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HomeMy Public PortalAbout5503 PARMERTON AVE_Plumbing__ 96A667A10E BI)61 11/96 - APPLICATION FOR PLUMBING PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM ® FEE ADDRESS WATER CLOSET LOCALITY ` lo— T BATHTUB NEAREST CROSSST llj�l�S SHOWER 3 00 OWNERMAIL LAVATORY ADDRESS SINK CITY 'r' C— TEL NO 96 DISHWASHER CONTRACTOR 4 S o/QF/ L�(lt2�p�-r:fY S CLOTHES WASHER _ ADDRESS 170 SWIMMING POOL RECEPTOR �/,/v/ - a CITY ✓/L� �!2 TEL NO 7�'L —1'U V LAWN SPRINKLER SYSTEM STATE ((,�_ //,// LIC WATER HEATER LICENSENO 2J�T V CLASS C—,34( GGAUTSSYSTEM OUTLETS tPLUMBING ISTRICT NO UP ZONE P SSED BY 0 THTSOER T MR USTRIAL o � -/'� Q0 4 TE APPROVAL O INSPECTION RECORD V K 6 Plan check fee PLUMBING PERMIT ISSUING FEE E TOTAL FEEPlan Check applicant NameAPPROVALS DA7E INSPECtOP SSIGNATURE DER$LAB WORK Address GH PLUMBING City Tel No PIPING1 HEREBY ACI(NOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND VENTTHATTHE ABOVE IS CORRECTANO AGREE TOCOMPLY WITH ALL COUNTY ORDINAND STATE LAW$REGULATING PLUMBING WATER HEATER IHEREDY CERTIFY THAI AM PROPERLY REGISTERED AND/OR LICENSMBING FIXTURE$ REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I ATESTLEGAL OWNER OF AND INTEND i0 RESIDE IN THE ABOVE DESCRIBED RESIDEPROPERTY ITY CO NOTIFIED SIGNATUREr/AL F -2 7, Z PLAN CHECK VALIDATI N c 5 9©�IAR JUN PGR911T V_LIL�L/TION c: �,M V CASH POLICY HOLDER,57.+r` K-'Pp POLICY, NUMBER2 yG A0 Z7;- .?;� - ®s WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT 1 hereby affirm that I have a certificate of consent to self In 20- 026 DPW 4/90 sure or a certificate of Workers Compensation Insurance,or a 76A667A , certified copy thereof (Sec 3800 Lab C PoliCompony COUNTY OF LOS ANGELES _ DEPT Of PUBLIC WORKS Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRIM OR TYPE) 5 03 Pay Certified copy n filed with the county budADDRESS inspection ADDRESSSS de rt ' NUMBER FIXTURE OR ITEM @ TEE LOCALITY i Date Applicant WATER CLOSET(TOILET) NEAREST V CRO CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUBS 5T COMPENSATION INSURANCE SHOWER OWNER 0 (This stolon need not be completed If the work Involved by MAI the permit is for one hundred dollars($100)or los) LAVATORY I certify that In the performance of the work for which this per- SINK NO mit is issued I shall not employ any person In any manner so as to bac me subject to the Workers ompensation Lows DISHWASHER _ CONTRALTO � S _ Dateqlz� Applicant CLOTHES WASHER ` ADDRESS '1 P NOTICE TO APPLICANT If after making this Certifi to of Ex SWIMMING POOL RECEPTOR emption you should become subject to the Workers Compen CITU \\ `�fEL NO sonon provisions of the Labor Code you must forthwith comp- LAWN SPRINKLER SYSTEMS v..� ly with such provisions or this permit shall be deemed revok STATE UC 17 ed .. / WATER HEATER 6 LICENSE NO CLASS J LICENSED CONTRACTORS DECLARATION DISTRICT N�O�O (� PROCESSE'- - _D BY ' I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect HOSE BIB DATE License Number Lic Class 0 1 . FINAL 0 Contra Fyfe '� BY ` 0 I am exempt under Sec lV1 uUL B 8P C for this reason Plan check fee W Date PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE �, p SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant- �' i - 42°60 1 hereby affirm that I am exempt from the Contractor's License Name - - Law for the following reason (Section 7031 5 Business and Professwns Code) Address ❑ 1, as owner of the property, will do the work and the City Tel No structure is not intended or offered for sale(Section 7044 - - TuTA(1 ITEM�3.2 i� Business and Professions Code) CONSTRUCTION LENDING AGENCY ����` 4.� 60 I hereby affirm that there is a construction lending agency for , ` Cygy E� the performance of the work for which this permit Is issued rn.A.11.1�-'00015/30"795 !