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Home My Public Portal About9572 PENTLAND ST_Plumbing__ 76 A 667-- CE 817 7-69 I�Ae`e APPLICATION FOR PLUMBING PER T COUNTY OF LOS ANGELES DEPARTMENT' OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING JOHN'A. LAMBIE, COUNTY ENGINEER ADDRESS 9572 PamtQnd St- 0 4f- COLEMAN W'. JENKINS. SUPT. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN PR NT OR TYPE) CROSS T. f NUMBER FIXTURE OR ITEM EACH FEE ' OWNER WATER CLOSET 1.50 MAIL BATH TUB 1.50 ADDRESS ` SHOWER 1.50 CITYTEL. NO. I city LAVATORY 1.50 CONTRACTOR ' SINK 1.50 ADDRESS 2 YY a Main St. DISHWASHER 1.50 CITY TEL.NO. CLOTHES WASHER 1.50 STATE LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR ,1.50 DISTRICT NO. G P' ZONE P BY LAWN SPRINKLER SYSTEM 2.00 WATER HEATER 1.50 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD OUTLETS OVER 30 5 PER SYSTEM FA Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING AddressGAS PIPING GAS VENT City, Tel. No. HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL, COUNTY ORDINANCES 'AND STATE LAWS REGULATING GAS TEST PLUMBING. 1 HEREBY CERTIFY THAT 1 AM.PROPERLY REGISTERED AND/OR UTILITY CO.-NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN.THE ABOVE DEB RIBED RESIDENTIAL PROPERTY. FINAL fni ' SIGNATURE �� 'JACK R. ALLEN, SUPERVISING MECHANICAL EN'G'R. OF PERMITTE moo PERMIT VALIDATION4!5> M.O. CASH. PLAN CHECK VALIDATION CK. M.O. CASH - 4c'--4- AR1G 5 D 350N01 �� DEPARTI mw OF COUNTY ENGINEER pP U�1lA B 1 N G. 1 DIVISION OF BUILDING AND SAFED 7 PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDING WILLIAM .A FOX. COUNTY ENGINE • ,;ADDRESS FOR APPLICAtA TO FILL IN LOCALITY BUILDING NEAREST ADDRESS CROSS ST. r DISTRICT N GROUP I ZONE Mlt No LOCALITY C,. !9 NEAREST CROSS ST. E RECEIVED BY Ready for Inspection DATE ISSUED OWNER Q e� MAIL INDUSTRIAL ADDRESS WASTE APPROVAL CITY E ALE" iLll TEL69 r .NO,/y 1{..`�-72,� IN PECTION RECORD �--®— PLUMBER , ADDRESS �y CITY �LL TEL N0.� 1S >-11.n /l�f LICENSE NO. O STATE UNTY f��// PERMIT FEES / a �UM9ER TYPE OF FIXTURE OR ITEM FEE m ' WATER CLOSET(TOILET) 0 0.80 560 O BATH TUB @ 0.80 0 SHOWER G 0.80 LAVATORY(WASH BASIN) q 0.80 60 KITCHEN SINK @ 0.80 go LAUNDRY TUB OR TRAY 0 0.80 �. SLOP SINK a 0.80 FLOOR SINK a 0.80 FLOOR DRAIN a 0.80 DISHWASHER d0 '0.80 DRINKING FOUNTAIN Of 0.80 ` URINAL z @ 0.80 GAS SYSTEM... ._..._OUTLETS @ 1.00 WATER HEATER @ 1.00 MISCELLANEOUS APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING L Sy Q TOTAL FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THI APPLI- GAS VENT CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST AND STATE OF CALIFO IA OR THAT 1 AM T E LEGAL OWN- ER OF THE ABOVE D r�RII D�RESI NTIA �yROPER s UTILITY CO.NOTIFIED o et 4 SOF PERMITT V�//� " - (G " .._.._.... _.._......_.._..... . ..._......_ FINAL 70AD87 DBS 17 r,L e� WORKERS'COMPENSATION DECLARATION IbA667A APPLICATION FOR. PLUMBING PERMIT I hereby affirm that. I. have a certificate of consent to self insure, or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) or o serified copy thereof(Sec. 3800, Lab. C'.) I COUNTY OF LOS'ANGELES BUILDING AND SAFETY 0liocv Nco:• .