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Home My Public Portal About9517 OLIVE ST_Plumbing__ ,HA887 APPLICATION! FOR PLUMBING PERMIT .1 DIVISION OF BUILDING AND SAFETY Deportment of County Engineer County of LoB Angeles BUILDING L•(,� r JOHN A.LAMBIE, COUNTY ENGINEER CASSATT D,GRIFFIN,SUPT.OF BUILDING LOCALITYTi-M �,LTA FOR APPLICANT TO FILL IN NEARSCROSS sT. OWNER SrDISTRICT NO'. OUP ZONEa READY FOR INSPECTION MAIL ADDRESS I Li 1 U/-I `/�I INDUSTRIAL I CITY JEMPLIt C111TEL.NO. WASTE APPROVAL PLUMBER W• IC TT INSPECTION RECORD IS ADDRESS 0 kfa 4 Vogl-& Piro mptwv- CITY v TEL.NO. LICENSE NO. NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 $ BATH TUB @ $1.00 SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $1.00. KITCHEN SINK @ $1.00 DISHWASHER @ •$1.00 LAUNDRY TUB ORTRAY @ $1.00. CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 GAS SYSTEM @ $1.00 w7 vk-vt f9 d1. APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING GAS PIPING TOTAL FEE GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE .LAWS REGULATING PLUMBING. DI PLUMBING FIXTURES I HEREBY CERTIFY THAT A PROPERLY REGI ERED AND/OR GAS TEST LICENSED AS REQUIRED BY LO ANGELES COUN NO STATE OF CALIFORNIA OR THA 1 M E L AL OWN F THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENT PR RTY. SIGNATURE " OF PERMITTEE FINAL .OHN A.LAMBIE.COUNTY ENGINEER y��am} ALIDATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR VS. M.O. CASH ;Co 9 7 5 5- J'Rl 2 9 . 3 2:J 0 Lo WORKERS'COMPENSATION DECLARA 7-AGVA I hereby affirm that I have a' certificate of consen to self 06 617r(:_sa, P P L I C A T I O N FOR PLUMBING PERMIT Insure,or a certificate of Workers'Compensation Insurartbe,or I N a certified copy thereof(Sec.3.800,Lab.C.) COUNTY OF LOS ANGELES ` BUILDING AND SAFETY Policy No. Company. . Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) F ING Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM FEEESS department. 1 LIDate Applicant WATER CLOSET' � ESTBATH TUB S ST. r• j , CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER LAVATORY MAIL (This section need not be completed if the work involved i ADDRESSCL by the permit is for, one hundred dollars ($100) or less.) SINK CITY t� TEL.N (� I certify that in the performance of the work for which this DISHWASHER ,permit is issued, I,shall not employ any person in any manner I CONTRACTOR G O so as.�to_become�subject to the Workers' . pensati Laws. CLOTHES WASHER Date Applicant SWIMMING POOL RECEPTOR a ADDRESS NOTICE TO APPLICANT: If, ter•making'this Certificate of CITY TEL.NO. to Exemption, you should bec. a subject to the. Workers' LAWN.SPR I N KLE R SYSTEM STATE. LIC. Z "Compensation provisions of the'Lab.or Code, you must forth- LICENSE NO'. CLASS with :comply with such provisions or this permit shall be WATER HEATER deemed revoked. ' DISTRICT N'O, P CESSED GAS SYSTEM OUTLETS LICENSED.CONTRACTORS DECLARATION OUTLETS OVER t) I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL �Z �� VALIDATION ness and Professions Code, and my license is in full force and DATE effect. FINAL License Number Lic.Class BY Contractor Date I am exempt from the licensing requirements as I am a Olen check fee licensed architect or a registered professional engineer i PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section. 7051, Bus- iness and;Professloos Code). TOTAL FEE Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I' hereby affirm that I am exempt from the Contractor.'s. Address Zicense Law.for the following reason (Section.7031:5, Busi- CityTel.No.. A'4 228 A. n�ss and Professions.Code): I, as owner of the property, am exclusively contracting # 0 0 0 0 0 5 with licensed contractors to construct the project (Section 7044,Business and Professions Code). 