HomeMy Public PortalAbout4933 RIO HONDO AVE_Plumbing__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0704030001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID I BUILDING ADDRESS: I
ITR: 16475 IT: 153 I 1 4933 RIO HONDO AV I
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:[ TEMP CA 917803741 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LOWER AZUSA 1
18590-028-017 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY, Cl
1 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 1 1
(TENANT: I TOTAL FEES 43.95 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: [
1 104/03/07 JK 09/30/07
[OWNER: TEL. NO: FI;!MCODfi:
ICLINTON, RICHARD (626) 451-5961- [ I
14933 RIO HONDO AV [ I V
ITEMP 917803741 1 ID SCRIPTION OF WORK I
I I IGAS LINE FOR HVAC SYSTEM
[APPLICANT: TEL. NO: 1 1 I
SAME AS OWNER ISPECIAL CONDITIONS:
ICONTRAI
1TEL. NO: I [APPROVALS DATE INSPECTOR SIGNATURE [
ISAME AS OWNER - I I I
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I I [WATER SERVICE I I I
1 I [PLASTIC YIN METAL YIN [ I I
[ARCHITECT OR ENGINEER: TEL. NO: [ I I I I
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LIC. NO: 1 I I I I
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[ I ILAWN SPRINKLERS [ [ [
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IREPORT ID: DPR263 ROUTE TO: BS0508
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76ASS7 08817 11-50 .��- --•-�.- APPLICATION FOR PERMIT
D&P_ARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
it DISTRIC (SRO P ZONEPERMIT NOr
FO APPLICANT O F LL IN r J
PLUMBER }i, RECEIVED BY READY FOR DATE ISSUED
Q"Ap FIRST INSPECTION 7
ADDRESS y 0
Fq BUILDING 4
CITY TEL.No. ^ 1 ��AADDRESS •J
COUNTY ®+ P �� OCALITY
LICENSE NO. EXPIRES 6 ,.�
NEAREST
PERMIT FEES CROSS ST.
NUMBERTYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET(TOILET) 0.50 $ ® ADDRESS 56 A
BATH TUB @ 0.50
CITY TEL No.
SHOWER 0.50 1 HEREBY ACKNO LEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.5D APPLICATION AND TE THAT THE ABOVE IS CORRECT
AND AGREE To CO Y WITH ALL COU RDINANCES
KITCHEN SINK @ 0.50 a AND STATE I AWB R ULATING PLU NG.
I CERTIFY THAT 1 POSSESH TH ABOV VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY Ly3ENSE. OR 1 TH EGAL OWNER
GAS SYSTEM UTLET9 0.5D OF THE RESIDENT[ 2 ERT C BED E.
SIGNATURE OF I I �,
WATER HEATER @ 0.50 PERMITTE
SLOP SINK @ D.SD INSPECTION RECORD
FLOOR SINK @ 0.50
FLO13R DRAIN @ 0.50 /
DISHWASHER@ 0.50 r��8'S"' ca)
DRINKING FOUNTAIN' @ 0.513 ^ —
URINAL @ O.•513 4
HOUSE SEWER @ 0.50 Z
MISCO
ELL EOU9
ax
P t O
APPROVALS
DATE INSPEOTOR•S NAME
ROUGH PLUMBING .rte
GAS PIPING A Qr✓�• '
GAS VENT V r
CESSPOOL @ I,OO CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.013SEWER
PERMIT I I.G GAS TEST
• UTILITY CO.NOTIFIED
TOTAL FEE FINAL /V W
WORKER'he�OMP,�tfifilcONDECLARATION 2"026 APPLICATION FOR PLUMBING PERMIT lJ
78A687A
I hereby affirm that I have a dMt)fricate of consent to self insure,
or a certificate of Worker's Compensation Insurance,or a certified
copy thereof(Sec.3800 Lab.C.)
10-0489604 CNA INSURANCE COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV.
Policy N Company
Certified copy is hereby furnished.
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
n
44+ Certified copy Is filed with the county building inspection ADDRESS
4Q 31 Rio 74ontin
department. NUMBER FIXTURE OR ITEM ® FEE
LOCALITY Tem le City
Date 1 1-15-90Applicant Owen Bros. Plumb. WATER CLOSET
NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST.
COMPENSATION INSURANCE BATH TUB ASSESSOR
(This section need not be completed if the work Involved by the SHOWER MAP BOOK PAGE PARCEL
permit Is for one hundred dollars($100)or less.) OWNER
I certify that in the performance of the work for which this permit LAVATORY L & W HOME CENTER
Is issued, I shall not employ any person in any manner so as toMAIL
SINK
become subject to the Workers'Compensation Laws. SQ ADDRESS 88 12 Las Tunas Drive
DISWASHERCITY . .
��n*A TELNOS 18-287-] 1 1
�
Date Applicant CLOTHES WASHER
NOTICE TO APPLICANT: If, after making this Certificate of CONTRACTOR
Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS
provisions of the Labor Code,you must forthwith comply with such 4265 N. Baldwin Ave.
provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM
LICENSED CONTRACTORS DECLARATION CITY TEL.NO.
I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER 818-443-00 8 d
(commencing with Section 7000)of Division 3 of the Business and STATE GAS SYSTEM OUTLETS LICENSE NO. 23] ]!} 1 LIC. C36-20-16 U
Professions Code,and my license is In full force and effect.
5 PER YSTEM DISTRICT NO. SED BY O
License.Number 231 741 Lic.class,06-20-16 ��
U
FINAL VALIDATION W
Owen Bros. Plumb 11-15-90 DATE p_
Contractor nate CO)
FINAL Z
I am exempt under Sec. BY
B.&P.C.for this reason
Date:
Plan check fee ►
•
Signature PLUMBING PERMIT ISSUING FEE$ /3 M
❑ TOTAL FEE C2,? M cz
Plan check applicant `"�' a
SINGLE FAMILY FICC I°S
HOME OWNER-BUILDER DECLARATION Name7. °DO
affirm that I am exempt from the Contractor's License Law �;
for the following7031.5, Business and Professions Address
reason(Section I i T 1=11L
Code):
❑ city Tel.No. TOTAL 28 ® 00
I,as owner of the property,will do the work and the structure
Is not Intended or offered for sale(Section 7044, Business CHECK 28.130
and Professions Code).
CHANGE °CI[j
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, 130013-13001 11/20/90
Civ.C.) 3938 1Ali 8°+?
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
representativ s of this County4o enter upon the above-mentioned
q rt fo action Pul o ,
SEE REVERSE FOR EXPLANATORY LANGUAGE
ature of Per ee Date