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Home My Public Portal About5414 PARMERTON AVE_Plumbing__ 76A667-CER17 12159 �EMPLE. CITY APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT]�1fa..TOyTFyCCOUNTY ENGINEER L' ,/ $J IAGBUILDING LAMtlIt (: NTY TY N`GNEOER� DREGS '7�'`( PAiRmapToK Avc, WILLIAM A JENSEN SUPT OF BUILDING LOCALITY FOR APPLICANT TO FITS IN cRossNPA Ir ArMr, R NUMBER FIXTURE OR ITEM OWNER 'LQA N n O F r WATER CLOSET ,A/ ADDS 3 ! O /t v E BATH TUB CITY--+ TEL NO SHOWER NMPLG`- 7 CONTRACTOR LAVATORY Sm ADDRESS DISHWASHER CITY TEL NO CONTRACTORS A ❑ LAUNDRY TUB REGISTRATION N COUNTY El CLOTHES WASHER DISTRICT NO GROUP ZONE PqQCESSED BY WATER HEATER GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD r, 0 O U 00 O ' W a. Ny F $1 DOPER ITEM / OR FDCIURE S APPROVALS DATE INSPECTOR S SIGNATURE PERMIT f 2 00 UNDER SLAB WORK TOTAL FEE ROUGH PLUMBING GAS PIPING ac 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING HOT WATER HEATER IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES 1'1� LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENT PROPER UTILITY CO NOTIFIED SIGNATURE OF PERMITTEE FINAL (yIt A ®r VAI.IDATION—"OBERT A WOOD CK Y 0 (= UPERVISING MECHANICAL ENG R Uf,04 7 8 6 Itu'G 5 D 300 WORKERS COMPENSATION DECLARATION 010M 7MM7DPW slag APPLICATION FOR PLUMBING PERMIT tJ � I hereby affirm that I have a cartllicate of consent to self Insure or a certificate of Worker a Compensation Insurance or a certified copy thereof(Sec 3800 Lab C) ,I ' COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS DEPT OF PUBLIC WORKS DIV Policy No Company ❑ Certified copy is hereby Iumished FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS 54J a.i ILDING ❑ e copy is filed with the county buildinginspector,inspector,department NUMBER FIXTURE OR REM ® FEE LOCALITY Dale Applicant WATER CLOSET _ NEAREST CERTIPICATE OF EXEMPTION FROM WORKERS - BATH TUB CROSS ST COMPENSATION INSURANCEASSESSOR e I MAP BOOK PAGE PARCEL (Thin section need not be completed d the work Involved by the SHOWER _ .L permit is for one hundred dollars($100)or lens) . LAVATORY OWNER (• iF I certify that In the performance of the work for which his permit is Issued' I shall not employ any person it any manner so as toSINK MAIL become subject to the Workers Compensation Laws ADDRESS DISWASHER - CITYV e - L HO Dela Applicant - CLOTHES WASHER CONTRACTOR 44 31 NOTICE TO APPLICANT It alter making this Certificate o/ � ' Exemption you should become subject to the Workers Compensation SWIMMING POOL RECEPTOR ADDRESS provisions of the Labor Code you must forthwith comply with such provisions or this permit shall be deemed revoked LAWN SPRINKLER SYSTEM ' LICENSED CONTRACTORS DECLARATION CITY TEL NO 1' I hereby enirm that I em licensed under provisions of Chapter 9 WATER HEATER - d (commencing with Section 7000)of Division 3 of the Business and STATE LIC Q Professions Code and my license is In full force and effect GAS SYSTEM 1 OUTLETS LICENSE NO CLASS Q OUTLETS OVER DISTRICT NO V Q 5 PER SYSTEM O Q Q License Number 4c Clens Cl U FINAL VALIDATION W DATEd b Contractor Date ' _ I C/)❑ I em exempt under Sac FINAL I ;/e AL / ? B&P C for this reason