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Home My Public Portal About5526 ROBINHOOD AVE_Plumbing__ ,PAS" r7 *-40 APPLICATION FOR PERMIT DEPARTMM OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING 1 WILLIAM J. FOX, CHIEF ENGINEER DISTR15,WO. G'R'08 ZONE — PERMITN FOR APPLICANT TO FILL IN B=IKIVED my Rra PLUMBER VALLEY Boin FvA FrIFW7FP;KIC$N DATE ISSUEDd/ A-DDRM8 900 LAST VAI I Ey Bl-vr). BUILDING CITY ROSEMEAD TIL. No. AT -2-271 0�-- ADDRESS C,OUKWLOCALITY -93M $"<Plftzg 4-aa-5--/ PERMIT FEES CROIro ST. TYPW or vix-ruhz opt tTKm PYlS OWNER MAIL wATKR cLosirmg r (To 'r� O.BO 0 RESS Y 7p- -BATH TU IS 0.50 S 0 Tim- NO. A, SHOWER 0.250 -HAT I HAVE READ THIP LAVATORY WAXH EIABIN — APPLICATION AND WTATW THAT THE AIDOVX 18 CORRECT AND-. � ) O,B0 --5.o AGREE TO COMPLY WITki ALL COUNTY ORDINANCES AND STATE LAWS REGULATING Pi-UM19IN(l. KITCHEN SINK I CQRTIFY THAT t P06811INS THE ASOVK VALID LOS LAUNDRY'nJIN TRAY O.BO At4GKL" CoUtfr-Y LICENSE. OR I AM THE LEGAL OWN[K OF THE RESIDENT] P OPKR'rY DESCRIBED AAOVV- GAS OYST UTLETS (D O.DO 0 SIGNATURE OF WATER HKATER O.DO PKRMI SLOP BINK !R 0.50 INSPE=ON HECOIR I FLUOR SINK 0.50 FLOOR DRAIN 0.3 DISHWASHER 0.5 DRINKING FOUNTAIN 0.80 URINAL 0.80 HOUR[SEWER 0.150 ff 0 APPROVALO DATE, lKsrwlcTopV9 KAhm 1116,dH PLUMBING GAS PIPING GAIS CESSPOOL 1.06 CK"FlOOL SEPTIC TANKS I 60TIC TANK - DRAIN ( ) PIT 1.001 1 SEWER PERMIT . . . . . . . . . . . . I.OQ G" TEST UTILITY CO. NOTIFIED TOTAL FEE Q FINAL- WORKERS'COMPENSATION DECLARATION 204026 DPW vw APPLICATION FOIA PLUMBING P E RM I T I hereby, affirm that I have a certtflcate of consent to se}f In- 7&&WA sure,or a certtflcate of Workers'Compensation Insurance,or a certtfled copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Polley No. Company ❑ Certified copy Is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Certified copy Is filed with the county building Inspectlon AbDRESS -2, -NUMBER F(TURE OR ITEM LOCALITY r, department. � � Date Applicant WATER CLOSET(TOILET) __ti d�5� CERTIFICATE OF EJO=MPTION R20M WORKERS' BATH TUB - • COMPENSATION INSURANCE SHOWER OWNERS 1_ o (This section need not be completed If the work Involved by MAIL the permit Is for one hundred dollars (;100)or lees.) LAVATORY ADDS -+4.Q sf I certify that In the performance of the work for which this per- SINK CATTY TEL NO. mit Is Issued, I shall not employ any person In any manner to as to become sub[ect to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Data Applicant CLOTHES WASHER ADD R1S5 NOTICE TO APPLICANT: If, after making this Certtficate of Ex- emption,you should become subject to the Workers'Compen- SWIMMING POOL RECEPTOR QTY TEL NO satlon provlslons of the Labor Code,you must forthwith comp- 1-AWN SPRINKLER SYSTF,MS ly with such provisions or this permlt shall be deemed revok- STATE UC- 0. WATER HEATER UOTISE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm That I am licensed under provisions of Chapter GAS SYSTEM OUTLETS �� 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license Is In full force and ef- 5 PER SYSTEM FINAL 1VALIDATION few• HOSE BIB DATE —` d License Number LIc. Class 0 FINAL P Contractor Data BY cc O I am exempt under Sec. B.BP.C- for this reason Plan check fee w Date: PLUMBING PERMIT ISSUING FEE; Signature TOTAL FEE r SINGLE FAMILY HOME OWNER-BUILDER DECLARATIQN Plan check applicant A•C•T.i I hereby affirm that I am exempt from the Contractor's License Name 4�. ? Law for the following reason- (Sectlon 7031.5, Business and Professions Code): Address i ITEMS 1, as owner of the property, will do the work and the city Tel. No. /� structure Is not Intended or 044 offered for*ale(Section 7 , TOTAL 41 - 85 Business and Professions Code). Poo. .00 CONSTRUCTION LENDING AGENCY C .0I I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit Ip Issued (Sec. 3097, Clv. C.). Lender's Name a 42683 1 PML-022 Lender's Address I certt#y that I have read this appJlcatlon 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 abo o-mentloned property