HomeMy Public PortalAbout4802 RIO HONDO AVE_Plumbing__ 7SAS67'-'.17 IF-49® APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBING 1
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL 1N DISTRICT NO. GROUP I ZONE PERMIT NO.
PLUMBER 'ZR7%J,. RECEIVED BY READY FOR_ DA E ISSU D
E - o FIRST INSPECTION
ADDRESS &AL
BUILDING
CITY � TEL. NO ADDRESS
COUNTY 6 " LOCALITY
LICENSE NO. / 7 EXPIRES O `I
NEAREST u
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNE
MAILle
WATER CLOSET (TOILET). @ 0.60 S ADDRESs3 OIt , ",A% Cl'lt-�y -+
BATH TUB 0.50 CITY TEL. N�O /�S&A
SHOWER 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 AND
KITCHEN SINK @ 0.50 STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL' OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE:
GAS SY6TEMOUTLETS I O.50 "SIGNATURE OF !i—
WATER HEATER @ 0.50 PERMITTEE ►� c7�e'!rl:�/
SLOP SINK @ 0.50 INSPECTION RECORD,1=
FLOOR SINK @ 0.50
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.50
DRINKING FOUNTAIN ® 0.50
URINAL @ 0.90
HOUSESEWER - Q 0.50 Z
MISCELLANEOUS C9
- o
APPROVALS
DATE / INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT 9' Int
CESSPOOL S 1.00 -CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.001 SEWER
PERMIT . 1.0o GAS TEST
UTILITY CO. NOTIFIEDWf
TOTAL FEE I $ l C' FINAL i
76A607-CI7
r• lass
APPLICATION FOR PLUMB IVIG PERMIT,
4 COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BLoIIH.D��GL,A1�NDn BI FETiTYir EMSNIEON BUILDING O
WILLIAM A.JENSEN,SUPT OF BUILDING
LO �
�l
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM oWmm `0
WATER CLOSET
BATA TUR ADDRESS D Z-
= ,1- TEL NO.
ssowER
CONTRACTR r S
LAVATORY
SINS ADDRESS 56 x je. L-L
DISHWASHER CITY TEL NO. MtA;
CONTRACTOR'S / �f STATE
LAUNDRY TUB REGISTRATION No. ( COUNTY ❑
CLOTBES WAS= DISTRRII NO. GROUPI
JZ�ONE PRO SSE Y
WATER HEATERJ'T
GAS SYSTEK INDUSTEM
WASTE APPROVAL
O C. INSPECTION RECORD
0
' F
V
P.
m
O1.00 PER ITEM
R F=T RE
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE REAP THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT 1 AM'PROPERLY REGISTERED AND/OR PLUMBING FIXTURES A
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM. THE LEGAL OWNER OF THE ABOVE,
DESCRIBED RESID PROPERTY. UTILITY CO.NOTIFIED r
SIGNATURE 11 1/2 V %� �P1
OF PERMITTE FINAL X v v j �r
�F OVAUDATION ROBERT A. OOD,
II
.O, 6,,g SUPERVISING MECEIiNICAL ENG'R
LAPU08 it _3 7 w h-Od 7 5 U 3.00 M�
76A667'CE817 12/59
APPLICATION FOR PLUM INO PERMIT
COUNTY OF LOS ANGELES .
DEPARTMENT OF COUNTY ENGINEER
BUILDIIG�AAND�SI�FETY DMSION FA
ING e
JOHN MBI OUNTY ENGINEER ESS
WILLIAM A.JENSEN, SUPT of BUILDING
LITY gyp- d
FOR APPLICANT TO FILL IN . ST
ST.
NUMBER FIXTURE OR ITEM
B
WATER CLOSETSS C5BATE TUB
SHOWER �.. •E �! NO.
LAVATORY CONTRACTOR ' 00
s m ADDRESS L
DISHWASHER CITY NO. a�
CO CTOR'S (� STATE
LAUNDRY TUB BEGISTRATION NO. j COIINTY ❑
CLOTHES WASHER DISTR10MO. P ZON PR CESSED S
WATER HEATER - I 4
GAS SYSTEM INDUSTRLRI.
WASTE VAL
r' 4l*ECTI0WRECtQlW %r
- a
O
v
oa
O
F
- O
w
a
lool
oo-
W $1.00 PER ITEM I 1
OR FIXTURE PROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 200 UNDER SLAB WORK
3
TOTAL FEE ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE 1S CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDE PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERM! FINAL
�e VALIDATION ROBERT A.WOOD.
U.O. "a SUPERVISING MECHANICAL ENG'R
h,
76A667-CE817 .12/59 TEMPLE CRT u
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
B o NSA. D c NTYir MSNION BUILDING
DDR�
WILLIAM A.JENSEN.SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO. FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET MAIL �t
ADDRESS r/
BATH TUB
CITY TEL NO.
