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Home My Public Portal About6220 PRIMROSE AVE_Plumbing__ 76AGOV 17 8-80 It APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY LU M mo I IN 0 1 COUNTY OF LOS ANGELES WILLIAM J. Fox. CHIEF ENGINEER DISTRICT NO. GROUP ZONE PERMIT NO. FOR APPLICANT TO FILL IN WINTERBOTTOM BROS�.,7INC, RECEIVED By READY FOR DATE ISSUED PLUMBER FIRST INSPECTION 1112 WESTMINs,rER AVE. 11 11 , 67 ADDRESS ALHAMBRA, GACIFOR "' BUILD ADDRESS 62 9,0 120 1 Ur-n C,c CITY TEL NO. COUNTY ) - LOCALITY LICENSE NO. fEXPIRES A - "All% .T t,PLF PERMIT FEES CROSS T _Tl_ NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER SEEKER LAUD CO MAIL 3612 Ee Lin OAtt Avc-O WATER CLOSET (TOILET) a O.SO 8 Fif) ADDRESS BATH TUB a 0.150 - 51) CITY A 17C AID I A ;:AL t F _ TEL. NO. SHOWER 0 0-50 - Fin I HEREBY ACKNOWLEDGE THAT .1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND LAVATORY (WASH BASIN) 0-50 rn AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK 0.50 50 .STATE LAWS REGULATING PLUMBING. I CERTIFY TH I POSSESS THE ABOVELOS 9 ANGEL COU-NT ICE E. OR I THE LE AL OWNER LAUNDRY TUB OR TRAY 0_50 - I;tII3 GAS GYSTr.,m--A--OUTLETS 0 0-30 5 OF T L I =A E. st R OF PERMITT I WATER HEATER 0.50 50 SLOP SINK 0.50 INSPECTION RECORD FLOOR SINK a 0.50 FLOOR DRAIN a 0.50 L @ 0.50 L t 0 44\pn $ F-: L D DISHWASHER t- AT. I an ��L OWp DRINKING FOUNTAIN 90 0.50 URINAL 0.50 HOUSE SEWER 50 z MISCELLANEOUS 0 APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL 1.00 ) CESSPOOL SEPTIC TANK: SEPT TANK I DRAIN I PIT 1.001 SEWER 1.00 GAS TEST FLpZFl L- PERMIT . . . . . . . . . . . . I 7d7�*j TOTAL FEE F3 100 1 UTILITYCO. NOTIFIED • FINAL h WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I':terbby affirm that I have a certificate of consent to self 76A667A insure, or a certiftcate of Workers'Compensation Insurance, CE 817(REV 10/81) or a certified copy the pany eo Sfec. 3800, Lab. C.) Policy Nol � COUNTY OF LOS ANGELES BUILDING AND SAFETY �� om ��d`'�'i�$ �� ' ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING G 19 Certified copy is filed with the cow wilding in ec-__, ADDRESS 6,910 RIA &VE AVC• tion d rfinenf. c NUMBER FIXTURE OR ITEM (D FEE /) LOCALITY ,/� Date_S07816 816 Appligon • WATER CLOSET ��/ NEAREST `�� r P� C/ CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB D CROSS ST. r'C_Al COMPENSATION INSURANCE OWNER (This section need not be completed if the work Involved by SHOWER the permit Is for one hundred dollars($100)or loss.) / LAVATORY a A MAIL fJ ADDRESS I certify that in the performance of the work for which thisa� permit is issued, I shall not employ any person in any manner SINK CITYJjF,A40AL.6 eyro TEL.NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER �C)Jv CONTRACTOR ''`/_ `e� G; / #�� Date Applicant CLOTHES WASHER (/ ADDRESS �6�� - WAL AILIT <-77 NOTICE TO APPLICANT: If, after making this Certificate of °t Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY � dd � TEL. NO.&-7r7•' Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRRic�T NQ. O ED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER } and Professions Code,and m license is in full force and effect. 5 PER SYSTEM I A. y DATEL J - VALI TION License Number •32/f 5-11 Lic. Cie. r••' e' to /s 4L FMA , / t; Contractor JAMU_ L 2111A• Date 3-�1'& I I C 0 ❑ I am exempt under Sec. B.BP.C. for this reason ✓ Plan check fee aI : PLUMBING PERMIT ISSUING FEE$ �� S Signature r -� yrJ) 4 3 3.6 A TOTAL FEE J(/ SINGLE FAMILY Plan check applicant # o o a 0 0 5 HOME OWNER-BUILDER DECLARATION Name I o o 5 2 5 0 I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Address o - 52.505 Professions Code): City Tel. No. ❑ I, as owner of the property, will do the work and the 03321 -86 structure is not intended or offered for sale (Section 7044, Business and Professions Code). 