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Home My Public Portal About5410 PERSIMMON AVE_Plumbing__ " r: COUNTY OF LOS ANGELES ;; APPLICATION FOR PERMIT Department of County EngineerPLUMBING DIVISION OF BUILDING & SAFETY .I WILLIAM J. FOX, County Engineer .R FOR APPLICANT TO FILL IN i DISTRICT Na. G OUPN .7 IA-(ZEIPERMIT NU- ;q-co_ivP PLUMBER 2 RECEIVED BY READY FOR DATE ISSUED ADDRESS i N 4/_S FIRST INSPECTICI d?rBU71 ILDING C CITY 7.c TEL No. s� ADDRESS /I f17 11.01 1�9 110f COUNTY LOCALITY LICENSE NO. EXPIRES I NEAREST PERMIT FEES CROs9 9T. t NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER MAIL WATER CLOSET(TOILET) Q 0.50 M ADDRESS ✓ O BATHTUB 49 0.50• i CITY TEL: No. SHOWER 0 0.50 , 1 HEREBY ACKNOWLEDGE, THAT 1 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 REGULAT G PLUMBING. 1 CERTIFY THAT I POS B THE ABOVE VALID LOB LAUNDRY TUB OR TRAY @ 13.SO i' ANGELES COUNTY LICE'S I AM THE LEGAL OWNER OF THE RESIDENTIAL PR TY DESCRI OV GAS SYSTEM OUTLETS 00 0.50 ,. SIGNATURE OF WATER HEATER @ 0.50 I PERM ITT E SLOP SINK O.sO INSPECTION RE FLOOR SINK @ 0.50 J'7/11,100 f) � /A.10 � Q SIs J' FLOOR DRAIN 00 0.50 tI 7 J•� a DISHWASHER @ 0.50 ll DRINKING FOUNTAIN" 0 0.50 F URINAL 0.50 iS HOUSE SEWER 0.50 _Z MISCELLANEOUS d 13 APPROVALS DATE INSPECTOR'S NAME •i ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL CESSPOOL SEPTIC TANK, SEPTIC TANK DRAIN ( ) PIT ( ) Q)? 1.00 SEWER PERMIT 1.013 I GAS TEST / ./ .,(' oK'J/Y•�'%�� O _7 '0 ®". UTILITY CO.NOTIFIED r TTAL FEE N �� FINAL 761667 DBS#17 10/58 c j• "� F DEURTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES WM.J. FOX.CHIEF ENGINEER . PLUMBING NATURE OF INSTALLATION DISTRICT NO. GROUP NE-- PERMIT NO. ROUGH FIXTURES COMPLETE RECEIVEq BY READY FOR DATE ISSUED HEATER CESSPOOL --I SEPTIC TANK JJ� FIRST INSPECTION GAS- MISCELLA EOI/ '' .� /— APPLICANT —APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY Joe K NAME ADDRESS ADDRESS.a4 ! rcd/rte (�_�. LOCALITY 3, �I NEAREST L CITY ��+a kSx �'r•+� `<� TEL.NORM^y s , CROBS ST. COUNTY v %F df fJ CERT.No. EXPIRES4C� LOCATION OF SEPTIC TANK, OR OESSPOOLiWZ MAIL ,J NORTH i C ADDRESS 1, �f{ CITY a TEC••No. I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE ,OF QUALIFICATION. PLUNDER, I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. � r ._ OWNER CORRECTIONS SOUTH DESCRIPTION OF WORK z ATH TUB FURNACE E aHOWER DISHWASHER p ® LAVATORY REFRIGERATOR -KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP I LOP SINK FLOOR DRAIN f WASH TRAY URINAL APPROVALS Z WATER CLOSET DRINKING FOUNTAIN D INSPRCTOR'S NAME WATER HEATER DENTALLAVATORY ROUGH PLUMBING METER SAB pODA FOUNTAIN I I I OUTL GAS PIPING I'GAS VENT 1 I I iCEBSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK I I CESSPOOI SEPTIC TANK '100' ! SEWER ( I s $ 1 UTILITY CO.NOTIFIED TOTAL FEE 4m� FINAL 7SAYSR-.