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Home My Public Portal About5595 ROSEMEAD BLVD_Plumbing__ 70A667 (CE-BIT)- 5n3 T E M, P L E C I T Y ammo m e m ✓Q APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION MAKE CHECKS PAYABLE TO BUILDING Rosemead Las Tunas Drive ADDRESS HARVEY T BRANDT, COUNTY ENGINEER LOCALITY le CityL FOR APPLICANT TO FILL IN (PRINT OR TYPE( NEAREST CROSS ST Same as above NUMBER FIXTURE OR ITEM ® IF�EE/�/� 1{ WATER CLOSET (Toilet) 12 00 OWNER Albertson's Market- MAIL Urinal .49 6 00 ADDRESS ' 1 D Fount. 00 CITY TEL NO 3 LAVATORY 9 00 CONTRACTOR Pangborn Plumbing Corp. SINK 18 00 ADDRESS 1 �ESy�/yy�� 'roadta DISHWASHER ' Is clrUs Angele$o9W37L NO 750-1161 CLOTHES WASHER �' STATE CENSE NO 11331 CLASS C�36 SWIMMING POOL RECEPTOR DISTRICT NO GROUP ZONE ESS D B LAWN SPRINKLER SYSTEM 7r?5 _, /1 U$TqI WATER HEATER �T� INDYP APAPflOVAL pp GAS SYSTEM OUTLETS +r7& / �INSPECTION RECORD t� 5O PERESYSTTEMR 30 BId / s 2 Floor Sinks 96 00 DrainsRAD 000 1 (}arba a Disposal 00 .5 J u,, /rocs: c. J. , o Plan check fee See R..e,s. t �oSA. 6Y0 N. wwPLUMBING PERMIT ISSUING FEE B 4 _v TOTAL FEE 181 0 .rIr IF APPROVALS D T I PECTOR i SIGNATURE Plan Check applicant UNDER SLAB WORK 5 _ Name ROUGH PLUMBING Address GAS PIPING City Tel NO GAS VENT HOT WATER HEATER _ 1 HEREBY AAT THE EDD! THAT I HAVE READ THIS APPLICATION AND STATE THAT THE MOVE ID LAND S AND LAWS E LATIHO PLUMBING FIXTURES WITH ALL COUNTY ORDINANCES AND STATE LAWS Rfi GULATING PLUMBING GAS TEST I HEREBY CEATIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSEDAD REQUIRED BY LOS ANGELES COUNTY AND !TATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER F AND INTEND TO RESIDE IN THE ABOVE DES I R PER" FINAL SIGNATU RE OF PERMITT PEFIMIT VALIDATIONtK M 0 GASH PLAN CHECK VALIDATION CK M 0 CASH 9 3 2xmrn e5 5 D 1 8 1.5 0 `I TswwvC Ice-wal -s/75 APPLICATION FOR PLUMBING PERMIT l BUILDING A SAFETY DIVISION FOR APPLICANT TO FILL IN (PRINT OR 7Y PEI BUILDING `� NUMBER FIXTURE OR ITEM ® FEE ADDRESS 4 WATER CLOSET LOCALITY BATH TUB NEAREST CROSS ST Lac a414E SHOWER OWNER LAVATORY MAIL ADDRESS SINK CITY TEL NO DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR ��LAWN SPRINKLER SYSTEM CITY T L N STAf ELI WATER HEATER e O LICENSE NO OS CLC 04SS 1(J—I GAS SYSTEM OUTLETS 3 00 DISTRICT pNO GROUP Z/OpNE CESSED BY OUTLETS OVER . 0 U 5 PER SYSTEM IND $TRIAL WASE APPROVAL H INSPECTION CORD Z Plan check fee A r PLUMBING PERMIT ISSUING FEE B TOTAL FEE Plan check applicant "t _ Name G APPROVALS DATE IxR Pee roR s oHAr DRe - UNDER SLAB WORK Address ROUGH PLUMBING City Tel NO GAS PIPING �^ IHEREBY ACKNOWLEDGE THAT I HAVE READ TRIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDI MANGES AND STATE LAWS REGULATING HOT WATER HEATER PLUM SI NO I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR PLUMBING FIXTURES LICE.BE0AS REQUIRED BY LOL A ELES COUNTY AND STATE OF GAS TEST CALIFORNIA OR THAT I AM OWNER Of AND INTEND TO RESIDE IN THE ABOVE DES E E L PROPERTY UTILITY CO NOTIFIED SIGNATURE OF PERMITTE FINAL PLAN CHECK VALIDATION Ce M G CASH PERMIT VALIDATION CK M 0 CZ -4-4-7: o tin A'-o -v- ;L I 8 °% 118 °%T 10 5 0 9y 10 � WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT �T I hereby affirm that I have a certificate of consent to self 20-0026 DPW 6/87 1 Insure or a cenrficate of Workers Compensation Insurance 76A667A ILII or a certified copy thereof (Sec 38DO Lab C ) e, COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS a3 Policy NOWL ,1311 Company �tYtK P10r1r Wev �V 1'1 ` Certified copy Is hereby furnishedFOR APPLICANT O FILL IN(PILIN OR TYPE) p Certified copy is filed with the county building inspec- AADADDRESSF1S A0 tion department NUMBER FIXTURE OR ITEM ® FEE LOCALITY `7@ Ge G Dote 6—��c9 App]iS WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORK RS BATH