HomeMy Public PortalAbout5444 PARMERTON AVE_Plumbing__ ^SASS] CE#BIT z 52 TEMPLE G� -l`(
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADDRESS 54" parmerton
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUPT OF BUILDING LOCJLL17Y Temple City
FOR APPLICANT i0 FILL IN CROBY Daines & El Monte
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET SI 25 C. Hertel
MAR
BATH TUB 1 25 ADDRESS Same
SHOWER 1 25 CITY Same TEL No C-1 k 9612
LAVATORY 125 CONTRACTOR Pac1£1c Installers
9INR 125 ADDRESS 10920 E. Grand
DISHWASHER 125 CITY Ten le City TEL NO 443 6905 �7
LAUNDRY TUB 125 REGISTRACONTRACTORS STATE
TION NO 211898 COUNTY ❑
CLOTHES WASHER 1Z5 DISTRICT NO GROUP ZONE PROCESSED BY
WATER FEATEBR laceme tsO _0 0 4-1 e-S-6vLoi<-
CAS SYSTEM OUTLETS 150 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM SO INSPECTION RECORD / d
0
1-
W
I 6
N
I Z
f
APPROVALS D TE INSPECTOR B SIGNATURE
PERMIT S 2 OG UNDER SLAB WORK r�
ROUGH PLUMBING I
TOTAL FEE 3150 \ `
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIDH
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE uwp REGULATING HOT WATER HEATER /
PLUMBING
31
1 NER®Y CERTIFY THAT I AM PROPERLY REGISTERED AMIDIOR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AN THE LEGAL OWNER OF AND INTEND TO
RSSIOE IN THE ABOVE DESCRIBED RE51DENTIAL P OPERTY UTILITY CO NOTIFIED /
SIGNATURE ./
OF PERMITTEE - FINAL ( �/�
ALIDATION ROBERT A WOOD
D CASH SUPERVISING MECHANICAL ENG R
a
1)li o 2 1..9 3� HAR 18 5 8 3,5 0-
7CA667 -C E051 "4
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING Sjf/i/ 7 'w
JOHN A LAM IE COUNTY ENGINEER ADDBL48 77
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILLW NEARCROSEST
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET 3125 MAIL
BATH TUB 125 ADDRESS 7
SHOWER 125 CI TEL NO
LAVATORY I is CONTRACTO
SM[ I t5 2 ADDESS
DISHWASHER 125 CITY TEL NOW
LAUNDRY TUB 115 CONTRACTOR 6 ATE
REGISTRATION NO 3SDq COUNTY
CLOTHES WASHER 125 DISTRICT NO I GROUP ONE I PXIDCEBBEO BY
RI
WATER HEATER 1 50 .,7 rO L
GAS SYSTEM OUTLETS 1 5D INDUSTRULL WASTE APPROVAL 0
OUTLETS OVER S PER SYSTEM 00 INSPECTION RECORD U
K
OG
6 _Z
--
APPROVALS DATE INSPECTOR a SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE S GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE HEAD THIS APPLICATION GAS VENT
AHD STATE THAT THE ABOVE Ie CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAW¢ REGULATING HOT WATER HEATER
Ptu MCING
HERESY PIEDCERTIFY THAT I AH PgortgLv gmlrt AND
AHD/GR PLUMBING FIXTURES
LICEH¢EO AS RW UIREO BY LOS AN6HLE9 COUNTY ANO BTATC OP GAB TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO
RHsm¢ IN THE ABOVE EDRmm RESIDENTIAL P PERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTE FINAL
/��iI1DATlON ROBERT A WOOD Q
cKK// M o CASH SUPERVISING MECHANICAL ENG R
LACO4 9 7 7—� OCT 16 5 D 5.75-
70A667 CER017 10-60
APPLICATION FO PLUMBIN PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BunalNc
BUILDING AND SAFETY DIVISION xDaaFsS ParmertQn
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY T le
FOR APPLICANT TO FILL IN NEARECROSST
3T
NUMBER FIXTURE OR ITEM EACH FEE
OWNER '
c, Hertpi
WATER CLOSET $125 MAIL
BATH TUB 125 Z ADDRESS SaMe ]Gi6