Date Plan check fee ; Signature PLUMBING PERMIT ISSUING FEE$ (� ❑ t TOTAL FEE S Plan check applicant l SINGLE FAMILY HOME OWNER BUILDER DECLARATION Name - t -' IAi-1-Tri I hereby affirm that I em exempt from the Contractors License Law c 7713for the following reason (Section 7031 5 Business and Professions Address — Code) ® City Tel Na -[ I as owner Of the property will do the work and the structure fI ITAL 4 .1i. _ 18c i9 not intended Or Offered for eel0 (Section 7044 BO910e99 � u� V r and Professions Code) / 1 , '.(HECK 41 nr i I � . CONSTRUCTION LENDING AGENCY CHANGE .fh, I hereby affirm that there Is a construction lending agency for the performance of the work,tor which this permit is issued (Sec 3097 Cly c> P0013-fjeU 1 11' C =4 Lender s Name r 7 ,52 1 i AN 11:it, Lander s Address I I certify that I have read this application and slate that the above Information Is correct I agree to comply with all County ordinances and State Hews regulating Plumbing and hereby authorize repro tatives of this County to enter upon the above mentioned prop y r maps on ur ses SEE REVERSE FOR E%PLANATORY LANGUAGE Signature of Pern ee Date r COUNTY OF LOS ANGELES TEMPLE CI T1 # CSOII -L0508 PERMIT D6 ANDMINT OF PUBLIC DEVFI 9701 IAS TY CA °L 0508 0409240002 BUII �'Vf, AND SAFETY / LAND DCVFI O''NFN' TEMPI F r-TY CA 91780 PIIG -- -'2") 2II5-0488 EXT LEGAL ID FEES PAID A6oR TR 13613 LT 79 5414 DARMERTON AV FEE DESCRIPTION QUANTITY UOM A'OUNT TEMP CA 917303505 5ESSCR I?POR-yYTffQ-ffj,aP NEAREST CROSS STREET DAINES 8573-007-007 01 PERMIT ISSUANCE FEC 27 75 THOMAS PAGF 597 GRID C3 LOCALTTY TEMPLE CITY, C 47 WATER HEATER(S) 1 00 NTH 16 20 MART—— - TOTAL FEES 43 95 ISSUED ON PPOCE.. EX-IPES ON 09/24/04 JK 03/23/05 FINAL BY CUDE GONZALES, LISA (626) 2f9 61�/- 5414 PARMERTON TEMP 917803505P W� R rLOCATE NATFP HEATER F36LTr.AFT —'" TEL r SAME AS OWNER - _ SPECIAL CONfi:TTbNe OC YYfFT.6-YEA- IT APPROVALS DATE INSFECTOP St GPATUR SAME AS -V'EP LIC NO UN6EvCA&-17T A S ,C IFLASTIC Y N MEi;L _G du TOT-GATn HEATER � B�C()�AO F-T7 'J?€S 'LXX0. JYRl1Y 1,LF� UNLIT) 040Ayl-G4MCV R-9 , REPORT ID DPRe63 ROUTE TO DS0506 i j� ` • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS P7 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUlJ9jUG.-ADDRESS---3 TR 13613 LT 79 ERT V FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP LA $0 0 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET 8573-007-007 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID C3 LOCALITY TEMPLE CITY 63 WATER PIPING BR/FIX 6 00 FIX 40 50 TENANT 64 WATER PIPNG <= 1 1/2 1 00 LIN 16 20 TOTAL FEES 84 45 07/26/99 UT 01/22/0 MOFFAT DANA SR CO TR MOFFAT TRUST (818) 444-0139- T Q q 5414 PARMERTON AV 7- 28 TEMP 917803505 AND 6 FIXTURES APPLICANT TEL NO RAFI COHEN 81800545-3 5080 GAVIOTA AVE SPECIAL CONDITIONS ENCINO, CA PNGELES O CONTRACTOR5 RAFI COHEN (818) 995-4503- P S INSPECTOR G 5080 GAVIOTA LIC NO UNDER SLAB WORK - ENCINO, 91436 630143 C36 WATER SERVICE IIII/ PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: ROUGH PLUMBING LIC NO GAS PIPING /(i 1171711 B'U'LB" L 0 W0luRUQs RiTrWMMATER a GAS TEST T� SUTILITY COMPANY NOT17M ery ce That J` � LWV REPORT ID DPR263 ROUTE TO BS05O8