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HomeMy Public PortalAbout5318 ROSEMEAD BLVD_Plumbing__ CE 813A i CE 817(R�V.6/781 ©5 � ` 4, � �� iti;� L� L APPLIN FOR PLUM9n NG PERMIT" COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ADDRESS NUMBER FIXTURE OR ITEM @ FEE WATER CLOSET •LOCALITY NEAREST BATH TUB CROSS ST. t. OWNER SHOWER LAVATORY MAIL ADDRESS SINK CITY TEL.NO .'GC DISHWASHERo CONTRACTOR CLOTHES WASHER O� SWIMMING POOL RECEPTOR l/ �... CITY TEL.NO.C� �. 0 LAWN SPRINKLER SYSTEM STATE / LIC. WATER HEATER ^v' d LICENSE NO. l` CLASS C"_ w GAS SYSTEM OUTLET APPROVALS DATE INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM IN ROUGH PLUMBING }} � GAS PIPING GAS VENT u C3 HOT WATER HEATER p0 I PLUMBING FIXTURES C, GAS TEST � Plan cher lw UTILITY CO.NOTIFIED [� TNG PERMIT ISSUING FEE$ all TOTAL FEE U FINAL Plan check applicant PLAN CHECK VALIDATION ' Name Address .'?029,7A City Tek No. { Q Q Q o Q Iz IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE 2 O O ' O THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 00. AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS O O 1 0'O 0�"� C REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE q .ry {� LEGAL OWNER OF.AND I TH�IDE57ED ABOVESIDENTIAL O v I f'�V 0 PR PERMTT. IGNATU RE OF"PER ITTEE DISTRICT NO ➢ OCPESSED INDUSTRIAL WASTE APPROVAL I COMPENSATION DECLARATION APPLICATION -FOR PLUMBING PERMIT I,he ,� that 1 have a certificate of consent to self in- 20-0026 DPW 4/87 76-0026 `IUI ?'sure,or a certificate bf Workers'Compensation Insurance,or a CE 817(REV. 8/86) certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT..�OF PUBLIC,WORKS Policy No. Company S�'ia TE FG.vQ .. ' Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspection ADDRESS S3 Jy J/. Ro fglr' department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY F q 14 r� 1, WATER CLOSET(TOILET) qb �^ 1 Lt r Date / Applicant tT�� 7 Po/Ud 01 NEAREST CROSSST.R�S` �An /J/�D/�Dj$/�� CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB f/ COMPENSATION INSURANCE SHOWER OWNER u U (This section need not be completed if the work involved byv'9 MAIL 5, 521P ,52,- C the permit is for one hundred dollars ($100)or less.) LAVATORY a ADDRESS , .J TU 57. I certify that in the performance of the work for which this per- SINK mit is issued, I shall not employ any person in any manner so p2 CITY�L TEL. NQ09r/_)y7 2 as to become subject to the Workers'Compensation Laws. DISHWASHER v K CONTRACTOR O �� i co Date Applicant - - CLOTHES WASHER 6 690 ADDRESS /V NOTICE TO APPLICANT: If, after making this Certificate of Ex- J3 ,5 p P�{/ L Al,, em tion,you should become subject to the Workers'Com en- SWIMMING POOL RECEPTOR o' p y 1 p CITY �? �La po�-V TEL. NO. sation provisions of the Labor Code, you must forthwith camp- LAWN SPRINKLER SYSTEM �1 1 - ly with such provisions or this permit shall be deemed revok- STATE n LIC. /� 1 ed. WATER HEATER /� LICENSE NO. / CLASS U- LICENSED CONTRACTORS DECLARATION l� DISTRICT I� �'// P CESSED Y I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS `S��/ 9,(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER D fe d Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL G V DATION l , pDATE 0. License Number oC (J Lic. Class i 0 Cl cc FINAL cc Contractorl7C/1Py 5�kd 414eli Date "�- � BY O 0 I amexempt under Sec. z 9.350'A � . # ° ° 5 B.