SHOWER CITY TEL puLAVATORY I25 CONTRACTORSINS 125 ADDRESS 0 E' GanaLaHwxsxER 1u crrY T TEL' ATE
MUNDHY TUB 1 7S REOL4THATION NO 2118 8s ATE
CONTRACTOR S
CLOTHES WASHER 1'25 DISTRI DNQ-I/- pRptlit_ 'Z NE P CE86EO BY
WATER HEATER 150
150 INDUSTRIAL y
CAS SYSTEM OUTLETS WASTE APPROVAL
11
GUTLESS OVER 5 PER SYSTEM 00 INSPECTION RECORD" U
0
' � G
replacement
W
6
Z
APPROVALS DATE INEPECTOM,S SIGNATURE
PERMIT E T OD UNDER SLAB WORK \,
ROUGH PLUMBING l
TOTAL FEE GAS PIPING / 1
1 HEREBY•ACKNOWLEDGE THAT I NAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE MOVE IS CORRECT AND AGRRE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REG.LAT'NO
PLUMBING HOT WATER'HEATER 1
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES �� 4
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST ,(
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESC BED RESIDE L P PES
UTILITY CO NOTIFIED Ir�
SIGNATURE / If
OF PERMITTEE nAj/3
FINAL
CAU
DATION ROBERT A�WOOD
, _ M o CASH SUPERVISING MECHANICAL ENG R
Lli�o1 0,3 4G OCT 4 5 U' 5.75^' Q "
D EMENT OF BUILDING AND SAFETY I APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES PLUMBING
WM J FOX CHIEF ENGINEER
fOCA
TURE OF INSTALLATIO D STR_lCT_N o i
FIXTURES COMPLETE ✓ vc,u
ClSSPOOL SEPTIC TANK READY FORRECE m Y FIRST INSPECTIONTE1 U®APPLICANT FILL IN HEAVILY O D PORTION ONLY
ADDRESSS � LOCALITY _ .i n NEARBBT
1 TEL No. CROSS STCOUNTY
k R ti EMPIRES f y11. NAME OF SEPTIC TANK, OR L 3 ADDRESS 7 ,
NORTH O
„ CITY TEL NO
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANO ELES COUNTY CEITIFICATE OF QUALIFICATION
1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVL
OWN"
CORRECTIONS
f "
SOUTH
J
DESCRIPTION OF WORK Z
[TOTALTFEE
TH TUB FURNACE 0
r �
tOWER DISHWASHER - O
VATORY REFRIGERATOR
TCHEN BINK WATER SOFTENER
OOR BINK SANDTRAP
POP SINK —FLOOR DRAIN
IASH TRAY URINAL ` APPROVALS
ATIER CLOSET DRINKING FOUNTAIN TS INSPECTOR•HANK
ATER HEATER DENTAL LAVATORY
ROUGH PLUMBING
TSR�GAB _ -----SODA FOUNTAIN OAS PIPING
OUTL
GAB VENT
CESSPOOL
TAL NUMBER OF FIXTURES SEPTIC TANK I
SSPOOL—JaEPTIC TANK SEWER
UTILITY CO NOTIFIED
FINAL
iW'&KERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT
` I hereby,affirm that have a certificate of consent r self CE 81 7( IL�
insure or a certificate of Workers Campenswon Insurance CE 817 (REV 8/88) U
or a certified copy thereof(Sec'3800 Lob C )
Poll No company £ �a1ND COUNTY OF LOS ANGELES DEPT; OF,PUBLIC'WORKS
Certified copy is hereby furnished
❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING) 541 p/7 7-0 , t
Certified copy is filed with the county b mg mapec ADDRESS /9S
hon department , NUMBER FIXTURE OR ITEM ® FEE -T
Date cZ'3 Apphto WATER CLOSET NOCAlS7V /!/MSI �'
CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST
COMPENSATION INSURANCE a OWNER L SU
(This section nand not be ccsf tpleted If the work Involved by SHOWER
the permit is for one hundred dollars($100)or less j LAVATORY MAIL -
I certify that in the performance of the work for which this ADDRESS
permit is Issued, I shall not employ any person in any manner SINK rye TV8 CITY r TEL NO
so as to become subject to the Workers Compensation Laws DISHWASHER
coN aAc o. pbAN IE L SEWER 6 A1,
