must forthwith comp- ly with such provisions or this permit'shall be deemed revok- STATE } P LIC. ed. WATER HEATER LICENSE'NO, U,3 2,7 J CLASSJ . 4 �� ' LICENSED CONTRACTORS DECLARATION - DISTRICT O. ��// P SSED I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS /1 �/ 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER (/ o fe d Professions Code, and my license is in?l force and ef- 5'PER SYSTEM FINAL V ATION a / r ��tsE DATE License Number L a� ✓ kic. Class �� O /7� * [f FI V Contractor(_-.(J/U/G�/L Date ` 0 O I am,exempt under Sec. W • a B:&P.C. for this reason Plan check fee co Do Date: - PLUMBING PERMIT ISSUING FEE$ v Signature TOTAL FEE -2o2& 1 A SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant. # 0 0 010'.0 5 I hereby affirm that I am exempt from.the Contractor's License Name Law for the following reason (Section 7031.5, Business and 0 0t1 6,5 0 Professions Code):. Address. 1 &5 05- Cit Tel. No. ° I, as owner•of the property, will do the work and the Y structure is-not-intended or•offered.forsale(Section 7044, -880 7 2 2' Business and Professions Code). , pop- 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 j Lender's Address I,certify that I.have read this application and state that the; .above informat'06.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- ntione property for kri-p-e-2jion purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE- Signature of Permittee Date COUNTY OF IAS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1201300004 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEA ID: I FEES PAID I BUILDING ADDRESS: I ITR: 11218 LT: 24 BL: E I I 9064 OLIVE ST I + FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917803006 [ (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: 15388-006-013 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, Cl I107 BATHTUBS/SHOWERS 1.00 FIX 16.30 SI I [TET: I TOTAL FEES 44.10 (ISSUED ON: PROCESSED BY: PLAN BY: [ 101/30/12 SR I (OWNER: TEL. NO: I IFINAL DATE FINAL BY: CODE: I CHAN ALBERT;REGINA (626) 806-6628- I I 19064 OLIVE ST ITEMP 917803006 1 IDESCRIPTION OF WORK 1 IREPLACED SHOWER VALVE 1 I I 1 [APPLICANT: TEL. NO: I I [SAME AS OWNER ISPECIAL CONDITIONS: [ 1 I I I I I (CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER - LIC. NO i 1UNDER SLAB WORK I I IWATER SERVICE I I [ I I 1PLASTIC YIN METAL YIN I I (ARCHITECT OR ENGINEER: TEL. NO: I I I I - I IROUGH PLUMBING LIC. NO: I I ✓ 11 (GAS PIPING IGAS VENT [ HOT WATER HEATER [ [ I IPLUMBING FIXTURES 1 [ I I 1 [LAWN SPRINKLERS I 1 I I I IGAS TEST [ I [ I I I UTILITY COMPANY NOTIFIED( I [ 1 I II I I [ I (GRAY WATER SYSTEM I I I I I I I I i I I I I I I I I I I I I I I I I I I (REPORT ID: DPR263 ROUTE TO: BS0508 I [ [ I