�',rE 817 7-59 1•' APPLICATION FOR PLUMBING ERMIT . , COUNTYOF LOS ANGELES DEPARTUMT•OF COUNTY ENGINEER sti Iss BUILDING AND SAFETY DIVISION JOHN A. LAMBIE..COUNTY ENGINEER COLEMAN W. JENKINS. SUPT. OF BUILDING LpCAymY ' FOR APPLICANT TO FILL IN(PR:NT. TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE jell - o�Ilrl�x WATER,CLOSET 1.50 MAIL -BATH TUB 1.5.0 ADDRESS' �JJ. SHOWER 1.50 CITY TEL.NO. �� LAVATORY 1.50 CONTRACTOR SINK 1.50 A DRESS DISHWASHER 1.50 CII TEL. NO. CLOTHES WASHER 1.50 ^ . 'S ATE LIZ 5 J LICENSE NO. CLASS SWIMMING-POOL RECEPTOR 1.50 DISTRICT NO. C�$QIIP �ZpNE E¢SED BY I' �1 ilk"7/ LAWN'SPRINKLER SYSTEM 2.00, I;��Q WATER HEATER 1.50 O INDUSTRIAL %TASTE APPROVAL GAS SYSTEM' OUTLETS 1.50 �v INSPECTION RECORD zOUTLETS OVER. 30 O 5 PER SYSTEM Plan check fee 25% of.above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE I` APPROVALS DATE INSPECTOR'S SIGNATURE Plan check-applicant •;NDER SLAB WORK Name 4OUGH PLUMBING Address GAS PIPING r AS VENT City. Tel. No. 'OT 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 AS TEST PLUMBING. 1 HEREBY•CERTIFY THAT 1 AM PROPERLY REGI RE AND/OR PTILITY CO.NOTIFIED - �- LICENSED AS REQUIRED BY LOS•-ANGELES. COUNT AND TATE OF CALIFORNIA OR THAT 1 AL R ,AND TEND TO _ RESIDE IN.TME AB �68eRIBED RESID L PE FI SIGNATURE I JACK R. ALLEN, suP RVISI CRANI CAL EN'G'•R. OF PE PERMIT VALIDATION CK. M.O. CASH PL HEC VALIDATION ""C K• M.O. CASH I' �q 3 8 � r � 6 . 5D 8.00- . 7GAGG7 (C6-817) - 1/78 ' J. • APPLICATION R PLUN&MNG PERMIT COUNTY OF LOS ANGELES ' DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BIJI LD I NG ® -f MAKE CHECKS PAYABLE TO: ADDRESS G OOV HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY ' `p FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST + CROSS ST. NUMBER FIXTURE OR ITEM 0 FEE WATER CLOSET 2.00 D� OWNER BATH TUB 2.00 Du AAIL DDRESS / SHOWER 2.00 b V CITY TEL. NO. LAVATORY 2.00 Od CONTRACTOR SINK 2.00 ADDRESS DISHWASHER 2.00 CITY TEL. NO. 6_2 CLOTHES WASHER 2.00 STATE LIC le LICENSE NO. CLASS lee_3 SWIMMING POOL RECEPTOR 2.00 DISTRICT NO.JGROUPJ ZONE "ESSly a LAWN SPRINKLER SYSTEM 2.00 V WATER HEATER 2.00 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 2.00 d INSPECTION RECORD o OUTLETS OVER C"j 5 PER SYSTEM .30 Cd C7 v W O- ti Plan check fee See Reverse PLUMBING PERMIT ISSUING FEE $ TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant 'UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING City Tel. No. GAS VENT HOT WATER HEATER IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. GAS TEST ��•7 =J:'!T"-�� I HEREBY CERTIFY THAT 1 A PR LY R STERED AND/OR UTILITY CO. NOTIFIED LICENSEDAS REQUIRED BY LO AN •S CO TY AND STATE OF CALIFORNIA OR THAT I AM T L OF, AND Ili ND TO RESIDE IN THE ABOVE DESC E IAL PROPERTY. FINAL �� -7 ^^•-*��F. SIGNATU RE OF PERMITTEE PERMIT VALIDATION CK. M.a. CASH PLAN CHECK VALIDATION CK. CASH 1 7 UL-1 APR 6 5 D 2 2,5 U At o I f ♦ . T ION im that I'have a certificate of