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Home My Public Portal About5645 PERSIMMON AVE_Plumbing__ 76AIP7•CE#Slyz 063 a:.a t'•.. APPLICATION FOR PLUM ING PERMI COUNTY OF LOS ANGELES u DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVLSION FNEARnEST ING �d p� �M/►'t o N Ile, JOHN A. LAMBIE, COUNTY ENGINEER ESS WILLIAM A.JENSEN, SUPT OF BUILDING LITY E p1- T FOR APPLICANT TO FILL IN S . /YG Oak Arc. NUMBER FIIGTURE OR ITEM EACH FEE OWNER WI RQ UG{7?OI�f WATER CLOSET $1.25 MAIL r�n BATH TUB 1.25 ADDRESS PfC OCoS M O �G r SHOWER 1.25 CITY ,E Cl rr TEL. NO. 7, LAVATORY 1.25 J CONTRACTOR cs>flnJ5 SINK 1.25 ADDRESS DISHWASHER 1.25 CITY a TEL. NO. � LAUNDRY TUB 1.25 REGISTRATION NO. COUNNTTYY Q CLOTHES WASHER 1.25 DISTRICT NCGR P ZONE RO BY WATER HEATER 1.50 p � RIAL GAS SYSTEM OUTLETS 1.50 WASTEINDUSAPPROVAL O WASTE APPROVAL OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U 0 f 4-S4b LU D. T, oz r w A > - '.s r3 ! - 'WIDIM Pt_Atj&REAJ 0 fib- DUT%4*&j �Aj.6 T//V `/El= 0 �..J APPROVALS DATE INSPECTOR SIGF ATURE PERMIT S 2 00 UNDER SLAB WORK —Z — d;,/ ,tvv�d.� •'"'�° r ROUGH PLUMBING 2q TOTAL FEE GAS PIPING Q 1 HEREBY ACKNO LEDGE GAS VENT THAT 1 HAVE READ THIS AP LICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER ��+d PLUMBING. /-;p R+" 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES ) /yr LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOVED IBED RESIDENTI UTILITY CO.NOTIFIED. SIGNATURE OF PERMITTEE.671 A&Z FINAL 6LIDACK. TION ROBERT A.WOOD M.0. CASH SUPERVISING MECHANICAL ENG'R LACos 0 1 3k2 AN29 5 0 7.25N ION WORKER'S I have a certificate of consent to 20.0028 DPW 9/89 APPLICATION FOR PLUMBING. PERMIT I hereby affirm,that I have a certificate of consent to self insure, 78A687A of a certificate of Worker's Compensation Insurance,or a,certified copy thereof(Sec.3800 Lab.C.) Policy No. Company COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. ❑ Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS �� r s�'a O� ❑ Certified copy is tiled with the county building Inspection f� department. - NUMBER FIXTURE OR ITEM ® FEELOCALITY (/-4 i 91 Date Applicant WATER CLOSET NEAREST /'� CROSS ST. ( 1 CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB COMPENSATION INSURANCE ASSESSOR �{ (This section need not be completed if the work Involved by the SHOWER MAP BOOK �S7_3 PAGE/ PARCEL.t7l permit is for one hundred dollars($100)or Iess.) LAVATORY OWNER V_R , !' ON I certify that In the performance of the work for which this permit Is Issued, I shall not employ an MAIL i' p y y person in any manner so as to SINK ADDRESS become subject to the Workers'Compensation Laws. DISWASHER CITY -- TEL.NO. (/;L-ff`. Date ApplicantCLOTHES WASHER NOTICE TO APPLICANT: If, after making thia Certificate of CONTRACTOR Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS provisions of the Labor Code,you must forthwith comply With such provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION WATER HEATER CITY TEL.NO.STATE LIC. an I.hereby affirm that I am licensed under provisions of Chapter 9 V (commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS LICENSE NO. CLASS Professions Code,and my license is In full force and effect. r OUTLETS OVER R O ESS 5 PER SYSTEM r License Number - Lic.Class FINAL VA DA ON W DATE -(j / � Contractor Date 999 r ❑ y A 1 I am exempt under Sec. BY B.