HomeMy Public PortalAbout9918 OLIVE ST_Plumbing__ 76AG67A(CE 617B)-11/76 ✓/'r V/✓`-'t/ �••-�
APPLICATION FOR PLUMBING PERMIT
a"I-® .
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER. FIXTURE OR ITEM FEE ADDRESS
WATER CLOSET y LOCALITY ��� L �}
BATH TUB NEAREST /J
CROSS STL-46 CSC
SHOWER OWNER /—
LAVATORY 11M IL
ADDRESS /Z$ B U G
SINK CITY TEL.NO.
DISHWASHER CONTRACTOR
/Z Q s �v
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR CITY �U V I �� TEL.NO3���J[�
LAWN SPRINKLER SYSTEM
STATE / / LIC. /
WATER HEATER LICENSE NO.Z 5" 5 CLASS`'3
GAS SYSTEM '2/6UTLETS U DISTRICT NO. GROUP ZONE P C ED BY
OUTLETS OVER 5 . O
S PER SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
as
up
I �
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel.No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE
GASTEST
LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE.DESCRIBED RESIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE }}
OF PERMITTEE ` FINAL b/Z'-!p
PLAN CHECK.VALIDATION CK. M.o. CASH PERMIT VALID ION u
M.O. CASH
14 4,�JWJ 22 5 D- 7.5 0 A
es
76A667 (CE-817)-8-71 � � /
APPLIaA��k FORLPLUMBING PERMIT {�
. � LJ
COUNTY OF LOS ANGELES
DEPARTMENT.OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS , v
LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE
OWNER •
WATER CLOSET 1.75
MAIL ty
BATH TUB 1.75 ADDRESS �, d Qj../ (J6
SHOWER 1.75 CITY ` TEL. NO.
LAVATORY 1.75 CONTRACTOR �� �St
SINK 1.75 ADDRESS V�,7.ej
DISHWASHER 1.75 CITY TEL. NO.' .y. t f
CLOTHES WASHER 1.75v 4L_
STATE LIC
SWIMMING POOL RECEPTOR 1.75 LICENSE NO. -�"�( / CLASS
DISTRICT NO. GROUP ZONE P SSS Y
LAWN SPRINKLER SYSTEM 1.75 �
' � f
WATER HEATER 1.75 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 135 INSPECTION R5JORD u
OUTLETS OVER ``', LL �
5 PER SYSTEM 30 !� 7. �. `U `_, 0
V
Ni
H
z
0
Plan check fee See reverse.
PLUMBING PERMIT ISSUING FEES 00
TOTAL FEE L
APPROVALS DATE INSPECTOR'S 91GNATU RE
Plan Check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY. PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY L09 ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OR' AND INTEND TO
RESIDE IN THE ABOVE DES 1BED RESIDENTIAL OPERTY. FINAL .7L
SIGNATURE
OF PERMITTEE •
PERMIT VALIDATION CK. M.0. CASH
PLAN CHECK VALIDATION CK. M.0. CASH
`, L(Co4482" 5 D 4.75
WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT
I hereby affirm that I have a certificate of consent to self i 76A667A
insure, or a certificate of Workers'Compensation Insurance, I CE 817(REV. 10/81)
or a certified copy thereof (Sec. 3800, Lab. C.) COcNTy Oo fOAGlQS
City BUILDING AND SAFETY
Policy No-2DI A�rc'ompany SCTV 9264
i
Pol
Certified copy is hereby furnished.
BUILDING
® FOR APPLICANT TO FILL IN(PRINT OR TYPE) I ADDRESS 9918 E. Olive St.