- .S=36a_Company3P= A 64 ./ r" Certified copy is hereby furnished. BUILDING C1FOR APPLICANT TO FILL IN(PRINT OR TYPE.) ADDRESS Certified copy is filed with the county buil inspec- tion department. NUMBER FIXTURE OR ITEM Q FEE LOCALITY Date r Appli4ant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM ORKERS' BATH TUB CROS ST. JJ COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by SHOWER the.permit is for one hundred dollars($100)or less.) LAVATORY MAIL ADDRESS i certify that in the performance of the work for which this permit i3 issued, I shall not employ any person in any ner SINK CITY TEL. NO. . so as to become.subject to.the Worker,'Compe s '45f Laws. DISHWASHER CONTRACTOR Y— + Date Y— pplicant. CLOTHES WASHER ADDRESS I NOTICE TO APPLICANT: If, after m..akin is Certificate of SWIMMING POOL RECEPTOR i Exemption, you. should become subject to the Workers' CITY TEL. NO. Compensation provisions of the Labor'Code,-you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. t�. � CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO OCESSED BY I hereby affirm that I am licensed.under provisions of Chapter 9 I.' GAS SYSTEM' OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER >- and Professions Code,and my license is in full force and effect. 5 PER SYSTEM. FINAL 96 VALIDATION I c J DATE �`�' 0 License Nurribe L`ic. Class FINAL09 /J Contractor ate " BY ❑ M9 I am..exempt under See. LM B.&P.C.for this reason I' H Date: Plan check fee ' - ►• m PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE :::a er"` Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION II Name 7 3 1 A I hereby affirm,that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5; Business and o. o. o. o'o.5 Professions Code): City 'Tel. No.. F-1 1, as owner of the property, will do the work and the ° ° 1 6E,l] structure is not intended or offered for sale (Section 7044, Business and Professions Code). I ® .0.a ° 1 6 F CONSTRUCTION LENDING AGENCY I 0 7 16—P 4 I hereby affirm that there is a construction lending agency for •.i the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name Lenders Address. I i 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 I i author' a repres fives .of this County to enter upon the l obov ..ment'i property for inspection purposes.. SEE REVERSE FOR EXPLANATORY LANGUAGE ignatu of Permittee Date I . I I • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0804160002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID I BUILDING ADDRESS: 1 ITR: 19316 LT: 15 1 I 9572 PENTLAND ST I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917803844 I (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: CLOVERLY 1 18590-013-007 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, Cl 107 BATHTUBS/SHOWERS 1.00 FIX 16.20 [ I ITENANT: 25 LAVATORIES/SINKS 1.00 FIX 16.20 11SSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1 145 WATER CLOSET/URINAL 1.00 FIX 16.20 104/16/08 VG 10/13/08 1 TOTAL FEES 76.35 1 I 10WNER: TEL. NO: 1 IFINAL DA E-' ( �'[Q BY: CODE: 1 ILIU LIMKEY;CHU YUN (626) 292-1273- I 1 \VD 1 19572 PENTLAND91780384 ST 1 IDESCRIPTION O\\\IFuWORKI( [TEMP 917803844 1 1PLUMBING FOR BATHROOM REMODEL 1 1 I I (APPLICANT: TEL. NO: 1 I 1 I 1SAME AS OWNER - 1 ISPECIAL CONDITIONS: 1 I I I I 11 1CONTRACTOR: TEL. NO: 1 (APPROVALS DATE ,INSPECTOR SIGNATURE 1 [SAME AS OWNER LIC. NO 1 ICER SLAB WORK I I I 1 i [WATER SERVICE I I I IPLASTIC Y/N METAL Y/N I I I 1ARCHITECT OR ENGINEER: TEL. NO: 1 I I I I _ IROUGH PLUMBING [ I I LIC. NO: 1 I I I I 1 IGAS PIPING 1 [ IGAS VENT 1 I I 1 IHOT WATER HEATER I I I IPLUMBING FIXTURES 1 1 ILAWN SPRINKLERS I I I 1 I IGAS TEST I I I 1 (UTILITY COMPANY NOTIFIED[ 1 I I 1CWv I I I I 1 1 1GRAY WATER SYSTEM 1 I I I I 1 I II I I I 1 1 I 1 I 1 1 I I I I 1 II I I I I 1REPORT ID: DPR263 ROUTE T0: BS0508 I 1 I I I I