2 ° ° 1 2 60 CONSTRUCTION LENDING AGENCY o 0 0,1 2 5 0 v I.,hereby affirm that there is a construction lending.agency ' for the performance of the work for which this permit is I �' 04 0 3—8 2 issued(Sec.3097,Civ.C.). Lender's.Name i 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize. representatives of this County to enter upon the above-mentioned property for inspection•purposes. S' ature of Permittee Date { WORKERS'COMPENSATION DECLARA a' 7,Bpa87A ' P P L I C A T I O N FOR PLUMBING PERMIT I hereby affirm that I have certificate of cons to sell, ce e»•Ix-so) insure,or a certificate of Workers'Compensation Insurarf6e,or a certified copy thereof(Sec.3800,Lab.C.) y I COUNTY OF LOS ANGELES � BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ❑ ADDRESS Certified copy is filed with the county building inspection INUMBER FIXTURE OR ITEM FEE department. Date Applicant I WATER CLOSET L CALI NEAREST ' BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER''` (This section need not be completed if the work involved LAVATORY MAIL } by the permit is for one hundred dollars ($100) or less.) SINK C ITY D D R ESS TE L.N U I certify that in the performance of the work for which this DISHWASHER _,/ O permit is issued, I shall not employ any person in any manner CONTRACTOR `� so asto_become �subject to the Workers' pensati Laws. CLOTHES WASHER ADDRESS U Date6-3-?? Applicant , SWIMMING POOL RECEPTOR W NOTICE TO APPLICANT: If, ter making this Certificate of CITY TEL.NO. Exemption, you should bec a subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. Z Compensation provisions of the Labor Code,you must forth- WATER HEATER LICENSE NO. CLASS with comply with such provisions or this permit shall be deemed revoked. DISTRICT NO. P CESSED GAS SYSTEM OUTLETS �^^ f� r LICENSED CONTRACTORS DECLARATION OUTLETS OVER ', 'oe 1 hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL ness and Professions Code, and my license is in full force and DATE / Z- 7 VALIDATION effect. FINAL License Number Lic.Class BY Contractor Date ❑ I am exempt from the licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer I PLUMBING PERMIT ISSUING FEE$ � acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE �— 6 Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section 7031.5, Busi- City Tel.No. P11 2 2 8 A ness and Professions Code): I, as owner of the property, am exclusively contracting # 0.0 0 0 0 with licensed contractors to construct the project (Section 7044,.Business and Professions Code). I 2 0 0 1 250 CONSTRUCTION LENDING AGENCY a 0 0 1 2 5 C c=i I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is I 0603-82 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 SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. S' ature of Permittee Date I s COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0909150012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: I I ON FILE 1 1 9517 OLIVE ST 1 I FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: TEMP CA 917803132 I 1ASSESSOR INFORMATION NUMBER: 101 PERMIT ISSUANCE FEE 27.75 1 THOMAS PAGE: 596 GRID: J4�YLOCALITY: TEMPLE CITY, Cl 8588-025-020 1 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 1 1 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 109/15/09 SR 09/15/10 1 (OWNER: TEL. NO: I IF AL TE F BY: CODE: 1 IGAVREL JAMES T (323) 283-3400- ] 1 a, 1 19517 OLIVE ST 1 y I ITEMP 917803132 1 �DE CRIPTION OF WORK ] I I (GAS LINE FOR HVAC SYSTEM 1 ]APPLICANT: TEL. NO: I I I ]AMERICAN HTG & AIR (626) 285-8206- 1 1 I 15308 NOEL DRIVE 1 ISPECIAL CONDITIONS: 1 ]TEMPLE CITY CA 91780 1 I I ]CONTRACTOR: TEL. NO: 1 ]APPROVALS DATE INSPECTOR SIGNATURE I ]AMERICAN HEATING AND A, C (626) 285-8206- 1 ] 15308 NOEL DR. LIC. NO ] ]UNDER SLAB WORK 1 I ] ITEMPLE CITY, CA 91780 664929020 1 I I ] ] I I IWATER SERVICE 1 (PLASTIC YIN METAL YIN I I I 1ARCHITECT OR ENGINEER: TEL. NO: I I I I I I - I ]ROUGH PLUMBING LIC. NO: I I ] I I ]GAS PIPING 1 1 I GAS VENT 7 ► 1 1 1 HOT WATER HEATER I I ] I IPLUMBING FIXTURES I I I ] 1 ]LAWN SPRINKLERS ] 1 I ] I IGAS TEST I I I 1 1 ]UTILITY COMPANY NOTIFIED( 1 1 I I CWV I 1 1 GRAY WATER SYSTEM I ] ] I I ] ] I 1 1 1 1 I I ] I 1 I ] ] I I I 1]REPORT ID: DPR263 ROUTE TO: BS0508 I 1 1 ] I I I