Certified copy is filed with the county building inspec-
tion department. NUMBER FIXTURE OR ITEM (off 'FEE
LOCALITY Temple Cit
Date 4-1-87 ApplicanPeneral Install. WATER CLOSET CNEAREST
ROSS ST. Olive St•
CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB
COMPENSATION INSURANCE SHOWER IOWNER Ruth Brodie
(This section need not be completed if the work involved by MAIL
the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS Same
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 81$19,285-3269
so as to become subject to the Workers'Compensation Laws. DISHWASHER
CONTRASTdeneral Installation
Date Applicant CLOTHES WASHER ApDRESS
NOTICE TO APPLICANT: If, after making this Certificate of I 6558 West Blvd
Exemption, you should become subject to the Workers' SWIMMIN L RECEPTOR I
Compensation provisions of the Labor Code, you must forth- CRY Los fAn eles TEL. N
LAWN SPRINKEM 0.753�,2541
L _ T
with comply with such provisions or this permit shall be S ATE LIC.
deemed revoked. ], WATER HEATER t 6 00 LICENSENOZ51839 CLASS C36
LICENSED CONTRACTORS DECLARATION DISTRICT NO. ESSED BY
I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM
(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER
and Professions Code,and my license is in full force and effect.' 5 PER SYSTEM 1V}�, FINAL1Z VALI TION
Sl A�9 DATE }
CIL
License Number — Lic. Class C36 1 L
FINA •
Contractor W-0. PrOvi.Ylpate 4-55 1 BY '
❑ C
I am exempt under Sec. CF
B.BP.C. for this reason LL
Plan check fee@ 6 4$8 A v
Date:
'n
Signature PLUMBING PERMIT ISSUING FEE$ 1 C
� o
TOTAL FEE 6 # 0 0 0 0 0 5
SINGLE FAMILY Plan check applicant
HOME OWNER-BUILDER DECLARATION Name I o,o 1 650
1 hereby affirm that I am exempt from the Contractor's License Address
Law for the following reason (Section 7031.5, Business and o 0 0 1 650cm
Professions Code): City Tel. No.
❑ I, as owner of the property, will do the work and the U 2 1 o-87
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 Poo
ordinances and State laws regulating Plumbing, and hereby
authorize representatives of this County to enter upon the
above-mentioned pr pprty spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee pate
WORKERS'COMPENSATION DECLARATION PW
'I hereby, affir'm'that I have a certificate of consent to-self m-0 76=A 4/90 APPLICATION FOR PLUMBING PERMIT
sure,or a certificate of Workers'Compensation Insurance,or a
certified copy thereof(Sec. 3800, Lab. C.)
<+. COUNTY OF LOS ANGELES' DEPT. OF.•PUBLIC WORKS:
Policy No. Company -
0 ' l(
Certified copy is hereby furnished. BUILDING p
❑ Certified copy is filed with the county building inspection FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS
department. NUMBER FIXTURE OR ITEM @ FEE
LOCALITY
Ddte Applicant WATER CLOSET(TOILET) /j(,0, d NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST.
COMPENSATIOWINSURANCE SHOWER OWNER
(This section need not be completed if the work involved by MAIL /�/ o/I ,�
the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS d
I certify that in the performance of the work for which this per- °
mit is issued, I shall not employ any person in any manner so SINK CITY ale ���.� y �� ' r.90
as to become subject to the Workers'Compensation Laws.. DISHWASHER Cy2u�C1
- CONTRACTOR
Date ' Applicant CLOTHES WASHER 33031 D0
ADDRESS7
NOTICE TO APPLICANT: If, after making this Cerfificate of Ex- SWIMMING POOL,RECEPTOR
-,
emption,you should become subject to the Workers'Compen- CITY TRIT �1 90
sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS
ly with such provisions or this permit shall be deemed revok- STATE
ed. WATER HEATER LICENSE NO. CLASS
LICENSED CONTRACTORS DECLARATION DISTRICT NO.
I hereby affirm that I am licensed under provisions of Chapter' GAS SYSTEM OUTLETS ��
9(commencing•with Section 7000)of Division 3 of the Business OUTLETS OVER
and Professions Code, and my license is.in full force and ef- 5 PER SYSTEM FINAL
1/ALIDATION
fect. HOSE BIB DATE �C
License Number Lic. Class ACCT°a
- - FINAL 133.90 V
Contractor Date BY 330- OC
0 I am exempt under Sec. O 1 ITEMS
B.&P.C. for this reason TOTAL '�''`� �9 � d
Plan check fee ► CHECK its°°0
Date: PLUMBING PERMIT ISSUING FEE$
SignatureQ
'TOTAL FEE /Q
SINGLE FAMILY :
HOME OWNER-BUILDER DECLARATION Plan check applicant CHECK iQ°��
I hereby affirm that I am exempt from the Contractor's License Name o& -0R qng c ox J z— CHANCE °00
Laim for the following reason (Section 7031.5,-Business and
Pr fessions.Code): Address p/�c
I, as owner of the property, will do the work and the City 7L G�Ty Tel. 0000-0001 7f 2/96
structure is not intended.or offered forsale(Section 7044, �,�,?� 1 �� 8'.47
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 perty fo. inspection purposes.