&P.C. for this reason Plan check fee , 1'1.01 a 5 0 Date: PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE ° 1.0'1 a 5 0 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant 0 i( 0 8 8 8 1 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 , a1, as owner of the property, will do the work and the City Tel. No. structure isnot intended or offered for sale(Section 7044, Business and Professions Code). pop 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 auth 'ze representatives of this. County to enter upon the abov entioned perty for inspection purposes. j4_ 7 _ 8� SEE REVERSE FOR EXPLANATORY LANGUAGE Sig VUre of Permittee Date I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1305080028 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: 1 5318 ROSEMEAD BL ON FILE IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 SGAB CA 917762211 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1 15388-010-004 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY CAI 1 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 1_ I (TENANT: I TOTAL FEES 44.00 (ISSUED ON: PROCESSED BY: PLAN BY: ILU MOTEL HOLDINGS LLC I 105/08/13 SR 1OWNER: _ TEL. NO: 1 IFINAL AT$ FIN CODE: ISHU MAI LU (626) 242-3558- 1 I�� 18238 BEVERLY DR 1 I ISGAB 917762211 1 SCRI TIO OF WORK 1 IGAS FOR BOILER (APPLICANT: TEL. NO: 1 IPAN, DZEN KUO (626) 284-5721- 11604 S MONTEREY ST ISPECIAL CONDITIONS: 1 IALHAMBRA CA 91801 ICONTRACTOR: TEL. NO: (APPROVALS - DATE INSPECTOR SIGNATURE 1 IDZEN KUO PAN (626) 284-5721- I 1 11604 S MONTEREY STREET LIC. NO 1 (UNDER SLAB WORK ALHAMBRA CA 91801 518456 * 1 IWATER SERVICE 1 _ IPLASTIC YIN METAL YIN 1 1 1 (ARCHITECT OR ENGINEER: TEL. NO: 1 I I I I IROUGH PLUMBING 1 LIC. NO: I I IGAS PIPING I 1 I IGAS VENT IHOT WATER HEATER I- 1 PLUMBING FIXTURES I ILAWN SPRINKLERS 1 IGAS) TEST I I 1UTILITY COMPANY NOTIFIED( 1 1 I 1CWV I I IGRAY WATER SYSTEM I 1 I I I I I I I I I I I I I I I I I I I* ADDITIONAL DATA ON FILE I I I 1 IREPORT ID: DPR263 ROUTE TO: BSO508 ( 1 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS - PL 0508 1303200028 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: _(626) 285-0488 EXT: (LEGAL ID: FEES PAID BUILDING ADDRESS: 1 I ON FILE 5316 ROSEMEAD BL 1 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( SGAB CA 917762211 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1 15388-010-004 101 PERMIT ISSUANCE FEE 27.80 1 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY CAI 1 125 LAVATORIES/SINKS 2.00 FIX 32.40 1 1 (TENANT: 145 WATER CLOSET/URINAL 1.00 FIX 16.20 11SSUED ON: PROCESSED BY: PLAN BY: 1 1 TOTAL FEES 76.40 103/20/13 SR I I I I I (OWNER: TEL. NO: 1 IF i`/{�/'/7�/D�//ATE FINAL BY: CODE: 1823 MAI LU (626) 242-3558- 1 I- �-�✓ '3 ' R" 18238 BEVERLY DR I 1 1 1SGAB 917762211 1 1DESCRIPTION OF WORK 1 1 IBAR SINK , LAVATORIE AND WATER CLOSET i I I I (APPLICANT: TEL. NO: I I I 1YUAN, SAM (909) 980-0358- I 1 I 17234 RAVENSWOOD PL I 1SPECIAL CONDITIONS: I (RANCHO CUCAMONGA I I I I I I I I I (CONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE 1 IFENG CONSTRUCTION CORP (909) 980-0358- 1 1 1 17234 RAVENSWOOD PLACE LIC. NO 1UNDER SLAB WORK 1RANCHO CUCAMONGA CA 91701 677951 * I1 1 I i 1WATER SERVICE 11 1 II PLASTIC Y/N METAL Y/N 1ARCHITECT OR ENGINEER: TEL. NO: I I 1 I IROUGH PLUMBING I I 1 LIC. NO: 1 1 1 IGAS PIPING I I I I I I I IGAS VENT I I 1 I I I IHOT WATER HEATER 1 I I I I I I I I (PLUMBING FIXTURES I I I I I I I 1 (LAWN SPRINKLERS I 1 i I I I I I 1 I IGAS TEST I I I I 1 1 1 I (UTILITY COMPANY NOTIFIEDI I I I I I I I I I ICWV I I I I I I IGRAY WATER SYSTEM 1 I 1 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 I I I I I I I I I I I I I I i 1 1* ADDITIONAL DATA ON FILE 1 1 1 I 1 1 I I i I I I I I I I (REPORT ID: DPR263 ROUTE TO: BS0508 I 1 I I I I I I