&P.C.for this reason Date: Plan check fee ' y ,z, %, PLUMBING PERMIT ISSUING FEE$ Signature 1 3 ❑ TOTAL FEE 140 60 SINGLE FAMILY i Plan Check applicant Cr HOME OWNER-BUILDER DECLARATION { Name AC CT e I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Address 3307 a. Coale): ` City Tel.No. 1 ITEMS �- I,as owner of the-property,will do the work and.the structure is not Intended or offered for sale(Section 7044, Business TOTAL 20.50 and Professions Code). , CASH 20.50 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the CHANGE oCl performance of the work for which this permit Is issued(Sec.3097, Civ.C.) Lender's Name 0000-0001 7/30!90 2111 1 AM 9a , Lender's Address 1 certify that I have read this application and state that the above 001.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 uponthe above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE r WORKERS'COMPENSATION DECLARATION 06A667A I hereby affirm that I have x certificate of consent to self .CE 617(2-661 APPLICATION FOR PLUMBING PERMIT insure,or a certificate of Workers'Compensation Insurance,or I a certified 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 inspection NUMBER FIXTURE OR ITEM • FEE ADDRESSV department. LOCALITY Date Applicant WATER CLOSET NEAREST .BATH TUB CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE SHOWER OWNER loll &Z PJV64TO (This section need not be completed if the work involved LAVATORY MAIL ADDRESS 0-rilt } by the permit is for one hundred dollars ($100) or less.) SINK CITY TEL.NO. 7-8/12 00- I I certify that in the performance of the work for which this DISHWASHER U permit is issued, I shall not employ any person in an)yp.Vpanner CONTRACTOR so as to become subject to the W rs'CompensioA Laws CLOTHES WASHER ADDRESS O Date,�PPlicant SWIMMING POOL RECEPTOR (~j NOTIC O APPLICANT: If, a ter making this Certifi a of CITYry,,�_ TEL.NO. W Exemption, you should become subject to the orkers' LAWN SPRINKLER SYSTEM STATE LIC. y Compensation provisions of the Labor Code,you must forth- WATER HEATER � LICENSE NO. CLASS with comply with such provisions or this permit shall be deemed revoked. DISTRICT NO. PROCESSED BY GAS SYSTEM OUTLETS LICENSED CONTRACTORS DECLARATION OUTLETS OVER I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM 9 (commencing with Section 7000)of Division 3 of the Busi- FINAL �»q—/r � VALIDATION ness and Professions Code, and my license is in full force and DATE / effect. FINAL License Number Lic.Class BY Contractor Date I am exempt from the.licensing requirements as I am a Plan check fee licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE 6 (J Lic,or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Address ;0: 6583A License Law for the. following reason (Section.7031.5, Busi- City Tel.No. ness and Professions Code): #( o o 0 0 0 5 I, as owner of the property, am exclusively contracting 0 '0 1 650 with licensed contractors to construct the. project (Section 7044,Business and Professions Code). J 0 0 0 1 '&50F— CONSTRUCTION LENDING AGENCY O,01 —8 2 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 application and state that the above information is correct.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordinances and State laws regulating Plumbing, and hereby "authorize representative this County to enter upon the above- tion d pr for)isurposes �N `, nature of Pe itte Date WORKERS'COMPENSATION DECLARATION i APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers'Compensation Insurance, CE 817(REV. 10/81) or a certified copy thereof(See. 3800, Lab, G.