The URL can be used to link to this page

Home My Public Portal About5538 PERSIMMON AVE_Plumbing__ �6A667-CE817-8-58 ��-•�.CJ . APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BLmm� I G AND SAFETY DIVISION BD INS )C 6 A. LAMBIE, Count+?Engineer CT D.GRUTM.Sup t of u,,c%g LOCALITY � + I'r' FOR APPLICANT TO FILL INNSS NUMBER FIXTURE OR ITEM }� C- WATER CLOSET OWNER MAIL BATS TUB ADDRESS 5 3 3 P&ft I ,J SHOWER c1TY £ 1�4 TEL NO. Ca i ��R�l LAVATORY CONTRACTOR '�6 ! ��., i am ADDRESS 1" � 6 O 4'I DRISWASHER CITY C-j O TEL. NO. G i 6-qS LAUNDRY TUB REGISTRAC OTOWS N NO. 1611 8::S COSTATE NTY ❑ CLOTHES WASHER DISTRICT NO. I GRgUE69 ZONE OCESSED BY WATER SEATER E GAS SYSTEM INDUSTRIAL WASTE APPROVAL ITISPECTION RECORD APPROVALS OR° 100 DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ 2100 ROUGH PLUMBING TOTAL FEE I igl 0 GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL PROPERTY. SIGNATUREF c Vy� 1l��/w FINAL /L.J�r7 ITT OF PERME - ROBERT A.WOOD. ®P ALIDATION SUPERVISING MECHANICAL ENG,'R CK. H.O. CASH "E04 APR 13 5 A 3.00 f6A667-CE817-8-58 APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION B7D:Z'NSGrrOHN A. LAMBIE, CouatF Ea�n eos AC JOHN J D. GRIFFIN,Supunt!of 8uildiag LY FOR APPLICANT TO FILL IN NEAREST ST. G�tJ NUMBER FIXTURE OR ITEM c OWNER �7 � ' AJ WATER CLOSET MAIL BATE TUB ADDRESS SHOWER CITY � TEL NO. LAVATORY CONTRACTOR —? v SIN$ ADDRESS / S(O✓,ir 44 DISHWASHER CITY I TEL. NO. LAUNDRY TUB CONTRACTOR'S STATE REGISTRATION NO. G' 3 COUNTY ' CLOTEM WASHER DISTRI NO. I GRQUP ZONE OGESSED BY WATER HEATER J /rj :g''`r'L-" GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD O gg�� I s� APPROVALS R PFI IIBE 5 G DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT S 2 00 ROUGH PLUMBING TOTAL FEE `'' v,r GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER WITH ALL COUNTY ORDINANCES AND STATE LAPIS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEG L OWN R OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL, SIGNATURE FINAL OF PERMITTE ROBERT A.WOOD. ®p ALTDATION SUPERVISING MECHANICAL ENG'R CR. R.O. CASH >�1/ORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I rhd!t by aff.r.�that I have a certificate of consent to self 76A667q insuCu ror�r,,arcertificate of Workers'Compensation Insurance, CE 817(REV. 10/81) y or r;certifled copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company . Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS (/F. tion department. NUMBER FIXTURE OR ITEM FEE �/ LOCALITY 14 G C , Cd. Date 2-��L_&-Appli, WATER CLOSET / 9. NEAREST CERTIFICATE OF EXEMPTIQ BATH TUB 6 O CROSS ST. COMPENSATION INSURAN SHOWER i) OWNER 11iC (This section need not be completed if thef work involved by (/ MAIL the permit is for one hundred dollars($100)or less.) LAVATORY �j ADDRESS fJ31 E J~N 0411,F I certify that in the performance of the work for which this `' permit is issued, I shall not employ any person in any manner SINK V CITY epiZ �' TEL. NO. so as to become subject to the Workers'Comp nsation Laws. DISHWASHER CONTRACTORJE Fiji w Date Applicant CLOTHES WASHER —ADDRESS NOTICE TO APPLICANT: a ter ing is Certific tood Exemption, you should become subje to the Wor SWIMMING POOL RECEPTOR ,/��// r� Compensation provisions of the Labor C de, you must forth- LAWN SPRINKLER SYSTEM CITY IDT Ail ve/.06 fA GR. TEL.NO,�,�..1T-V7 with comply with such provisions or his permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. / CLASS C^ LICENSED CONTRACTORS DECLARATION DISTRICT NO ROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL _ 011 y DATION jj DATE License Number, Lic. Class i� C 3Epu�d�dA y� _ vv FIN c Contractor �17ff) I BY A/ ❑ I am exempt under Sec. F B.BP.C. for this reason G 7 29` �� Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ C Signature -. TOTAL FEE e--- SI GLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name ;25 1 S2 A I hereby affirm that I am exempt from the Contractor's License ' Address I # 0 0 0 0 0 5 Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. 1 - 4650 ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section ® - 46506 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY o7.29-86 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.). l Lender's Name Lender's Address 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 authorize representatives of this County to enter upon the above-menti ed property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE e f Permittee -�� Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0308210023 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: L D BUILDING ADDRESS: TR: 13613 LT: 25 5338 PERSIMMON AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802801 ASSESSOR I 0 0 LIMBER: NEAREST CROSS STREET: FREER 8573-005-013 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TENANT: TOTAL FEES 43.95 ISSUED 0 : PROCESSED : P P 0 : 08/21/03 JK 02/17/04 OWNER: TE 0: F I NA FINAL BY: CODE: HUDSON;STEPHANIE (626) 446-0953- 5338 PERSIMMON AV 6 TEMP 917802801OF R NEW VA SYSTEM APPLICANT: O: SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TE 0: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO UNDER SLAB WORK WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR G R: 0: ROUGH PLUMBING LIC. NO: GAS PIPING GAS VENT HOT WATERHEATER PLUMBING FIXTURES LAWN SPRI RS GAS- TEST UTILITY COMPANY NOTIFIED' CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508