SHOWER
LAVATORY CONTRACTOR
SINK ADDRESS 14 ,1
DISHWASHER CITY
CONTRACTOR'S TATE ❑
LAUNDRY TUB REGISTRATION NO. CO ❑
CLOTHES WASHER DISTR T NOS/ GROU ZONE P C Y
WATER HEATER ((bb// /,CTI
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
O
- - O
a4
O
F
. - U
W
OSF>PER ITEM
RTQ $ I .. /
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE 'v ROUGH PLUMBING
` GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER /
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES /6>
LICENSED AS REQUIRED BY LOS ANGELES COUNTY.AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED I
SIGNATURE _
OF PERMITTE FINAL
� VALIDATIO OBERT A.WOOD,
. M.0. Om SUPERVISING MECHANICAL ENG'R
[ ;?' 8774% FEB 26 5 D :3.0.0
t
'WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT
I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 �J�I
insure, or a certificate of Workers' Compensation Insurance, 76A667A
or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS �J
Policy tryVV� o�Sipony
Certified copy is hereby furnished. BUILDING
FOR APPLICANT TO FILL IN(PRINT OR TYPE)
Certified copy is filed with the county building inspec- ADDRESS (0 QAC alo
tion epartment. NUMBER FIXTURE OR ITEM @ FEE
LOCALITY r A _f
Date r�`� , Appli4ont / WATER CLOSET /111110 NEAREST
CERTIFICATE OF EXEMPTION FR ORKERS' BATH TUB CROSS ST.
COMPENSATION INS NCE SHOWER OWNE
(This section need not be completed if the work Involved by MAIL
the permit is for ono hundred dollars($100)or less.) LAVATORY ADDRESS
I certify that in the performance of the work for which this
permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO.
so as to become subject to the Workers'Compensation Laws. DISHWASHER
CONTRACTOR �-
Date Applicant CLOTHES WASHER ADDRESS/?�
NOTICE TO APPLICANT: If, after making this Certificate of
Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR sr
Compensation provisions of the Labor Code, you must forth- CITY/4/ L� d L. NO..T
with comply with such provisions or this LAWN SPRINKLER SYSTEM
p y p permit shall be STATE LIC. -_
deemed revoked. WATER HEATER LICENSE NO. CLASS /
LICENSED CONTRACTORS DECLARATION DISTRICT NO. ROCESSED BY
I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS D
(commencing with Section 7000) of Division 3 of the Business OUTLETS OVER
and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL }
DAT -' " VALIDATION C
License Number Lic. Class L
t — C� FI
Contractor Date- a i B C
❑ C I am ex under Sec. W
B.BP.C. for this reason 0.
Plan check fee cr
Z
Date:
PLUMBING PERMIT ISSUING FEE$ V
Signature
TOTAL FEE
Plan check applicant
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm that I am exempt from the Contractor's License Address
Law for the following reason (Section 7031.5, Business and
Professions Code): 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, 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 regulating Plumbing, and hereby
authorize repres totives of this County to enter upon the
abo ion perty for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature mittee Date
ti
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1007140002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS:
ITR: 16475 IT: 51 I I 4802 RIO HONDO AV
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917803738
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LOWER AZUSA I
18590-025-017 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY, Cl
1 107 BATHTUBS/SHOWERS 3.00 FIX 48.80 1
ITENANT: 125 LAVATORIES/SINKS 2.00 FIX 32.50 11SSUED ON: PROCESSED BY: PLAN BY:
1 145 WATER CLOSET/URINAL 2.00 FIX 32.50 107/14/10 SR
I TOTAL FEES 141.60 1 1
IOWNER: TEL. NO: I IF TE FI BY: CODE:
CHIU, RINGO H (626) 286-6014- I 1 ��
4802 RIO HONDO AV
ITEMP 917803738 I IDESCRIPTION OF WORK
I I IPLUMBING FOR TWO BATHROOMS REMODEL I
I I I I
(APPLICANT: TEL. NO: I I I
1SAME AS OWNER -
I 1 ISPECIAL CONDITIONS:
I I
I I I I
(CONTRACTOR: TEL. N0: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
ISAME AS OWNER - I I I
I LIC. NO I (UNDER SLAB WORK 1 1 I
I I I i I
I (WATER SERVICE I I
1 1 IPLASTIC YIN METAL YIN
(ARCHITECT OR ENGINEER: TEL. NO: I I I
I - I IROUGH PLUMBING /( I
LIC. NO: �J
1 (GAS PIPING
�� VENT
I IHOT WATER HEATER I I
I 1PLUMBING FIXTURES 1 I I
I I I I I I
ILAWN SPRINKLERS I I I
IGAS TEST I
UTILITY COMPANY NOTIFIED(
I I ICWv I
I I I I I
I IGRAY WATER SYSTEM I
I I I I I
I I I I I I
I I I I I I
I I I I
I I I I
I I I I I 1
IREPORT ID: DPR263 ROUTE TO: BS0508 I 1 I
I I I I I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0703190001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
` PHONE: (626) 285-0488 EXT:
LEGAL ID: i FEES PAID i BIIILDING ADDRESS:
JTR: 16475 LT: 51 4802 RIO HONDO AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917803738
ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: LOWER AZUSA
8590-025-017 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY, Cl
113 DISHWASHER(S) 1.00 FIX 16.20
TENANT: 60 DWV REPAIR OR ALTER 1.00 SYS 16.20 JISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
163 WATER PIPING BR/FIX 1.00 FIX 6.75 03/3.9/07 JK 09/15/07
TOTAL FEES 66.90 1
OWNER: TEL. NO: FI AL DAT JFIY: CODE:
ICHIU, RINGO (626) 286-6014- I DA/
4802 RIO HONDO AV
y--
TEMP 917803738 ID CRIPI OF WORK
PLUMBING FOR KITCHEN
APPLICANT: TEL. NO:
SAME AS OWNER SPECIAL CONDITIONS:
CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER LIC. NO IUNDER SLAB WORK
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TEL. NO: I I
IROUGH PLUMBING
LIC. N0: iGAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
(UTILITY COMPANY NOTIFIED
jC
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508