The URL can be used to link to this page

Home My Public Portal About5351 PARMERTON AVE_Plumbing__ WORKERS COMPENSATION DECLARATION APPLICATION- FOR PLUMBING PERMIT I hereby affirm that I haveove a o certificate of consent to self in 7(10076 DPW ago sure or a certificat?of Workers Compensation Insurance ora 76A667A - .- certified copy thereof (Sec-3800 Lab C ) Policy No • Company - COUNTY OF LOS,ANGELESI '+ DEPT OF PUBLIC } \ F-] Certified copy is hereby furnished .` FOR APPLICANT TO FILL IN(PRIM OR TYPE) BUILDING r r d L Certified copy is filed with the county bmldmq vispection ADDRESS ✓ 3C! 1 !V A1C�ra/1 r7 i _ department NUMBER • _ FIXTURE OR ITEM @ FEE LOCALITY rt°.1ki - T WATER CLOSET(TOILET) a V Date.Applicant NEAREST , CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER - - yOWNER bl IA41 - v7 C—Al L (This section need not be completed If the work involved by - MAIL the permit is for one hundred dollars($100)or less ) I j LAVATORY - ADDRESS t ' a I certify that in the performance of the work for which this per SINK t p 4Q mit s issued I shall not employ any person in any manner so '� - CITY l TEL NO g'i8_�� // as to become subject to the Workers Compensation Laws DISHWASHER CONTRACTOR Data ' Applicant CLOTHES WASHER' , ADDRESS NOTICE TO APPLICANT If, after making this Certificate of Ex SWIMMING POOL RECEPTOR i emption, you should become subject to the Workers Compen CITY TEL NO cation provisions of the Labor Code you must forthwithicomp LAWN SPRINKLER SYSTEMS ly with such provisions or this'permit shall be deemed revok STATE LIC t ed , - WATER HEATER _ LICENSE NO CLASS , LICENSED CONTRACTORS DECLARATION DISTRICt NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS • 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code and my license is in full force and of 5 PER SYSTEM FINAL VALIDATION fect HOSE BIB ` DATE _ License Number Lic Class _ d FINAL ACCT.A O Contractor Dote BY V 123 •90 am exempt under Sec - � O 1 ITEMS 0 B 8P C for this reason Plan check fee , TOTAL 123. 9'O H Date PLUMBING PERMIT ISSUING FEE$ Ns 123.90 Cf74WGE s00 2 Signature - - TOTAL FEE _ 11A`,�C - SINGLE FAMILY - HOME OWNER BUILDER DECLARATION Plan check applicant I hereby affirm that I am exempt from the Contractor s License Name Low for the following reason (Section 7031 5, Business and 0' �s� WV OM1- 2/21/96 Professions Code) Address ` a • 4909 1 AM 10:13 dl as owner of•the property, will do the work and the ~ City Tel No ` 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 ' s Lender s Address _ I certify that I have read this application and state that the s above information is correct I agree to comply with all County ordinances and Stale laws regulating Plumbing, and hereby r ^ authorize representatives of this County to enter upon the above-men nod property f r inspe non purposes t SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee ate „ • COUNTY OF LOS ANGELES TEMPLE CITY 0508 PLID ING PERMIT - ' DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0710100016 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS ITR 13613 LT 62 5351 PARMERTON AV I I FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803504 1 (ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET DAINES 18573-005-023 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID C3 LOCALITY TEMPLE CITY Cl 107 BATHTUBS/SHOWERS 1 00 FIX 16 20 ITENANT 125 LAVATORIES/SINKS 1 00 FIX 16 20 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 145 WATER CLOSET/URINAL 1 00 FIX 16 20 110/10/07 SR 04/07/06 TOTAL FEES 76 35 1 OWNER TEL NO F NAL DATE FINkL BY CODE 1LY DIANA V, YIP PAUL (626) 443-0281- 15351 PARMERTON AV `�-<z / M (TEMP 917803504 I IE RIPON OF WORK��K PLUPIDING FOR NEW BATHROOM APPLICANT TEL NO 1LY (626) 443-0281- 1 1 5351 PARMERTON AVE SPECIAL CONDITIONS TEMPLE CITY CA 91780 I CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE ISATURN SYSTEMS INC (310) 329-2728- 115916,5 FIGUEROA LIC NO UNDER SLAB WORK GARDENA, CA 90248 683127 B IWATER CE PLASTIC EY/NMETAL YIN ARCHITECT OR ENGINEER TEL NO I I TROUGH PLUFIB ING 1 LIC NO GAS PIPING (GAS VENT IHOT WATER HEATER I IPLUMEINO FIXTURES 1 I 1LAWN SPAINRLERS 1 1 1 GAS TEST 1 1 (UTILITY COMPANY NOTIFIED( cwv 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 I I I REPORT ID DPR263 ROUTE TO DS0508 I I I ' COUNTY OF LQS 1kNGELES TEMPLE CITY 9 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0607260020 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS TR 13613 LT 62 5351 PAAMERTON AV , FEE DESCRIPTION QUANTITY WM AMOUNT TEMP CA 917803504 ASSESSOR INFORMATIOH NUMBER NEAREST CROSS STREET DAINES 8573-005-023 01 PERMIT ISSUANCE PEE 27 7S THOMAS PAGE 597 GRID C3 LOCALITY TEMPLE CITY C 07 EATHTUBS/SHOWERS 1 00 FIX 16 20 TENANT 25 LAVATORIES/SINKS 1 00 FIX 16 20 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 45 WATER CLOSET/URINAL 1 00 FIX 16 20 07/27/06 SK 01/23/07 51 LOW PER GAS 5 OUTLET 1 00 SYS 16 20 OWNER TEL NO TOTAL FEES 92 55 F NAt� P BY CODE LT DIANA V YIP, PAUL (626) 443-0207- 11yy11�`1` /�jLl 5351 PARHRRTON AV I` TEMP 917803504 DESCRIPTION OF WORK - PLLMBING FOR NEW BATHROOM APPLICANT TEL NO LY (626) 443-0281- 5351 PARMERTON AVE SPECIAL CONDITIONS TEMPLE CITY CA 91780 CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE SATURN SYSTEMS INC (330) 329-2728- 15916 S FIGUEROA LIC NO UNDER SLAB WORK GARDENA, CA 90248 683127 B WATER SERVICE PLASTIC Y/M METAL Y/N ARCHITECT OR ENGINEER TEL NO ROUGH PLUMBING LIC NO 1 GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID DPR263 ROUTE TO BS0508