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Home My Public Portal About4932 PERSIMMON AVE_Plumbing__ 76A667 03517 7-51 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF.LOS ANGELES - WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICT GR UP ZO PERMIT LADDERESS BER ► • A /®.r/! RECEIVED BY READY FOR DATE •IBBUED FIRST INSPECTION p ( C !as /• /l Kf�`.�! a-�I/1L-� / O CITY TEL No. ADDRESS �2- 1?Q�_/%1 -'SA&A ate- � `,� COUNTY LOCALITY i� .l�iX�I A..• �o e� BOUNTY NO. EXPIRES , . . . r NEAREST � PERMIT FEES cRDeB Br. f� �cFJ f� NUMBER TYPE OF FIXTURE OR ITEM FEE 13WNER •�j MAIL WATER CLOSET(TOILET) 0 0.50 IB 1 ADDRESS BATH TUB 0 0.50 CITY TEL. No. SHOWER 0 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR IAM THE LEGAL OWNER OF THE RESIDENTIALz PRO ERTY DESCRIBED ABOVE. GAS SYSTEM OUTLETS 0 0.50 SIGNATURE OF WATER HEATER (97 0.5D PERMITTER —�!!'7/L I�►�C_./^� £w SLOP SINK 0.50 INSPECTION RECORD :�" FLOOR SINK 0.50 FLOOR DRAIN Q 0.50 DISHWASHER WSO DRINKING FOUNTAIN 0.50 URINAL J I HOUSE SEWER ® 0.50 _Z MISCELLANEOUS Is O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAB PIPING GAS VENT 1 CESSPOOL @ 1,430 CESSPOOL i SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) 1.00 SEWER PERMIT . . . . . . GAS TEST UTILITY CO.NOTIFIED TOTAL FEE 77 P, 70 FINAL zees 27 5-50 i® APPLICATION FOR PERMIT <. DEPARTMENT OF BUILDING AND•SAFETY COUNTY OF LOS ANGELES PLUMBING 1 WILLIAM J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL.IN DISTRICT'NO. GROUP I ZONE PERMIT NO: C � PLUMBER+/v P�f�O�� P/L(�//Yf Q%�Q/Vj f /1/�/�� RECEIVED BY READY FOR DATE ISSUED ADDRESSrs/DD�+jy /✓ �/Gl//l+ij ./J/4 F �� FIRST INSPECTION CITY .4// " 041r ' TEL/. NO. 4� � ADDRESSCOUNTY LICENSE NO:;.fl r EXPIRES LOCALITY �'+.�6/� �j NEAREST PERMIT FEES CROSSSX, NUMBER TYPE OF FIXTURE OR'ITEM FEE OWNE „ester sfi/u ✓ �� ) MAIL WATER CLOSET (TOILET) @ O.SO IS 70 IfB ADDRESS d e 00,BATH TUB 0 0.50 CIT lg-� TEL. NO-4:K ,r SHOWER @ 0.501 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) @ 0.50 -f-0 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND f KITCHEN SINK @ 0.50 ''Q STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT I POSSE387THE ABOVE VALID LOS r LAUNDRY TUB OR TRAY @ 0.50 jJ ANGELES COUNTY VC fC I AM THE LEGAL OWNER OF THE REST T _RO RTY DESCRIBED ABO7E. GAS SYSTEM OUTLETS @ 0.50 ro dL`�, SIGNATURE OF ' WATER HEATER @ 0.5.0 �J PERMITT SLOP SINK @ 0.50 .� INSPECTION RECORD FLOOR SINK @ 0.30 FLOOR DRAIN @ 0.50 DISHWASHER @ 0.501 DRINKING FOUNTAIN 0.50 URINAL @ 0.50 .HOUSESEWER @ 0.50 Z MISCELLANEOUS L7 (r 0 T6 G ero 44� e-4c APPROVALS DATE INSPECTOR'S NAME UGH PLUMBING GAS PIPING GAS VENT CESSPOOL @ I.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT . 1.00 GAS TEST TOTAL FEE UTILITY CO. NOTIFIED $ FINAL WORKERS'COMPENSATION DECLARATION 20-0026 DFW 4/90 APPLICATION FOR PLUMBING PERMIT I ht:Fek)y, a#Ir n that I have a certificate V consent to self in- 76A667A sure,ora tertificate of Workers'Compensation Insurance,ora certified.copy thereof(Sec. 3800, Lab. C.) 1 Policy No.:-Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS' Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM ADDRESS '-Z �(Pi Ko department. FEE LOCALITY WATER CLOSET(TOILET) Ddte Applicant CNEAR ROSSEST ST. CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE I SHOWER OWNER (This section need not be completed if the work.involved by MAIL the permit Is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK CITY, TEL.NO. mit is issued, I shall not employ any person in any manner.so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date. Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen.- CITY TEL. NO. sation provisions of the Labor Code,you.must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall.be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO: CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO: PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL tett. VALIDATION HOSE BIB DATE' License Number Lic. Class IL i, FINAL A- (T.s V CI . ontractor Date I BY 3303 0 I am exempt under Sec. / t., B.sP.C. for this reason Plan check fee pop. TOTAL ' TEMS �- H Date: PLUMBING PERMIT ISSUING FEE$ �l CHECK 74.10 z Signature I TOTAL FEE CHANGE �� SINGLE FAMILY HOME OWNER-BUILDER DECLARATION. Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name ��_� /7 Low for the following reason (Section 7031.5, Business and ! 6/95 Prof sions Code): Address 1044 1 PM 4:51 hOJ I as owner of the property, will do the work and the j 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.). • I Lender's Name Lender's 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 au tho'ze re resentatives of this County to enter upon the ab ov nt ned. roperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date i WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I WeBy, a#iVn that I have a certificate bf consent to self in- �b�jA�+V 4/90 sure,or a Certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) Policy No. Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS' ❑ Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) 111 ADDRESS �jrZ e-, P't {}'(.1� Certified copy is filed with the county building inspection department. NUMBER FIXTURE OR ITEM @FEE LOCALITY Ddte Applicant WATER CLOSET(TOILET) , NEAREST �� CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. tiQ COMPENSATION INSURANCE SHOWER OWNER J c ea if (This section need not be completed if the work involved by MAIL the permit Is for one hundred dollars($100)or less.) LAVATORY ADDRESS Gj I certify that in the performance of the work for which this per- SINK CITY TEL. NO. mit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER N IN LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION GAS SYSTEM OUTLETS DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter �� 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER 6 and Professions Code, and m license is in full force and ef- 5 PER SYSTEM FINAL y / VALIDATION fect. HOSE BIB DATE �Z` ei License Number Lic. Class CL FINAL ACCT. O Contractor Date BY 331074.113 { i 8 F1 I am exempt under Sec. .! E)EI'Itir V W B.&P.C. for this reason Plan check feepop. TO S AL 7411 m 1 (7)N Date: PLUMBING PERMIT ISSUING FEE$ CHECK 7`)n�i{3 F' Signature TOTAL FEE 0 C1'ANGE � SINGLE FAMILY " HOME OWNER-BUILDER DECLARATION• Plan check applicant I hereby affirm that I am exempt from the Contractor's License Name 010-100-000 6/26/95 Law for the following reason (Section 7031.5, Business and �, Prof sions Code): Address x044 1 P14 4.- 4L hFJ ' as owner of the property, will do the work and the City Tel. No. structure is not intended or offered for sale(Section 7044, i 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 Lender's Address I certify that I have read this appJication and state that the above information is correct.I agree to comply with all County , ordinances and State laws regulating Plumbing, and hereby author of this County to enter upon the above for inspection purposes. � —'7 cq—o`� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date COUNTY OF LOS ANGELS TEMPLE CITY 9 0508 PLUMBINi ..