00 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 hey,@ read this application and state that the above info atiS is correct. I agree to comply with all County ardina so d'State laws re }luting Plumbing, and hereby out nze r rese atives of his ty-ta nter u on the ove-rq inspection pur.oses. ✓� 3 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of 6rmittee Date WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERM8T I he;eby`affirm that I have a certificate of consent to self 76A667A 'fl insure,%or a certificate of'Workers'Compensation Insurance, CE 817(REV. 10/Bl) or`'a certified copylthereof Oec. 3800, Lob. 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 /S7,0 // � p21 M A-V IE Certified copy is filed with the county building inspec- ADDRESS ti0!�liV tion department. NUMBER FSETUREORITEM @ FEE �E7gn LOCALITY 1✓ L. Date Appligant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. 5+41>0" COMPENSATION INSURANCE SHOWER OWNER C2g:,� L r l`4qo me (This section need not bo completed if the work Involved by MAIL �f tho permit is for one hundrod dollars($100)or loss.) LAVATORY ADDRESS7-20 I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner SINK CITY�.�5 A P� CC TEL.NO.�o,qW so as to become subject to the Workers'Compensation Laws. DISHWASHER ��"f CONTRACTOR Date J-97-Jr(v Applicant c,-4vd00F , CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY TEL. NO. with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CWS LICENSED CONTRACTORS DECLARATION DISTRICT NQ. SED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS OQ (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER 5 L (� and Professions Code,and my license is in full force and effbct. 5 PER SYSTEM FINAL /� V IDATION DATE` ` a License Number Lic. Class / L` C Contractor Date F IA Z _ ❑ I am exempt under Sec. �✓�� BAP.C. for this reason Plan check fee ® d Date: U PLUMBING PERMIT ISSUING FEE$ B4 3 4. A Signature -09 TOTAL FEE p 0 0 0 0 0 5 Plan check applicant SINGLE FAMILY 1 ° °-1 650 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address o 0 o 16505 Law for the following reason (Section 7031.5, Business and Professions Code): 0 a,0 18 6 City Tel. No. ® I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section 7044, Business and Professions Code). 01, 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 ^ y&4p, 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 pr erty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date • COUNTY OF'LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1201310023 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID BUILDING ADDRESS: I ITR: 17179 LT: 556220 PRIMROSE AV I ] FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:[ TEMP CA 917801614 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: GARIBALDI 15385-012-020 101 PERMIT ISSUANCE FEE 27.80 [ THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl 1 107 BATHTUBS/SHOWERS 1.00 FIX 16.30 1 [ [TEST: 125 LAVATORIES/SINKS 1.00 FIX 16.30 (ISSUED ON: PROCESSED BY: PLAN BY: I 1 145 WATER CLOSET/URINAL 1.00 FIX 16.30 101/31/12 SR 1 1 I TOTAL FEES 76.70 1 I IOWNSR: TEL NO: I [FINAL A FINAL BY• CODE: ISMITH, BERNARD (626) 890-6053- 1 1 wly n 16220 PRIMROSE AVE I I f - (TEMPLE CITY CA 91780 1 IDESOR- I OF WORK 1 ( ECPLUMB NG R BATHROOM RENK)D 1APPLICANT: TEL. NO: 1 I I ISAME AS OWNER ISPECIAL CONDITIONS: 1 I I 1CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER - 1 [ I LIC. NO I UNDER SLAB WORK I � I I [ WATER SERVICE I 1 I I [ IPLASTIC YIN METAL YIN I I I 1ARCHITECT OR ENGINEER: TEL. NO: [ I I I I I - [ IROUGH PLUMBING [ LIC. NO: I I [ [GAS PIPING IGAS VENT I I 1 I ]HOT WATER HEATER I I I I IPLUMBING FIXTURES I I I I I I (LAWN SPRINKLERS I I I I I I I I IGAS TEST I IUTILITY COMPANY NOTIFIED[ CWV I I I 1 I IGRAY rR SYSTEM 1 I I I [ I I I [ I I I I I I I I I I I I I I [ I I IREPORT ID: DPR263 ROUTE TO: BS0508 I I I I I I