r*1
4i,;. . SEE REVERSE FOR EXPLANATORY LANGUAGE ;
Signature of Permittee Date.
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0101230032
BUILDING AND-SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 6755 LT: 7 9918 OLIVE ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803238
ASSESSOR IN-FORMATION NUMBER: NEAREST CROSS STREET: BALDWIN
8589-005-002 01 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 ON: PROCESSED BY: PLAN BY: EXPIRES ON:
01/23/01 UT 07/22/01
OWNER: TEL. N0: :FINAL ATE FI CODE:
BRODIE GEORGE H;RUTH M (818) 285-3269-
9918 OLIVE ST 3 (� Z b0
TEMP 917803238 SCR IO -OF WOR
GAS LINE FOR HEATING AND COOLING SYSTEM
APPLICANT: TEL. NO:
JAMES WUKMIR CO., INC (626) 442-2148-
11500 RAMONA SPECIAL CONDITIONS:
EL MONTE, CA
CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE
JAMES WUKMIR CO. INC. (626) 442-2148-
11500 RAMONA BLVD. LIC. NO D SLAB WORK
EL MONTE, CA 91731 285626 C10 WATER SERVICE
ARCHITECT OR ENGINEER: E 6 'I yY r" " y(I r `I PLASTIC Y/N METAL Y/N
' vk
� ROUGH PLUMBING
LIC. NO'
AS PIPING
it- ---- --------- -------- ----------- ----- -----,i GAS VENT
OT WATER HEATER
+ - - ---- ------ --- - - - - --
PLUMBING F I ES
'l LAWN SPRINKLERS
GAS TES
Ll
r UTILITY COMPANYNOTIFIED
CWV
: z - - .yGRAY WATER SYSTEM
Zoo
REPORT ID: DPR263 ROUTE TO: BS0508
• COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1102230030
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: 1
ITR: 6755 LT: 7 I 1 9918 OLIVE ST
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917803238 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
18589-005-002 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, Cl
151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.30 I I
ITENANT: TOTAL FEES 44.10 [ISSUED ON: PROCESSED BY: PLAN BY: 1
1 , 102/23/11 SR 1
(OWNER: TEL. NO: I IFIINAL DATE` FI BY: CODE: 1
IBRODIE GEORGE H;RUTH M (626) 285-3269- I 1✓��` I
19918 OLIVE ST
ITEMP 917803238 1 IDESCRIPTIO14 OF WORK 1
I 1 1EXTENDING GAS LINE FROM DRYER TO STOVE 1
(APPLICANT: TEL. NO: 1 I I
ISAME AS OWNER
1 SPECIAL_aCO,NDITION(S: 1
(CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE
ISAME AS OWNER - 1 I I
I LIC. NO I (UNDER SLAB WORK I 1 1
[ I (WATER SERVICE I I I
IPLASTIC Y/N METAL Y/N 1 I 1
(ARCHITECT OR ENGINEER: TEL. NO: 1 I I I I
I - I IROUGH. PLUMBING I I I
LIC. NO.
IGAS PIPING
IGAS VENT I 1 1
IHOT WATER HEATER I I I
I I I
I I IPLUMBING FIXTURES I I I
I I I
I I ILAWN SPRINKLERS I I I
I I IGAS TEST
I I I
I [
UTILITY COMPANY NOTIFIEDI I I
I I ICWV I I I
I IGRAY 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 I I
I I I I I I
IREPORT ID: DPR263 ROUTE TO: BS0508 I I I I
I I I I I I