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. BUILDING v 6� ❑ FOR APPLICANT TO FILL IN(PRINT OR.TYPE) ADDRS r Certified copy is filed with the county building inspec- NUMBER FIXTURE ITEM tion department. @ FEE LOCALITY Date Appliqant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by SHOWER MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK / CITY TEL.NO. (7_811. so as to become subject to the Worker'Compens on Law DISHWASHER CONTRACTOR A Date d Applicant CLOTHES WASHER NOTIC TO PLICANT: If, after making this Certif' to of ADDRESS SWIMMING Exemption, you should become subject to the orkers' POOL RECEPTOR Compensation provisions of this Labor Code, you must forth- CITY TEL.NO. LAWNSPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed.revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. P OCESSED BY, I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000).of Division 3 of the Business OUTLETS OVER >_ and Professions Code,and license is in full force and effect. 5 PER:SYSTEM FINAL �f9� VALIDATION DATE �/ r(�( 0 n. License Number Lic. Class FINAL Contractor Date BY L ❑ 1 am exempt under Sec. V AU , er B.B,P.C. for this reason y Plan check fee ► Date: PLUMBING.PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that 1.am exempt from the Contractor's License Address Law for the.following reason (Section 7031.5, Business and Professions Code): City Tel. No. 1 '7 8 Q'A I, as owner of the property, will do the work and the structure is not intended or offered for sale (Sectionloop4o'0 0 o o 5 7044, Business and Professions Code). s. - CONSTRUCTION LENDING AGENCY 2,oTo 1 '6.5,0 I hereby affirm that there is a.construction lending agency for 0 a o 1 be 5 C the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). 0.6.C 6-84 Lender's Name Lender's Address I certify that I have read this application.and state that the ► above information 1s correct. I.agree to comply with:all County ordinances.and.State laws regulating Plumbing, and hereby authorizerepresent Ives of this County to enter upon the above-mentione perty f i spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ignature•o ermitt to COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1006220007 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 13935 IT: 20 5645 PERSIMMON AV (FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:] NEARESCA T 9178028809 TREET: LIVE OAK ASSESSOR INFORMATION NUMBER: CROSS 8573-001-018 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, C 163 WATER PIPING BR/FIX 1.00 FIX 6.75 ]TENANT: 164 WATER PIPNG <- 1 1/2 1.00 LIN 16.20 11SSUED ON: PROCESSED BY: PLAN BY: 1 1 1 TOTAL FEES 50.70 106/22/10 SR 1 [OWNER: TEL. NO: [ [FINAL DATE FI BY: CODE: [ BROUGHTON AMOS (626) 201-8820- i 1144 1 5645 PERSIMMON AV [TEMP 917802809 1 1D SCRIPTION OF WORK 1 I I [INSTALL NEW 1" COPPER WATER SERVICE. INSTALL NEW 3/4" HOT & [ I I [COLD COPPER PIPING UNDER HOUSE, POC ® EXISTING BATH #1 [ ]APPLICANT: TEL. NO: I I [STP ENTERPRISES INC. (626) 287-7544- 1 15454 TEMPLE CITY BL. [ SPECIAL CONDITIONS: [ [TEMPLE CITY CA 91780 ] [ ]CONTRACTOR: TEL. NO: 1 ]APPROVALS DATE INSPECTOR SIGNATURE ] ]STP ENTERPRISES, INC. (626) 287-7544- ] 1 1 15454 TEMPLE CITY BLVD. LIC. NO [ ]UNDER SLAB WORK ] 1 1 ]TEMPLE CITY, CA 91780 598157BC36 1 1 ] 1 1 ]WATER SERVICE ]ARCHITECT OR ENGINEER: TEL. NO: (PLASTIC YIN METAIi - 1 1 ROUGH PLUMBING �`,,�/ 1 LIC. NO: 1 1 1 1 ] (GAS PIPING ] ]GAS VENT I I ] I I ]HOT WATER HEATER I I ] I I I 1 I 1 ]PLUMBING FIXTURES 1 1 1 LAWN SPRINKLERS 1 1 1 I I I I I I ]GAS TEST 1 1 1 ] ]UTILITY COMPANY NOTIFIED( I 1 I I ICWV I 1 I I I [GRAY WATER SYSTEM I I ] I I I I I I I I I I I I [ I I I I I I I ]REPORT ID: DPR263 ROUTE TO: BS0508 [ 1 1 1 I I ] I I