for Inspection purposes. —V 3 q Q CU SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Pe Ittee / Date T 'WQRIER'S COMPENSATION DECLARATION20002E DPW o/(Q Therapy affirm chat I have a,certlllcate of-consent td calf Insure, 79ABC7 APPLICATION FOR PLUMBING PERMIT �J or a certlflcate of Workers,Compensatlbn Insuranoe, or a certlfled copy therebf(Sec. 3800 Lab.C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT. OF PUBLIC WORKS DIV. Poacy No. Company ❑ CsRtM1ed Dopy Is hereby turrrietred. FOR APP_cANT TO FILL IN(PRINT OR TYPq CertNed copy In sled with the county buildtp Inspection departrnerrL NUMBER FD(TURE OR rFE1A o FEE LOCALITY Dade Applbarrt •\ WATER CLOSET / NEAREST CROSS ST. CERTIFICATE OF EXEMFTION FROM WORKERS' BATH TUB p/ COMPENSATION INSURANCE MAP BOOK SQ f0 PAGE O� PAF1C>Z QD (rho section read not be oompWod K the wort Involved by the SHOWER parralt is for one hundred dollar($100)or kmm) LAVATORY OWNER �1✓ I oerdfy that In the performance of the work for which this permit ry Is Issued, I shall not employ any person In any manner so as togplK MAILADD6�D E �� f}fJ� become subject to the Workers' Oompensatlon Laws. Di8WASFER CITY MvAiAovi A eA - TEL Nof pK�362-64 7 Data APpilcant CLOTHE8 WASHER NOTICE TO APPLICANT: It, 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 provlabna or this permtt shall be deemed revoked. LAWN SPR NKLER SYSTEM , 2� LICENSED CONTRACTORS DE(.-ARATION [TTY Ta-NO. I hereby affirm that I am licensed under provisions of Chapter 9 WATER BEATER STATE (commencing with Section 7000) of Dtvlalon 3 of the Business and � (V� ProfsaaJona Code,and my license Is In full force and effect GAS 6`BTEM OUTLETS LICENSE NO. CLASS OUTLETS OVER DISTRICT NO. PROCESSED BY [[ 6 PER SYSTEM Lkwoo Number LIC.Claae H DATE %F L(DATION W a Contractor Dale FrrAL XCT.T Z F-1I am exempt under Seo. BY - 3 119.10 — B.BP.C.for this reason Plan check fee ' 1 ITEM Data. PLUMBING PERMIT ISSUING FEF i TOTAL 119_ 10 ❑ TOTAL FEE � � d f 119.113 plan&wKk appkw—rt SWGLE FAMILY HOME OWN01-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.6, Quelness and Professions Address 007t]-13301 yr /94 Code): City Tel. No. 3362 1 9"-1• 1,as owner of the property,will do the work and the structuro Is not Intended or offered for sale (Section 7044, Business and Profaasions Code). , CONSTRUCTION LENDING AGENCY I hereby affirm that them Is a oonstructlon lending agency for the performance of the work for which this permit Is Issued (Sec. 3097, Ctv. C.) Lenders Name Lenders Address I certify that I have read this applloatlon and state that the above , Information Is conn. I agree to compty with all County ordinances and State laws regulating plumbing, and hereby authorize representattves of this County to enter upon the above-mentioned property for Inspection purposes SEE REVERSFE FOR EXPLANATORY LAHOIIAGE Signature of Perinittee Date l J COUNTY OF LOS ANGELES TEMPLE CITY iR 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0406290019 a BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 ►' PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID 9.Ur-LDING ADDRE�-S: TR: 16957 LT: 83 5526 ROBINFAM AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802718 ASSESSOR INFORMATION NUAM: NEAREST CROSS STREET: BALDWIN 8586-018-005 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B3 LOCALITY-: TEMPLE CITY-, C 07 BATHTUBS/SHOWERS 1.00 FIX 16.20 25 LAVATORIES/SINKS 1.00 FIX 16.20 . 45 WATER CLOSET/UZINAL 1.00 FIX 16.21) 06/29/04 JK 12/26/04 TOTAL FEES 76.35 OWNER- TEL. N-0: FINAL DATE— FIZ BY. CODE: CHHOR SIV H (626) 357-6017- 6.�� 5526 ROBINHOOD AV TEMP 917802718 DEscmpuoN OF WORK, PLUMBING FOR NEW,BATHROOM APPLIMT: TEL. NO: HL14NG (626) 452-9190- SPECIAL HUANG TENG-TSAN (626) 452-9190- - 5423 hALIFAX RD LIC. NO UNDER SLAB WORK TEMPLE CITY, CA NONE WATER SERVICE ARCHITECT OR EWMMR: PLASTIC Y/N METAL Y/N LIC. N0: 0 GAS VENT ROT WATER HEATER PLUMBING FIXTUT�� t-AWN SPRINKLERS GAS TEST Cwv GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508