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HomeMy Public PortalAbout5745 RIO HONDO AVE_Plumbing__ 76 A 667-CE 817 468 /' APPLICATION FOR PLUMBNG PER;� COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER PADDRESS UILDING BUILDING AND SAFETY DMSION N�. Q� JOHN A. LAMBIE. COUNTY ENGINEER 0 COLEMAN W. JENKINS. SUPT. OF BUILDING OCALITY FOR APPLICANT TO FILL IN(PR NT OR TYPE) EARESST.TROSS NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET 1.50 BATH TUB 1.50 ADDRESS 0s f ! ON SHOWER 1.50 CITY TEL. NO LAVATORY 1.50 CONTRACTOR 1�41L En SINK 1.50 ADDRESS ® a® E DISHWASHER 1.50 CITY TEL. NO CLOTHES WASHER 1.50 STATE LIC LICENSE NO. CLASS SWIMMING POOL RECEPTOR 1.50 *1Qj DISTR CT NC. GROUP ZONE R LAWN SPRINKLER SYSTEM 2.00 �WATER HEATER 1.50 INDUSTRIAL WASTE APPROVAL GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD 0 OUTLETSOVER 5 PER SYSTEM .30 ILU O. Vf z Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE S 1 2 100 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Name ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel. No. HOT WATER HEATER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST PLUMBING. I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED AA LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER IAN. INTEND TO RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL OPERTY. FINAL ' SIGNATURE JACK R. ALLEN, SUPERVISI .G-M CHANICAL ENG'R. OF PERMITTEE PERMIT VALIDATION cK. M.0. CASH PLAN CHECK VALIDATION CK. M.O. CASH 1 nP- 6 5 1 6 FE 5D 3.50- I 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 insure, or a certificate of Workers'Compensation Insurance, 76A667A 'L)I or a certified copy thereof(Sec.`b800, Lab. C.) I COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS 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 inspec- ADDRESS�� ~� N` 0 tion department. NUMBER FIXTURE OR ITEM @ FEE LOCAL TT' _( A\AJ> 1 Date - Appli4ant j • WATER CLOSET NEAREST • CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER ��© (This section need not be completed if the work Involved by pT�O the permit is for one hundred dollars($•100)or less.) LAVATORY DDRESS CM2. i I certify that in the performance of the work for which thisOf permit is issued,I shall not employ any person in any manner SINK CITY 9®� TEL.NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER Gyw _ CONTRACTOR Date applicant CLOTHES WASHER ADDRESS 1 NOTICE TO APPLICANT: If, after making this Certificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers' CITY TEL.NO. Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC, _ deemed revoked. WATER HEATER LICENSE NO. CLASS -LICENSED CONTRACTORS DECLARATION j DISTRICT NO. P ESSED BY I hereby affirm-that I am licensed under provisions of Chapter 9 `' GAS SYSTEM OUTLETS Q J (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER r� and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VALIDATION DATE License Number L•ic:Class FINAL e Contractor Date j BY * s C ❑ I am exempt under Sec. �.J I p 4' L B.&P.C. for this reason 1LC O .1i 1 NF1°+�0 ;' ;Plan check fee ® Cr a ITEM Date: ' PLUMBING PERMIT ISSUING FEE$ Q Signature. TOTAL 4:5 m 60 TOTAL FEE CHECK 45.60 Plan check applicant � ,i.,,- SINGLE FAMILY C�tiPil7E elsl7 HOME OWNER-BUILDER DECLARATION i Name I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and, (.I[I[Itl—LIlI.L if ' Professions Code): Cit C, Tel. No. 822 1 PM 12:03 Lel 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 off irm 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 ordinQnces and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection urposes. �„ SEE REVERSE FOR EXPLANATORY LANGUAGE `� k Signature of Perm ttee Date WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT � 20-0026 DPW 4/90 Y, affirm that I have o certificate of consent to self in- 76A667A y,certi{Icate of Workers'Compensation Insurance,or a copy thereof(Sec. 3800, Lab. / COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Wompany ! is hereby furnished. _ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING » ` 11Srert copy is filed with the county building inspection ADDRESS.cJ �, /�-C.Q ["epartment. f1 / NUMBER FIXTURE OR ITEM @ FEE LOCALITY / �_1 •(/l WATER CLOSET(TOILET) Dote• y_Applicant / NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER NER (This section need not be completed If the work Involved by MAIL r� the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS„y 7 I certify that in the performance of the work for which this per- SINK CITY Z2 TEL.NO. mit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER f�V� TRA OR Mot*pj o -6', �FO Date f CLOTHES WASHER ADDRESS r ICE TOAPPLICANT: If, after makin is Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY L Qr®�i(,��, TE rd� a sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS tr ly with such provisions or this permit shall be deemed revok- STATE ` LIC. ed. WATER HEATER LICENSE NO -*&-U CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. y /PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS ` Gyo 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER 5 PER SYSTEM -Z� VALIDATION and Professions Code, and my license is in full force and ef- FINAL fect. '`^',� / HOSE BIB DATE -g License Number�l-tl-�i-GG Lic. ClassCL ` FINAL 5V Contractor a74(A6 MAU-4 tO Date BY IM ACCT.IT' I am exempt under Sec. 33U3CF 4.�e40 v B.BP.C. for this reason Plan check fee 1 ITEMS w Date: PLUMBING PERMIT ISSUING FEE$ TOTAL 43. 40 � Signature. � i/D TOTAL FEE 'T CHECK 43.40 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant CHANGE ,Op I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and Professions Code): Address 0{Mfj—cM01 3/21/96 I, as owner of the property, will do the work and the City Tel. No. 5439 1 AM 9 50 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 representatives of this County to enter upon the above-mentioned property for inspection purposes. Z", 4 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 0904280007 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: ITR: 6561 LT: 1 UN: .005 I I 5745 RIO HONDO AV 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917802433 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: WORKMAN I I8587-003-007 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 1 I ITENANT: I TOTAL FEES 43.95 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I I I 04/2809 SR 10/25/09 I (OWNER: TEL. NO: I IF NAL DA)E: FI AL BY: CODE: I IALMOITE VIOLETA (626) 291-2449- I I �f �b 15745 RIO HONDO AV I I l ITEMP 917802433 I DESCRI TI N OF WORK I I IGAS LINE FOR HVAC SYSTEM I IAPPLICANT: TEL. NO: 1 I I IRONS HEATING AND AIR CONDITIONING (626) 674-1650- I I I 1367 N. JENITER AVE. I SPECIAL CONDITIONS: I ICOVINA, CA 91724 1 ICONTRACTOR: TEL. NO: 1 1APPROVALS DATE INSPECTOR SIGNATURE 1 IRON'S HEATING AND A/C INC. (626) 674-1650- I 1 I 1367 N. JENITER AVENUE LIC. NO I (UNDER SLAB WORK I I I ICOVINA, CA 91724 910446 C20 I I I I IWATER SERVICE I I I I I IPLASTIC YIN METAL YIN I I I (ARCHITECT OR ENGINEER: TEL. NO: I I I I I I - I IROUGH PLUMBING I I I LIC. N0: I GAS PIPING GAS VENT I I I I I IHOT WATER HEATER I I I I I (PLUMBING FIXTURES I I I I ILAWN SPRINKLERS I I IGAS TEST I I I I I (UTILITY COMPANY NOTIFIEDI I I I ICwV 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 I I IREPORT ID: DPR263 ROUTE TO: BS0508 I I I I I I I I