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Home My Public Portal About5751 RIO HONDO AVE_Plumbing__ 76 A 667—CE 817 468 APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN(PRINT OR TYPE) NEAREST CROSS ST. NUMBER FIXTURE OR ITEM EACH FEE 7 OWNER ,` WATER CLOSET 1.50 MAIL BATH TUB 1.50 ADDRESS SHOWER 1.50 CITY + TEL. N til 4P ~ LAVATORY 1.50 CONTRACTOR SINK 1.50 ADD DISHWASHER 1.50 CITY L TEL. N / CLOTHES WASHER 1.50 STATIiLIC LICENSE NO. 0' CLASS 3� SWIMMING POOL RECEPTOR 1.50 DISTRICT yQ. GRO P ZONE PR EBBED BY LAWN SPRINKLER SYSTEM 2.00 00 0 WATER HEATER 1.50 INDUSTRIAL WASTE APPROVAL Z GAS SYSTEM OUTLETS 1.50 APPECTION RECORD OUTLETS OVER 30 � 5 PER SYSTEM I 1, O. U) z Plan check fee 25% of above. See reverse. PLUMBING PERMIT ISSUING FEE 8 2 00 TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE Plan check applicant UNDER SLAB WORK Mame ROUGH PLUMBING Address GAS PIPING GAS VENT City Tel. No. HOT WATER HEATER 1 HEREBY ACKNOWLEDGE THAT 1 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. 1• HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO 17 RESIDE IN,THE ABOVE DE RIBED RESIDENTIAL P OPE Y. / FINAL G SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL E OF PERMITTEE PERMIT VALIDATION CK. M.O. ASH PLAN CHECK VALIDATION CK. M.O. CASH 5D 3.50;" 4 WORKERS' I have aSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I have a certificate of consent to self in- 20-0026 DPW�� stLre„s$r a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Policy No. • Company Cbrtified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ..m - 1, Certified copy is filed with the county building inspection ADDRESS sXs,-- department. ,s-•department. NUMBER FIXTURE OR ITEM FEE LOCALITY r'O Date Applicant WATER CLOSET(TOILET) NEAREST' CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST , /,.., r COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed If the work Involved by MAIL the permit is for one hundred dollars(;100 or loss.) LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK CITY 7EL. NO �C mit is issued, I shall not employ any person in an anner so as to becomes jec to the Workers'Compen io laws. DISHWASHER CONTRACTOR tno Date Applicant %�� CLOTHES WASHER ADDRESS 5-' NOTICE T A LICANT: If, after making this Certificate - emption,you should become subject to the Workers'Cc m n- SWIMMING POOL RECEPTOR CITY TEL.NO safion provisions of the Labn. Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE LIC. .: ed. WATER HEATER LICENSE NO. c JG . CL45SZ# LICENSED CONTRACTORS DECLARATION DISTRICT NO. r PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS / !/f 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER %-%—.11•• /f and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINALr fect. -9s�Lf�� /rr1� HOSE BIB DATE 5-41A V�_--r ��ION License Number r Lic. Class 2. O �i FINAL L T i EM--J sq0 Contractor � � Date = _ • •'�4 0 o 91 ❑ I am exempt under Sec. B.&P.C. for this reasonW Plan check fee , t:ilhl4!it °,_& MR. PLUMBING PERMIT ISSUING FEE$ Z Signature Oma``- C' TOTAL FEE 0(±33-30-1_1 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant 4;37 4,:, 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 I, as owner of the property, will do the work and the City Tel. No. 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 11110.above information is correct.I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize r sentatives of this County to enter upon the a v -men on T!pr erty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee ate COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0302210007 ' ENILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL D: FEES PAID BUILD-ING ADDRESS: TR: 6561 LT: 1 UN: .003 5751 RIO HONDO AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802433 ASSESSOR INF IO NUMBER: NEAREST CROSS STREET: WORKMAN 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 1.00 FIX 16.20 11 CLOTHESWASHER(S) 1.00 FIX 16.20 ISSUED 0 R XP . 21 HOSE BIBB(S) 1.00 FIX 16.20 02/21/03 JK 08/20/03 . 25 LAVATORIES/SINKS 1.00 FIX 16.20 OWNER: TEL. N0: 45 WATER CLOSET/URINAL 1.00 FIX 16.20 F N9hDA, FINAL B CODE: ANDREWS DANIEL P (626) 285-3651- 47 WATER HEATER(S) 1.00 WTH 16.20 5751 RIO HONDO AV 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TEMP 917802433 TOTAL FEES 141.15 DESCRIPTION OF WORK � PLUMBING FOR ADDITION APPLICANT: TE - O: SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATUR SAME AS OWNER - LIC. NO UOER PAB WORK D i WATER-SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR G 0: ROUGH PLUMBING LIC. N0: GAS PIPING S VENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS S UTILITY COMPANY NO ED CWV GRAY WATER SYSTEM REPORT !D: DPR263 ROUTE TO: BS0508