HomeMy Public PortalAbout5336 ROSEMEAD BLVD_Plumbing__ 76A667 Des 17 11-50 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY Imfta ARMmqk
COUNTY OF LOS ANGELES PoLuffitsIN
WILLIAM J. FOX, CHIEF ENGINEER
DISTRICT NO. GROUP ZONE RMI NU.
FOR APPLICANT TO FILL IN
PLUMBE i` ♦ RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION _ 3
ADDRESS v
BUILDING
CITY ' ' .—% ADDRESS t' J
C7 I
COUNTY LOCALITY
LICENSE NO. EXPIRES -
NEAREST
PERMIT FEES CROSS 5T.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET(TOILET) @ 0.50 $ ADDRESS
BATH TUB @ 0.50 CITY TEL. No.
SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE I5 CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING.
1CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR-1 AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPER7,Y DESCRIBED ABOVE.
GAS SYSTEM OUTLETS @ 0.50 fjI
SIGNATURE OF
WATER HEATER @ 0.50 PERMITTEE a _ ,
SLOP SINK @ 0.5D INSPECTION RECORD
FLOOR SINK @ 0.50 /
FLOOR DRAIN @ 0.50
DISHWASHER @ O.SO
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50 '-`
7y, Q
HOUSE SEWER @ 0.50 G� ?
MISCELLANEOUS
O
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
�I GAS PIPING
GAS VENT
�. CESSFOOL @ 1,00 $ CESSPOOL. _
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT I 1.00 GAS TEST
UTILITY CO. NOTIFIED
TOTAL FEE $
FINAL
76AF67C (CE-817B) -9/75
APPLICATION FOR PLUMBING PERMIT
BUILDING AND S F TY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Z2 Af
NUMBER FIXTURE OR ITEM @ FEE ADDRESS ^"
WATER CLOSET 13.00 LOCALITY
BATH TUB NEAREST
CROSS ST.
SHOWER OWNER
9 LAVATORY MAIL
ADDRESS
SINK CITY TEL. NO.
DISHWASHER CONTRACT.O
s
CLOTHES WASHER
ADDRESS e 0�"-f '
SWIMMING POOL RECEPTOR
NO.a�1
LAWN SPRINKLER SYSTEM CI Y. TEL./^
STAA
LIC
WATER HEATER LICENSE NO.2 /^ 3J� CLASS o
/ DISTR CT NO. GROUP ZONE PRESSE BY V
GAS SYSTEM OUTLETS
OUTLETS OVER `0"' y O"
5 PER SYSTEM INDUSTRIAL w
WASTE APPROVAL �
INSPECTION RECORD
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBINGc 7 ,
City Tel. NO. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER ?
PLUMBING.
I HEREBY CERTIFY TM T I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES G�` d6(v
LICENSED AS REQUIRED LOS ANGELE COUNTY AND STATE OF GAS TEST �,1,✓� fe
CALIFORNIA OR THAT I M THE LEGAL �R OF, AND INTEND TO w,
RESIDE IN THE ABOVE SC I EO RESIO L P OPERTY. UTILITY CO. NOTIFIED
�.7 ural,
SIGNA TU RE
OF PERMITTE FINAL cK: j .g'
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CASH
7604ZAN, 2 5 i 16.50 `
✓ .
' C
76A667A ICE 8178)- 1 1/76
,-.tPPLICATION FOR PLUMBING PERMIT
MIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS
�j � ���
WATER CLOSET LOCALITY
NEAREST A /J
BATHTUB CROSS ST. r
SHOWER OWNERt
LAVATORY MAI L
ADDRESS
SINK CITY TEL.NO.
DISHWASHER CONTRACTOR
CLOTHES WASHER r
ADDRESS
SWIMMING POOL RECEPTOR
CITY ���7r� TEL.NO. ~g-7f:00
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER
LICENSE NO. � CLASS Gig
GAS SYSTEM OUTLETS DISTRICT NO. I GROUP ZONIJ PR VESSED BY
OUTLETS OVER L:�— (9 C, C
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD a .
z?7 0
Lu
�=r
u
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check applicant
APPROVALS DATE INSPECTOR'S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel.No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES I9
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE
LEGAL OWNER OF,AND INTEND TO RESIDE E BOVE DESCRIBED RESIDENTIAL GAS TEST
PROPERTY. � UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE FINAL /, n s •��� �`,�!> `•` ,�.-<,'I
,'�.� i
PLAN CHECK VALIDATION' CK. M.O. CASH PERMIT VALIDATION cK. M.O. CC'ASH
991�J 14 5 0 7.50a
7EAS67 17 5-50 10 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY PLUMBING
���g'
COUNTY OF LOS ANGELES
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT,NO. GROUP ZONE PERMIT NO.
