HomeMy Public PortalAbout9426 OLIVE ST_Plumbing__ 76A667-CE817-8-57
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADDRESS _ a �V -e'. 5-1-
JOHN A. LAMBIE, COUNTY ENGINEER
CASSATTD.GRIFFIN, SUPT OF Bu.ILDING LOCALITY 'jr l
FOR APPLICANT TO FILL IN NEAREST
CROSS.ST.
NUMBER FIXTURE OR ITEM r
OWNER
WATER CLOSET MAIL s'
BATH TUB ADDRESS i
SHOWER CITY .NO.
LAVATORY CONTRACTOR
SINK ADDRESS y7,6
DISHWASHER CITYr .NO.
LAUNDRY TUB CONTRACT 'S STAT
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER
DISTR�,T NO. GROUP =ZONEDY FOR INSPECTION
WATER HEATER . �>
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
'r ��- 5�yea-.�'ri Li rYs' Z...E••�P� . !-'...Y....,.� .
APPROVALS
$1.00 PER ITEM DATE INSPECTOR'S SIGNATURE
OR FIXTURE $ UNDER SLAB WORK.
ROUGH PLUMBING
PERMIT S 00
e� GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP 1CATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING.
1 HEREBY CERTIFY THA' 1 AM PROPERLY REGISTERED. AND/OR GAS_TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO. NOTIFIED
DESCRIBED RESIDENTIAL PROPER-7.
SIGNATURE
OF PERMITTE FINAL
ALIDATION ROBERT A. WOOD,
SUPERVISING MECHANICAL ENG'R
CK. M.0.
LACo 6 6 9 1 L NOV 14 5 A 7.0 0 M
' y, .K•eM � ..
�eneerr n s-s�'i® APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING 1
WILLIAM J. .FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTR`CjTWO. GROUP ZONE PERMIO.
/-767'
PLUMBERfs� RECEIVED J READY FOR DATE ISSUED
`��J FIRST INSPECTION
ADDRESS 1 -P Ll—/I r
r7l
/�r.1 1 BUILDING f-n f
CITY -� 4 w�`,., TEL. NO. ADDRESS `% .?+ 6!
COUNTY LOCALITY
LICENSE NO. EXPIRES
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OR FIXTURE OR ITEM FEE
OWNER
MAIL.
WATER CLOSET (TOILET) 0.50 $ -ADDRESS �Ar _ qq��
BATH TUB O.SO S GJTY : L�IF TEL. NO.
SHOWER ® 0.50 1 HEREBY A CNOWLEDGE THAT I HAVE READ T S
J APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
LAVATORY (WASH BASIN) ® 0.50 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK .0 0.50 hANG
S REGULATING PLUMBING.
IFY .THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
4eSIDENTI,QI.�P�t012ERTY DESCRIBED ABOVE.
GAS SYSTEM OUTLETS (� 0.50 E OFWATER HEATER Q 0.50 ITTEI SLOP SINK. Q 0:50INSPECTIGN RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN ® 0.50
DISHWASHER @ 0.50
DRINKING FOUNTAIN Q 0.50
URINAL Cid 0.50 J
HOUSESEWER .0.50 Q
Z
MISCELLANEOUS (�
(Y
O
I
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING I ell
GAS VENT
CESSPOOL 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT 1.00 SEWER
PERMIT l:oo GAS TEST
h UTILITY CO. NOTIFIED
TOTAL FEE S !J
FINAL
76A667 DBS 17 7-5I APPLICATION FOR PERMIT
DEPARTMENT OFNG AND SAFETY PLUMBING
COIINTY OFF LOS LOS ANGELES
--WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT . GR PO E .
4711-s 2.