Date aCLOTHES WASHER ADDRESS
NOTICE TO APPLICANTT If If after making this Certificate of
Exemption you should become subject to the Workers SWIMMING POOL RECEPTOR -
Compensation provisions of the Labor Code you must forth i LAWN SPRINKLER SYSTEM CITY )JAC TEL NO (� 209
with comply with such provisions or this permit shall be STATE //�T LIC
deemed revoked WATER HEATER UCENSE NO 7 /Q 7 S CLASS :.3 I(o
LICENSED CONTRACTORS DECLARATIONOUDISTRIC� SSE
1 hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM TLETS
(commencing with Section 7000) of Division 3 of the Business OUTLETS OVER
and Professions Code and my license is in full force and effect 5 PER SYSTEM
DATE -� V ATION v
License Number- Lf7 10 7-5be Class C 3
FIN
Contract1st' WS-t`4 Dote -23 -87 l 0
BY C1
❑ '
1 am exempt under Sec Wd
y
8 6P C for tFin reason
Dote Plan check fee polo 279a7A 2
PLUMBING PERMIT ISSUING FEE$ s is s e s 5
Signature -
' - TOTAL FEE
Pion check applicant I'e e 4Q5,0
SINGLE FAMILY ei e e 4 Q 5 0 6
HOME OWNER-BUILDER DECLARATION Name - • _
I hereby affirm that I am exempt from the Contractor's License Address O 9 23-87
Low for the following recson.(Section 7031 5' Business and
Professions Code) Coy Tel No
❑ I as owner of the property, will do the work and the
structure is not intended or offered for sale (Section ►
7044 Business and Professions Code) '
CONSTRUCTION LENDING AGENCY -
1 hereby affirm that there is a construction lending agency for '
the performance of the work for which,this permit is issued
(Sec 3097 Gv C )
Lender's Name
Lender's Address ^ '
I certify that I have read this application and stole that the ►
above information Is correct I agree to comply with all County
ordinances and Wallows regulating Plumbing and hereby
e reres tot as of this County to enter upon the
above- nti
ned p rty for inspection purposes
SEE REVERSE FOR EXPLANATORY LANGUAGE
nature O e minae Date -
COUNTY OF LOS ANGELES TEMPLE CITY # 0508PLLMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9808040024
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE (818) 285-0488 EXTLEGAL ID FEES PAID BUILDING DDRES
-
TR 13613 LT 74 15444 PARMERTON_AV= -
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP-CA 917803505
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET -
8573-007-002 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID C3 LOCALITY TEMPLE CITY
13 DISHWASHER(S) 1 00 FIX 16 35
TENANT TOTAL FEES 44 10
ISSUED ON PROCESSED BY PLAN BY EVFflFE9-5W--
08/04/98 UT 08/04/99
OWNER TEL NO FINAL DATE FINAL BY CODE
LYSAK BOHDAN,LYDIA TRS LYSAK TRUST
5444 PARMERTON AV .c-
TEMP 917803505 - - -"
C CHANGE OUT_OF_DI HWASH -.
APPLICANT TEL NO
D AND H SERVICE (818) 343-4009-
6029 1/2 RESEDA BL SPECIAL CONDITIONS
TARZANA, CA
S Ph1GELES CCONTRACTOR TEL NOAPPROVALS DATE INSPECTOR SIGNATURE
OV
D AND H SERVICE (818) 343-4009-
6029 1/2 RESEDA BLVD LIC NO LINDER SLAB WORK
TARZANA CA 91356 704779 C36
/ WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER TEL NO
ROUGH PLUMBING
LIC NO 1111111 GAS PIPING
GAS VrNT
U'U LOCA WA Uo K8
n-UgTR FIXTURES
d 8
D 0
A, _ GAS TEST
A 0 A g
rc ServOe 7ha¢��` CWV
GRAY WATER SYSTEM
REPORT ID DPR263 ROUTE TO 850508