/O
PLUMBER (� _ ( RECEIVED BY READY FOR DATE ISSUED
7 FIRST INSPECTION
ADDRESS 611 9 ♦� 4:•..�
%0166'' BUILDING
CITYadj TEL. NO. ADDRESS
COUNTY LOCALITY
LICENSE NO. EXPIRES
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET (TOILET) Q 0.50 S 1 ADDRESS 19A 7
BATH TUB @ 0.501 CITY TEL. NO.
SHOWER @ 0.501 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING PLUMBING.
KITCHEN SINK @ 0.50 I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
LI GAS SYSTEM--,,I-OUTLETS @ 0.50 I SIGNATURE OF f r
WATER HEATER @ 0.50 I PERMITTEM a:! ` '4 '-Yy .4,,,�.�`
SLOP SINK @ 0.501 INSPECTION RECORD
FLOOR SINK @ 0.50
1 1
J FLOOR DRAIN @ 0.501
_ J DISHWASHER @ 0.501
J DRINKING FOUNTAIN @ 0.501
URINAL @ 0.501 (� J
HOUSESEWER @ 0.501 I a
MISCELLANEOUS I I C7
I�J
I
APPROVALS
I� DATE INSPECTOR'S NAME
i
1 I ROUGH PLUMBING
GAS PIPING
1 1 GAS VENT
CESSPOOL @ 7.00 II I CESSPOOL �I
ISEPTIC TANK: SEPTIC TANK
I DRAIN ( ) PIT ( ) @ 1.00 I SEWER
PERMIT . I I.00 GAS TEST
UTILITY CO. NOTIFIED I"
TOTAL FEE $
6
FINAL
WORKERS'COMPENSATION DECLARATION 76A667A
I herkby aifir1n that I have a certificate of consent to self CE 617 (2-60) APPLICATION FOR PLUMBING PERMIT {�
insure,or a certificate of Workers'Compensation Insurance,or (J
a certified copy thereof(Sec.3800,Lab. .) �. A
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company
Certified copy is hereby fur shed. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
Certif' d copy is filed wit t t county ' di i s
NUMBER FIXTURE OR ITEM • FEE ADDRESS
LL 1Yty WATER CLOSET LOCALITY
Ae
,-D te; ApplicanI NEAREST
BATH TUB CROSS ST. e
CERTIFICATE OF EXEMPTION FRO
COMPENSATION INSURANCE
SHOWER OWNE
LAVATORY
MAIL �.3
(This section need not be completed if the work involved ADDRE (rte y
by the permit is for one hundred dollars ($100) or less.) SINK CITY EL.N l a0
I certify that in the performance of the work for which this DISHWASHER v /''/ V
permit is issued, I shall not employ any person in any manner CONTRACTOR L,. fr
so as to become subject to the Workers' Compensation Laws. CLOTHES WASHER �/1// �„/ 0
ADDRESS
Date Applicant SWIMMING POOL RECEPTOR U
NOTICE TO APPLICANT: If, after making this Certificate of CITY, ' TEL.N >,/ LU
Exemption, you should become subject to the Workers' LAWN SPRINKLER SYSTEM f a�
P J STATE 1 LIC. /
Compensation provisions of the Labor Code, you must forth- LICENSE N . 7�.)3 CLASS —
with comply with such provisions or this permit shall be WATER HEATER
DIST NO. PRC)CESS
deemed revoked. GAS SYSTEM OUTLETS
LICENSED CONTRACTORS DECLARATION OUTLETS OVER
1' I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM
/9 (commencing with Section 7000) of Division 3 of the Busi- FINAL �r �} o Q� VALIDATION
ness and Professions Code, and my license is in full force and DATE r ((J�
r effect. s
FINAL
License Numb Lic.Class �!� BY
Contracto Date M 0
\\❑ I am exempt from the licensing requirements as I am a Plan check fee
licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$
acting in my professional capacity (Section 7051, Bus-
iness and Professions Code). TOTAL FEE
:QP 137,7A
or Reg.No. Date Plan check applicant
0 0 0 0 0 5
HOME OWNER-BUILDER DECLARATION
Name I o 0 1 0.00
I hereby affirm that I am exempt from the Contractor's Address
License Law for the following reason (Section.7031.5, Busi- City Tel.No. 0 0 0 1 Q,Q Q X0
ness and Professions Code):