PLUMBERREADY FOR
RECEIVED BY FIRSTINBPECTION DATE IBB ED
ADDRESS /'�
BUILDING ff /_ /� �J ��
CITY TEL No. ADDRESS f/ 5�A
COUNTY LOCALITY-12:24 77 [B 401
BE NO. EXPIRES
PERMIT FEES CR SS ST. e,-le E,Q L- ��'E�YIiE
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNERMAIL
q 6•••
WATER CLOSET(TOILET) ! 0.60 $ ADDRESS G 6 A _ �7%4a l
BATHTUB ® 0.60DITM'`�E/yfQ�(If (r/r_kTEL ND.�T^ O ?2'
SHOWER Q 0.60 'I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) 0.60 APPLICATION AND STATE THAT THE ABOVE 19 CORRECT
•
r AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN BINK $ 0.60 AND STATE LAW19 REGULATING PLUMBING.
I CERTIFY THAT I POSSESS THE ABOVE VALID LOB
LAUNDRY TUB OR TRAY 0 0.60 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
BAB SYSTEM OUTLETS 0 0.60 OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
SIGNATURE OF. . AA 'A�
WATER HEATER 0 0.60 PERMITTIE
SLOP SINK @ 0.60 INSPECTION RECORD
FLOOR BINK Q 0.60
FLOOR DRAIN 0.60
DISHWASHER O.'513 cg;Q —;- re=-S
L
DRINKING FOUNTAIN 0.60 �y�•�� jt
URINAL 0.60 1 , Q
HOUSE SEWER O.BO t ' ti Z_
MISCELLANEOUS
ellAG3� O
�
�tl ivyFBI A
CIA f
APPROVALS ������.,
_ DATE n'8/IN9PECT0 B NAME"
ROUGH PLUMBING 9��(a_
GAB PIPING .(J
GAB VENT
CESSPOOL 1,00 CESSPOOL /3
SEPTIC TANKi SEPTIC TANK /O, d Aillf . I,
DRAIN (' ) PIT ( ) 1.00 SEWER ID /�l),f'••1 .I v,
PERMIT 1.00 GA8 TESTI'
UTILITY CO.NOTIFIED
- TOTAL-FEF
+JL
—f
76A667 oBB 17 11-so APPLICATION FOR PERMIT
DEPARTMENT`OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WIIrL1AM J. FOX, CHIEF ENGINEER PLUMBING 1
FOR APPLICANT TO FILL INDISTRICT NO. GROUP z MIT NO.
'Aaaaele
PLUMBER ow m V.dl� RECEIVED SY READY FOR DATE IBBU D
FIRST INSPECTION ate- eon
g l J
ADDRESS gX ev �+
BUILDING
CITY � ._ TEL NADDRESS ]r�^x
COUNTY LOCALITY r
LICENSE NO. EXPIRES
NEAREST
PERMIT FEES CROSS ST. Ayjlls .y
NUMBER TYPE OF FIXTURE OR ITEMFEE OWNER ,� ,,:►,_..p., ..nv
WATER CLOSET(TOILET) @ 0.50 S
ADDRESS
BATH TUB 0.50 CITY TEL. No.
SHOWER O.SO 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE 18 CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN 81NK 0.50 AND STATE LAWS REGULATING PLUMBING.
F CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
GAS SYSTEM OUTLETS 0.50
SIGNATURE OF �/', �i_ ,q�t� F' 3.{hj
WATER HEATER 0.50 PERMITTEE v u �'f "'° ` �^hl� f`^
SLOP SINK 0.50 a.INgl?ECJM RECORD
P.
FLOOR SINK 0.50
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50
J
URINAL @ 0.50 Q
HOUSE SEWER @ 0.50 ?
MISCELLANEOUS 99
lz
O
APPROVALS
DATE IMBPE13TOR-9 NAME
ROUGH PLUMBING
GAB PIPING
GAS VENT /
CESSPOOL @ 1.00 CESSPOOL i
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT (X) @ 1-OD SEWER
PERMIT I 1.00 GAS TEST
UTILITY CO.NOTIFIED
TOTAL FEE S
FINAL
WORKER'S COMPENSATION DECLARATION 20-0026 DPW 9/89
i I hereby affirm that I have a certificate of consent to self Insure, 7SA687A APPLICATION FOR PLUMBING PERMIT
or a certificate of Worker's Compensation Insurance, or a certified
I copy thereof(Sec.3800 Lab.C.)
COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV.
Policy No. Company
Certified copy is hereby furnished.
❑
FOR APPLICANT TO FILL IN(PRINT OR TYPE)Certified copy is filed with the county building inspection ADDRESS
department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY
Date Applicant WATER CLOSET NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST.
COMPENSATION INSURANCE BATH TUB
ASSESSOR
(This section need not be completed If the work Involved by the SHOWER MAP BOOK PAGE PARCEL
permit is for one hundred dollars($100)or less.) OWNERf�-
Z
I certify that in the performance of the work for which this permit LAVATORY //
Is issued, I shall not employ any person in any manner so as tc1 AIL
SINK ADDRESS
become subject to the Workers'Compensation Laws.
DISWASHER CITY TEL.NO. f�I�
Date Applicant CLOTHES WASHER CONTRACTOR &-1&11f11Z4
NOTICE TO APPLICANT: If, after making this Certificate of
Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS
provisions of the Labor Code,you must forthwith comply with such
provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM
LICENSED CONTRACTORS DECLARATION CITY TEL.NO. ' }
I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER O
(commencingwith Section 7000 of Division 3 of the Business and STATE LIC.
)
Professions Code,and my license is in full force and effect. GAS SYSTEM OUTLETS LICENSE NO. CLASS V
DISTRICT NO. PROCESSED BY
i OUTLETS OVER O
Ir
5 PER-SYSTEM '
License Number Lic.Class F
FINAL VALIDATION W
DATE �.
Contractor Date Cc
F1I am exempt under Sec. BY AL ?
+ BAP.C.for this reason
Date: Plan check fee
pill.Signature
PLUMBING PERMIT ISSUING FEE$ 6f p
Plan check applicant TOTAL FEE /, /J
cF
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Name �,(.�tiv
I hereby affirm that I am exempt from the Contractor's License Law
for the following reason(Section 7031.5, Business and Professions Address 3303 4�e:t:�
Code): i � .1.�
E 0
I,as owner of the property,will do the work and the structure City Tel.No.
is not intended or offered for sale(Section 7044, Business ?i}{ L +fg- "-�#''
'-
and Professions Code). oil s,•c
CAIN T#oL
CONSTRUCTION LENDING AGENCY oF�c)
i I hereby affirm that there is a construction lending agency for the 4>-iANGE T
performance of the work for which this permit is issued(Sec.3097,
Civ.C.)
Lender's Name
236 1 AM 31.19
1 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
propert!X for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
.Qlnnativ. of Parmlffoe �9te
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0611140010
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 ERT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
ON FILB
9426 OLIVE ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803156
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: ENCINITA
8590-003-004 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, C
47 WATER HEATER(S) 1.00 WTH 16.20
TENANT. TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
11/14/06 JK 05/13/07
OWNER: TEL. NO: FINAL DAT DBY: CODE:
CLOHERTY BILLIE M (626) 286-5614-
9426 OLIVE ST
TEMP 917803156 DESCRIPTION OF WORK
WATER HEATER CHANGE OUT
APPLICANT: TEL. NO:
TEKANA (310) 515-1311-
17111 S. BROADWAY SPECIAL CONDITIONS:
GARDENA, CA 91780
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
ACTION CONTRACTORS (310) 515-1311-
17111 SOUTH BROADWAY LIC. NO UNDER SLAB WORK
GARDENA, CA 90248 B/L00000
WATER SERVICB
PLASTIC YIN METAL YIN
ARCHITECT OR ENGINEER: TEL. NO:
ROUGH PLUMBING
LIC. NO:
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
UTILITY COMPANY NOTIFIED
CWV
GRAY WATER SYSTEM
* ADDITIONAL DATA ON FILE
I
REPORT ID: DPR263 ROUTE TO: BS0508
I