consent to 7M666DPW9/89 APPLICATION FOR PLUMBING PERMIT 75A667A I helebylaffirm that I have a certificate of consent to self Insure, , or a certificate of°Worker's Compensation Insurance, or a certified copy theS&f(Sec.3800 Lab.C.) Policy NOPC9 460 6 9 Company REPUBLIC INDEMNIT90UNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. ❑ Certified copy is hereby furnished. g1 FOR APPLICANT TO FILL IN(PRINT OR TYPE) PDDR SS 5 410 PERSIMMON AVE. LI UILDING Certified copy is filed with4coubuilding'nspecti ndepartment. NUMBER FIXTURE OR ITEM ® FEE LOCALITY TEMPLE CITY Date R/�1 /9 7ApplicWATER CLOSET NEAREST CROSS ST. CERTIFICATE OF EXEOM WORKERS' BATH TUB ASSESSOR COMPENSATION INSURANCE (This section need not be completed if the work Involved by the SHOWER MAP BOOK PAGE PARCEL permit is for one hundred dollars($100)or less.) OWNERCALVIN NGUYEN I certify that in the performance of the work for which this permit LAVATORY is issued, I shall not employ any person in any manner so as toSINK ADAIL DRESS 5410 PERSIMMON AVE. become subject to the Workers'Compensation Laws. Date $�3 1/Applicant DISWASHER CITY TEMPLE CITY TEL.NO8 _ — 0 4 8 NOTICE TO APPLICANT: If, after making this Certificate of CLOTHES WASHER CONTRACTOR Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS 638 SOUTHERN AVE. provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION c'TORANGE TEL.NO9 21—0 8 0 0 > I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER Q, (commencing with Section 7000)of Division 3 of the Business and STATE LIC.1 GAS SYSTEM OUTLETS 1455 LICENSE N0.468609 CLASS C2— C . Professions Code,and my license is in full force and effect. C OUTLETS OVER DISTRICT NO. PROCESSED BY JX 5 PER SYSTEM License Number 4 6 8 6 09 Lic.Class G2 0 6 ' FINAL C , •„�Q,j' DATE a�!_/a-Cj 3 VALIDATION III Contr a e 8T31T/0 2 4-v I am exempt under Sec. FINALBY B.&P.C.for this reason Date: Plan check fee 0. PLUMBING PERMIT ISSUING FEE$ 24.V5 Signature N�AACCTov ❑ TOTAL FCS139_'10 3u,07 39a3D SINGLE FAMILY Plan check applicant x HOME OWNER-BUILDER DECLARATION Name ... a 1 ITM_ I hereby affirm that I am exempt from the Contractor's License Law TOTALTOTAL ,5� mfir,� for the following reason (Section 7031.5, Business and Professions Address Code): City Tel.No. CECK '39°30 ❑ I,as owner of the property,will do the work and the structure ° I is not intended or offered for sale(Section 7044, Business and Professions Code). , CONSTRUCTION LENDING AGENCY _ 0000—Ml q/ 4/92 1 hereby affirm that there is a construction lending agency for the + 9 f [r t performance of the work for which this permit is issued(Sec. 3097, 57.641 91 7 021 Civ.C.) Lender's Name N/A 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 authorize representatives of this County to enter upon the above-mentioned Pro rty for inspectio purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ue� t $/31/92 Signature of P ittee�� Date