13 I, as owner of the property, am exclusively contracting 7 2 3-80
with licensed contractors to construct the project
(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 SEE REVERSE FOR EXPLANATORY LANGUAGE
ordinances and State laws regulating Plumbing,.and hereby
authori a representatives of is Co nt to enter upon the
above tinned proper rns c o pose
Signature of Permittee Dat
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0403010017
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
ON FILE 5336 ROSEMEAD BL
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SGAB CA 917762211
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
5388-010-001 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H4 LOCALITY: SAN GABRIEL, C
25 LAVATORIES/SINKS 1.00 FIX 16.20
TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
03/01/04 VG 08/28/04
OWNER: TEL. NO: F FINAL BY: CODE:
CHANG, KEH YAUN (626) 927-9755-
125 N. ALHAMBRA AVE. , t`
MONTEREY PARK 91775 DESCRIPT� N K
REPLACE EXISTING SINK
APPLICANT: TEL. NO:
HSU (626) 236-8005-
616 N. OLIVE AVE. SPECIAL CONDITIONS:
ALHAMBRA, CA 91801
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
HSU, GEORGE (626) 236-8005-
616 N. OLIVE AVE. LIC. NO UNDER SLAB WORK
ALHAMBRA, CA 91801 383572 B
WATER SERVICE
_ PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TEL. NO:
- ROUGH PLUMBING
LIC. NO:
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
UTILITY COMPANY NOTIFIED
CWV
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1102070001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
(LEGAL ID: FEES PAID BUILDING ADDRESS:
ON FILE 5336 ROSEMEAD BL
1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SGAB CA 917762211
ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: OLIVE
15388-010-001 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, CI
1 105 BACKFLOW DEVICE(S) 1.00 DEV 16.30
TENANT: I11 CLOTHESWASHER(S) 1.00 FIX 16.30 IISSUED ON: PROCESSED BY: PLAN BY:
IGO GO SPA 117 FLOOR DRAIN(S) 1.00 FIX 16.30 102/07/11 SR 1
1 121 HOSE BIBB(S) 2.00 FIX 32.50 1 1
OWNER: TEL. NO: 125 LAVATORIES/SINKS 7.00 FIX 113.90 IFINAL DATE FIN Y: CODE:
IYOU, JING (213) 392-2293- 141 TRAP PRIMER(S) 1.00 SYS16.30 I 1
15126 ROSEMEAD BLVD. 145 WATER CLOSET/URINAL 1.00 FIX 16.30 "fit ��I
ISAN GABRIEL CA 91776 147 WATER HEATER(S) 1.00 WTH 16.30 IDIESCRIPTION OF WORK
1 151 LOW PRS GAS 5 OUTLET 2.00 SYS 32.50 (TENANT IMPROVEMENT PLUMBING
1 TOTAL FEES 304.50 1
APPLICANT: TEL. NO:
ICHIANG, SOLON (213) 392-2293-
15126 ROSEMEAD BLVD. 1 (SPECIAL CONDITIONS: 1
ISAN GABRIEL CA 91776 1 1 1
(CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE I
ITIM 0 HALE PLUMBING CONTRACTOR (323) 855-8136- 1 1 I
11555 N AVENUE 46 .LIC. NO 1 1UNDER SLAB WORK I
ILOS ANGELES, CA 90041 689391 C36 1 I� I
1 I WATER SERVICE I 1 I
1 I (PLASTIC YIN METAL YIN I I I
1ARCHITECT OR ENGINEER: TEL. NO: I I I I
ICALLAHAN, DAVID (626) 466-8500- 1 (ROUGH PLUMBING 1 1 1
11024 S. CALIFORNIA ST. LIC. NO: 1 11 I 1
ISAN GABRIEL, CA 91776 NONE 1 IGAS PIPING 1 I 1
I I I I I I
I I IGAS VENT I I 1
I I I I
I IHOT WATER HEATER 1 1
I I (PLUMBING FIXTURES 1 I I
I I (LAWN SPRINKLERS I I I
I I I I I I
I I IGAS TEST I 11 11
I
I I 1UTILITY COMPANY NOTIFIEDI I I
I ICWV
I (GRAY 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 I I I I I
I (REPORT ID: DPR263 ROUTE TO: BS0508 I I I 1
I I I I I I
I