� Q (Sec 3097 Cry C ) _ _ S Lender s Name _ - 0644 1 PM 1:17 Lenders 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 c�Rve-mentioned property for inspection Purp9ses SEE REVERSE FOR EXPLANATORY LANGUAGE ignolure of PermlAee Date WORKERS COMPENSATION c TION fconsent DECLARATION � APPLICATION FOR PLUMBING PERMIT here§y�frnrf that I have o certificate of consent to self in- �76��A� 4/90 ' sure,or a certif cote of Workers Compensation Insurance or a certified copy thereof(Sec 3800, Lab C ) Policy No1020924004company Valley FO�_ COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS Certified copy is hereby furnished ® FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy isfiled with the county building inspection ADDRESS 5503 Parmerton department NUMBER FIXTURE OR ITEM FEE ITV Data 1-1-95 Applicant Owen Bros Plmb I WATER CLOSET(TOILET) Tpmnlp City NEAREST - a CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER [ OWNER L & W Home Center (This section need not be completed if the work involved by J MAIL ' the permit Is for one hundred dollars ($108)or less ) LAVATORY ADDRESS 8812 E Las Tuns Dr I certify that in the performance of the work for which this per SINK - mit is issued I shall not employ any person in any manner so C1TV San Gabriel TEL NO 287-1 131 as to become subject to the Workers Compensotion Lows , DISHWASHER CONTRACTOR Owen Bros 1 Plumbing, Inc Dote Applicont CLOTHES WASHER r ADDRESS 4265 N Baldwin Ave NOTICE , y APPLICANT If after making this Certificate of Ex- SWIMMING POOL RECEPTOR emotion, you should become subject to the Workers Compen-comp- CITY El Monte Ca TEL NO 443-0078 when provisions provisions of the LaM-Code you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revak- STATE LIC ed WATER HEATER LICENSE NO 231-741 CLASS C36-20-16 LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER e and Professions Code and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect HOSE BIB DATE _� y License Number 231-741 Lic Class C36-20-16 FINAL c V Contractor Owen Bros PLMBDote 9-30-95 BY _ Iz Pam exempt under Sec �lC F.t OF B 8P C for this reason 33M72.4SW Plan check fee ► a Oats PLUMBING PERMIT ISSUING FEE$ _ Signature , TOTAL FEE SINGLE FAMILY HOME OWNER BUILDER DECLARATION Plan check applicant _ l�C-+L�� 1 hereby affirm that I am exempt from the Contractor s License NameT9TAIL Law for the following reason (Section 7031 5 Business and Professions Code) Address CHECK 72,il) ❑ 1` as owner of the property, will do the work and the City Tel' No CHMGE structure is nal 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 J 74�Y 1 All j:_j the performance of the work for which this permit is issued r (Sec 3097, Civ C J Lender s Name a Lander s Address T� , 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 lows regulating Plumbing, and hereby - t authorize representatives of this County to anter upon the bove me property purposes ,��,t � /p ii SEE REVERSE FOR EXPLANATORY LANGUAGE gnoture of�rminea to—.�LI COU(TY OF LOS ANGELES TEMPLE CITY 'T# D5D8 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS - PL 0508 9710310011 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA - PHONE (818) 285-0488 EXTLEGAL ID FEES PAID BUILDING ADDRESS . TR 13613 LT 117 5503 PARMERTON AV FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802930 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET 8573-009-002 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE _597 GRID C3 LOCALITY TEMPLE CITY 27 PRESS REG DEVICE(S) 2 00 DEV 32 70 ` TENANT TOTAL FEES 60 45 ISSUED,ON PROCESSED BY PLAN BY EXPIRES ON 10/31/97 UT 10/31/98 MERLO NICHOLAS A,MARY L TRS - r` 5503 PARMERTON AV 1 TEMP 917802930 INSTALL PRESSURE REGULATOR AND PRESS&E RELIEF VALUE ON WATER HEATER APPLICANT TEL NO KEVIN SHAW PLUMBING (626) 359-1864- L CONDITIONS 4 CONTRACTOR NO �&eLES CQ APPROVALS DATE KEVIN SHAW PLUMBING (818) 359-1864- 129 E COLORADO BL STE 114 LIC NO MONROVIA, CA 91016 414122/C36 WATER SERVICE OPLASTIC Y/N METAL Y/N ARCHITECT OR ENGINthX TEL NO ROUGH 15LUMBING LIC NO Mill GAS VEF � h PUBLIC WORKS R6T-"rffvTvayq- PLUMBING co LAWN SPRINKLERS •O o 00 rvice _ REPORT ID DPR263 ROUTE TO RS0508 - 1 _ r