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Home My Public Portal About5912 RENO AVE_Plumbing__ • L • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT • ` DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0506140012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: SgioZ+ LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 5904 LT: 149 UN: .003 59218 RENO AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801528 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: GARIBALDI 5384-017-016 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: 93 LOCALITY: TEMPLE CITY, C 07 BATHTUBS/SHOWERS 3.00 FIX 48.60 TENANT: 11 CLOTHESWASHER(S) 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 13 DISHWASHERS) 1.00 FIX 16.20 06/14/05 JK 12/11/05 25 LAVATORIES/SINKS 4.00 FIX 64.80 OWNER: TEL. NO: 45 WATER CLOSET/URINAL 2.00 FIX 32.40 FINAL DATE FINAL BY: CODE: THONG, NEI (626) 373-8316- 47 WATER HEATER(S) 1.00 WTH 16.20 5912- RENO AV 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TEMP 917801528 TOTAL FEES 238.35 DESCRIPTION OF WORK PLUMBING FOR ADDITION AND REMODEL APPLICANT: TEL. NO: SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO UNDER SLAB WORK WATER SERVICE PLASTIC YIN METAL YIN ARCHITECT OR ENGINEER: TEL. NO: LIC. NO: ROUGH PLUMBING l� GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508 96 u--amv-11 9 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN LAMeIE.County Enees ADDRESS - ) ('( Z '�1 - � _ A: rG N O TT D. GRUTM,Sup t of tilu LOCALITY FOR APPLICANT TO FILL IN NEAREST NUMBER FIXTURE OR ITEM CROSS ST. K-LVA O S"& WATER CLOSET I,OWNER MAIL Se-1 1 2 �- ��s C BATH TOB ADDRESS �. aHowEa cm B` &,-&aCmc. r(-,(TEL.No. LAVATORY (CONTRACTOR Sig :ADDRESS DIMIWASHER CITY NO. LlWNDRY TUB CONTRACTOR'S STATE ❑ REGISTRATION NO. COUNTY CLOTHES WASHER DISTRICx.NOj GROUP ZONE READY FOR IRSPECTIOR WATER HEATER Xr GAS SYSTBM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD vv APPROVALS • 0 $1.00 PER ITEM E I' DATE INSPECTOR'S SIGNATURE OR FIXTURE UNDER SLAB WORK PERMIT $ OO ROUGH PLUMBING. TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT 1 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 1 HEREBY CERTIFY..THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED. AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ?' CALIFORNIA OR THAT 1 AM THE LEGPL-.OWNER OF THE ABOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE—;11 (� — FINAL OF PERMITTEE ROBERT A.WOOD. Or VALIDATION SUPERVISING MECHANICAL ENG-FtCK. M.0. CASN 'p'2867% FEB 27 5 A 4.00 18 WORKER'S COMPENSATION DECLARATION 20-0026 DPW P9fe9 APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self insure, or a bertificate 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 `/ ❑ Certified copy is filed with the county building Inspection FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS f a? Ii(/p department. NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. (JSlA COMPENSATION INSURANCE / ASSESSOR (This section need not be completed If the work Involved by the SHOWER —/ �. MAP BOOK PAGE PARCEL permit is for one hundred dollars($100)or less.) _/ OWNER ` ^0" I certify that in the performance of the work for which this permit LAVATORY is issued, I shall not employ any person in any manner so as toSINK MAIL become subject to the Workers'Compensation Laws. ADDRESS DISWASHER CITY TEL.NO Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of CONTRACTOR Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code, you must forthwith comply with such ADDRESS provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.NO. > I hereby affirm that I am licensed under provisions of Chapter 9 �� `�WATER HEATER O• (commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS STATE LIC.LICENSE NO. CLASS C C) Professions Code,and my license is in full force and effect. OUTLETS OVER DISTRICTNO,n� PROCESSED BY Q 5 PER SYSTEM License Number Lic.Class V FINAL U j DATE 2 VALIDATION a Contractor Date rA ElFNAI L I am exempt under Sec. F B.&P.C.for this reason Date: Plan check fee 0 16 Signature PLUMBING PERMIT ISSUING FEE$ tt.,•- r_1 Z/- FEE' ?,l({ dy„;,41E SINGLE FAMJLY Plan check applicant _ HOME OWNER-BUILDER DECLARATION , Name _ I hereby affirm that I am exempt from the Contractor's License Law -f 0TSL _ g for the following reason(Section 7031.5, Business and Professions Address 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). 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, 5791 c1el 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 ordinances and State laws—regAting Plumbing, and hereby authorize representativ is County W enter upon the above-mentioned property for n Toc�purpo s. i�� SEE REVERSE FOR EXPLANATORY LANGUAGE Signa re of Permittee l Date WORKERS'COMPENSATION DECLARATION APPLICATION! FOR PLUMBING PERMIT I hereby affirm that I have o certificate of consent to self 20-0026 DPW 6/87 insure, or a certificate of Workers'Compensation Insurance, 76AG67A or o certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELS- DEPT.OF PUBLIC WORKS Policy No. Company ; Certified copy Is hereby furnished. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) I BUILDING Certified copy is filed with the county building inspec- ADDRESS V tion department. NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE OWNERnn � ADD (This section need not be completed If the work Involved by SHOWER MAIL -�S � /� t the permit Is for one hundred dollars($100)or less.) LAVATORY / ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL.NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER �C• L•G CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL. NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be & STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED B ' Y I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER -pf � e and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL -9VALIDATION 0. DATEO License Number Lic. Class 0 FFNALContractor DateY ❑ I am exempt under Sec. W B.BP.C. for this reason Plan check fee � Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE SINGLE FAMILY Plan check applicant •1 HOME OWNER-BUILDER DECLARATION Namefy:�04 I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and � �� 95.655Prof ssions Code): City Tel. No. T..s._•C I, as owner of the property, will do the work and the 1 I•Ll structure is not intended or offered for sale (Section TOTAL 5 e 46 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I CHECK 55.65 1 hereby affirm that there is a construction lending agency for iNLi oI the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name 10130-13001 5/24/53 Lender's Address 983191 1 AN 10 a CR 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 authoriz prelentatives of this County to enter upon the above-me . nedp perty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sign6fure of ermittee Date