HomeMy Public PortalAbout9847 OLIVE ST_Plumbing__ IGA887-CE#817 5=-&!-
APPLICATION
=6I-APPLICA'T°ION FOR PLUMBING PERMIT:
COUNTY OF LOS ANGELES .
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIiYISION BUILDING
JOHN Aa Lr4MBIE. COUNTY ENGINEER. r ADDRESS O
WILLIAM A.'JENSEN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO F= INT
CR=M4 . �!
NUMBER FIXTURE OR ITEM OWNER
} WATER CLOSET
' DADDAD�S �
BATS TUB
C. TEL.n-2 ae
SHOWER
LAVATORY CONTRACTOR Alert Alumbing & Heaving
ADDRESS 13933 So. Crenshaw- Blvd..
sum --DISHWASHERCITY ' Hawthorn-e TEL.NpOS
coffm1935y/ uA0
LAUNDRY TUB' REGMITRAZICIfffNO. — COUNTY 13
to CL07M WASHER DISTRI�NO. G P
WATER HBATER +
IMMUSTEM
Y - GAS SYSTl3IB WASTE APPROVAL �
IIEM407I011 RECORD
• �;` !�.Ta �, awl. -6fi�d f �{_�ad-�'�►� �l��fli7�i�.
S_SLBt♦•PER ITEM.
d; OR FD[TDBE- APPROI�LB DATE NSFECTOR•9 SIGNATUPA
PERMIT N 2 1 00 UNDER SLAB WORK " �� 7✓ e '
F TO'IAI_ FEE ROUGH PLUMBING !oZ •^ J a'd°�-'- r�es1
`� GAS PIPING
1 HEREBY A.gXH0WLEDGE THAT 1 NAVE READ THIS APPLICATION
'? AND BTATE.THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY s GAS VENT - I
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
2.PLUMBING. V -.i.- „—�,_•,
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS, ANGE S-COUNTY AND STATE OF GAS TEST " ...�3
t' CALIFORNIA OR THAT 1 AM THE LE OWNER OF THE ABOVE et
'• DESCRIBED RESIDENTIAL PROPE UTILITY CO.NOTIFIED
SIGNATURE l r:• ll ,If/. d
OF PERMITTEE _ {�
FINAL !v
ALIDATION ROBERT A WOOD.
/ E
M.0. CASH SUPERVISING MECHANICAL ENG'R
LAC0 6 6 4 3Q! 100 7 5 A 11.2 5~
WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING
PERMIT
I hereby, affirm that I have a certificate of consent to self in- 76AM A 490 @' ®® ®� YW9 ®�]V Pd' dF9®
sure,or a certificate of Workers'Compensation Insurance,or a
certified copy thereof(Sec. 3800, Lab. C.)
Policy No.6969—OOO�800L NMIC COUNTY OF LOS ANGELES DEFt. OF PUBLIC WORKS
Certified copy is hereby furnished. Z50,37 TEMPLE CITY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
[1 Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM ADDRESS 9847 OLIVE ST
J department. @ FEE
LOCALITY TEMPLE
Dcite 4-1-94 Applicant W-O_ PROVTN WATER CLOSET(TOILET) NEAREST CITY
CERTIFICATE OF EXEMPTION FROM WORKERS'
BATH TUB CROSS ST. BALDWIN AVE
COMPENSATION INSURANCE SHOWER OWNER RALPH CANZONERI
(This section need not be completed if the work involved by MAIL
the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS9847 OLIVE ST
I certify that in the performance of the work for which this per-
mit is issued, I shall not employ any person in any manner so SINK CIT`TCITy, . NO.2 8 6 1� J
G•
as to become subject to the Workers'Compensation Laws. DISHWASHER 1
CONTRACTORG NE L INSTALLATION
Date. Applicant CLOTHES WASHER
ADDRESS
NOTICE TO APPLICANT: If, after making this Certificate of Ex-
tion,you should become subject to the Workers'Com en- SWIMMING POOL RECEPTOR
em
P Y I P CITY L.NO'75
sation provisions of the Labor rode,you must forthwith comp- LAWN SPRINKLER SYSTEMS LOS ANGELES 9 0 0 4 —a S�{
ly with such provisions or this permit shall be deemed revok- STATE LIC.
ed. WATER HEATER LICENSE NO. 1 1 CLASS
LICENSED CONTRACTORS DECLARATION DISTRICT NO. ! �i ""�� PROCESSED BY
I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS �/ ro 7a ��G ;
9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER Wu G
and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION
fect. HOSE BIB DATE f- —�
151839 839 IL
License Number Lic. Class C36 0
W.O PROVIN 4-94 BY AL V
Contractor. o Date
I am exempt under Sec. S V
B.$P.C. for this rens n Plan check fee y
D PLUMBING PERMIT ISSUING FEE$
Signature 26 40
TOTAL FEE 41 85
SINGLE FAMILY applicant
Plan check a
HOME OWNER-BUILDER DECLARATION pp i
I hereby affirm that I am exempt from the Contractor's License Name
Law for the following reason (Section 7031.5, Business and * �_;�,�
Professions Code): Address �
I, as owner of the property, will do the work and the City Tel. No. � �
structure is not intended or offered for sale(Section 7044, 1 IT
Business and Professions Code). ® TOTAL •r,�c
CONSTRUCTION LENDING AGENCY CHUCK CK
I hereby affirm that there is a construction lending agency for } r fl,the performance of the work for which this permit is issued CHANGE
-
(Sec. 3097, Civ. C.).
Lender's Name ••
111130-12001 7/U.I.
Lender's Address
Oro? 1 AM 11:0_
I certify that I have read this application and state that the
above inf motion is correct. I agree to comply with all County
ordinance and State laws regulating Plumbing, and hereby
authorize epres fives o his County to enter�upone
abov me Tionpetinspection purosSEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of ermittee Date
,
COUNTY OF LOS ANGELES I TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0107090013
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGALID: _7MMID IBUILDING ADDRESS:
ON FILE 9847 OLIVE ST E
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: !TEMP CA 91780
ASSESSOR INFORMATION NUMBER: (NEAREST CROSS STREET: BALDWIN
8588-020-013 101 PERMIT ISSUANCE FEE 27.75 'THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY
51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20
TENANT: TOTAL FEES 43.95 ISSUED 0PROCESSED : PLAN PIR S .
i 07/09/01 UT 01/05/02 .
OWNER: TEL. NO: FINAL'D TE FI CODE:
9845,OLIVEYST
TEMP 917803256 DESCRIPTION 0 0
GAS LINE FOR A/C LEMIT
APP E
CHOY (626) 309-0745-
9435 DAINES DR r- SPECIAL CONDITIONS:
TEMPLE CITY CA 91780
CONTRACTOR: TEL. NO: 61 5 E�P;,+ +e,
� � � �^� ���� APPROVALS ATEINSPECTOR SIGNATURE
C M ELECTRIC CO. (626) 309-0745- !/ ,
9435 DAINES DR LIC. NOUNDER-SLAB-WORK
%
TEMPLE CITY, CA. 91780 519987 C10 WATER SERVICE
d C �`' /`! `;`� PLASTIC Y/N METAL Y/N
ARCHITECT OR G �fi 1 `.
ROUGH PLUMBING
LIC. NO.,/
GAS PIPING
r - ------- - -- -- - J GAS VENT
TOT HOff ER
Ll
- - - -- - - - - PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TES ll
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-
UTILITY COP 0 ED
CWV
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GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508