•'Eir:t.,Y DEPARTMENT OF PUBLIC W,,RKS 9701 LAS TUNAS PL 0508 0%'0360011 BUILDING AND SAFETY / LAND DcVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-04,13.. FMZ 1AlD cMuING ADDRESS: - TR: 4902 LT: 5 BL: .001 FEE DESCRIFTIO4032 PERSIMMON AV td: QLIi•n1_'Y; U,74: AMOUNT: T',•MP CF 917804114 ASSESSOR. INFGRMA ION NUMBER: -r NEAREST CROSS STREET: GRAND 8574-024-008 01 PERMIT ISSUANCE FEE 27.75 TdOMIAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TENANT: TOTAL FEES 43.95 ISSUEi� iltl: PROCESSED BY: LAt! BY: EXPIRES ON: 10/U6/04 JK 04/04/05 OWNER: Ft.- NO: FINAL v.w FINA CODE: - CLARK;RUGSELL (62i) 401-0603- r 4932 P: .�IMMGN .:V TEMP 917804114 IF IG' LINT.: OR THE OADDITION I APPLICAtd1: TEL. SAME rS5I� IECIAL CONDITIONS:- i I CONTRA`GR —`- - ""-TEL. NO: AP?rt7VP.�5 DAT? INSPECTOR SIGMA UR[ —j SAME AS OWNER - LIC. NO UNDER SLAB WORK 01-TER S,RVICE cL. y0: ' (PLASTIC Y/N METAL Y/N ARCHa i u�i2 cn%EtP.: i LTC. N0: {,1'0 G LUMBING (CATS PIc1G --- — `� --- - ------ �, ,,_NT ----- I--- - -- i IH40,MT-RNEA ER FL M BI G FInTU12ES — UAR-S—Pt INNRURS —i 1urtS 7ESi a �U?TITY COMPANY NOT I FIE —t CL-JV —II f>li�WY—J11 EY, SYSTEM REPORT ID: DPR263 ROUTE TO: SS0508 I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0405200024 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: E ID: FEES PAID BUILDI G ADDRESS: TR: 4902 LT: 5 BL: .001 4932 PERSIMMON AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917804114 ASSESSOR FORMATIO NUMBER: NEAREST CROSS STREET: GRAND 8574-024-008 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 3.00 FIX 48.60 TENANT: 21 HOSE BIBB(S) 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLA BY: TrE 25 LAVATORIES/SINKS 4.00 FIX 64.80 05/20/04 VG 11/16/04 . 45 WATER CLOSET/URINAL 2.00 FIX 32.40 OWNER: TEL. NO: 47 WATER HEATER(S) 1.00 WTH 16.20 ODIXCRrPTION T FINAL CODE: CLARK;RUSSELL (626) 401-0603- 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 4932 PERSIMMON AV TOTAL FEES 222.15 TEMP 917804114 0 O K ING FOR ADDITION APPLICANT: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIi.NATURE SAME AS OWNER - LIC. NO UNDER SLAB WOR WATER SERVICE RRCHITECT OR ENGINEER: TEL. 0: PLASTIC Y/N METAL Y/N LIC. NO: ROUGH PLUMBING GAS PIPING V6 GAS VENT HbT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV o GRAY-WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY 9 0508 PLUMBiNG PERMIT ' DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0405200024 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 DUPLICATE PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 4902 LT: 5 BL: .001 4932 PERSIMMON AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917804114 ASSESSOR INFORMATION UMBER: NEAREST CROSS STREET: GRAND 8574-024-008 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 3.00 FIX 48.60 TENANT: 21 HOSE BIBB(S) 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLAN B -EXPIRES ON: 25 LAVATORIES/SINKS 4.00 FIX 64.80 05/20/04 VG 11/16/04 45 WATER CLOSET/URINAL 2.00 FIX 32.40 _ OWNER: TEL. N0: 47 WATER HEATER(S) 1.00 WTH 16.20 FINAL D FINAL BY: CODE: CLARK;RUSSELL (626) 401-0603- 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 � 4932 PERSIMMON AV TOTAL FEES 222.15 11W TEMP 917804114 DES I 5N OF WOR P 18ING FOR ADDITION APPLICA T: TEL. NO: SAME AS OWNER - SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO UNDER SLAB WORK WATER SERVICE ,ARCHITECT OR ENGINEER: TEL.-N0: PLASTIC Y/N METAL Y/N LIC. N0: ROUGH PLUMBING GAS PIPING ! I I _., GAS VENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS 10&r GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508