TUB CROSS ST COMPENSATION INSURANCE (This section no"not be completed If the work Involved by SHOWER OWNER /�Gf3e�L`tSo..T` -s the ponnif Is for one hundred dollars($100)or Ives ) 3 LAVATORY MAR ADDRESS I comfy that in the performance of the work for which this permit Is Issued I shall not employ any person in any manner Sim CITY TEL NO so as to become subject to the Workers Compensation Laws DISHWASHER CONTRAC1TOft _ a Date Applicant CLOTHES WASHER NOTICE TO APPLICANT If, after making this Certificate of ADDRESS /6,7 . Exemption, you should become subject to the Workers SWIMMING POOL RECEPTOR CIT, !4J Compensation provisions of the Labor Code you must forth- LAWN SPRINKLER SYSTEM —"4 " 9� r Ory,1r with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO 'W/3CLASS 3(0 LICENSED CONTRACTORS DECLARATION DISTRICT NO BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS 1 (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER v }} and Professions Code and my license s In full force and effect 5 PER SYSTEM FINAL Q VALIDATION a License Number y5Nl3. Llc Class C– O FLooti S7 Q DA 0164W ranst– �ct� n..�dLe, FI Contracts�ect.'+%Ctr Date Fi�7�`6� ol 74.,ac b,by5 B i ❑ I am exempt under Sec Ipso( B 8P C for this reason Plan check fee N Dote Z PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check applicant SINGLE FAMILY .5 HOME OWNER-BUILDER DECLARATION Name wnnT 1 hereby offum that I am exempt from the Contractor's License Address Law far the following reason (Section 7031 5 Business and Professions Code) City Tel No 3W 136.50 ❑ I as owner of the property, will do the work and the 1 ITES structure is not intended or offered for sale (Section , TpTp� 136.50 70", Business and Professions Code) CONSTRUCTION LENDING AGENCY .�X Me5D I hereby affirm that there is a construction lending agency far 00a .00 (Sec performance of the work for which this permit Is Reared (Sec 3D97, Civ C ) Lender s Name 1 6/ 7/85 tender's Address 3831 1 A111�a5S I certify that I have read this application and state that the 01110,above information is correct I agree to comply with all Count' ordinances and State laws regulating Plumbing and hereby authorize reprelentatives of this County to enter upon the a ave-mentlonnedyroperty for Inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE G- 7—cc 9 Signa re of Pe Itt Date r COUNTY OF LOS ANGELES TEMPLE CITY N 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0911100024 BUILDING AND SAFETY-1 LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS BR 62 PG 3 PC 1 5595 ROSEMEAD BL (FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917601802 ENANT SESSOR INFORMATION NUMBER I NEAREST CROSS STREET LAS TUNAS 1 97-031-060 101 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY Cl 115 DRINKING FOONTAIN(S) 1 00 FIX 16 20 17 FLOOR DRAINS) 7 00 FIX 113 40 ISSUED ON PROCESSED BY PIAN BY EXPIRESON K ISUPER A FOODS 19 FLOOR SINS) 25 00 FIX 405 00 11/10/09 SR 11/10/10 1 121 HOSE BIBB(S) 2 00 FIX 32 40 1 OWNER TEL NO 123 INTERCEPTOR(S) 1 00 SYS 16 20 FINAL DATE FINAL BY CODE ISUPER A FOODS (562) 755-3434- 125 LAVATORIES/SINKS 16 00 FIX 259 20 1 r 1 17200 DOMIMON CIRCLE 147 WATER HFATER(S) 1 00 WTH 16 20 COMMERCE, CA 90040 151 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20 IDESCRIPTION OF WORK 52 ADDN OUTLETS > 5 1 00 OUT 4 20 (PLUMBING FOR TENANT IMPROVEMENT GROCERY STORE APPLICANT TEL NO 165 WATER PIPING 2-3 IN 1 00 TOTAL FEES L N 950 55 30 1 I TRULOVE (909) 336-9768- IPO BOX 930 ISPECIAL CONDITIONS I ITWIN PEARS CA 92391 1 1 1CONTRACIOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE I IP R FORMANCE CONTRACTORS (562) 201-3957- 1 114714 SABINE DRIVE LIC NO I (UNDER SLAB WORK ILA MIRADA, CA 90638 808513 B 1 I WATER SERVICE (PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER TEL NO TRULOVE CHRIS (909) 336-9768- ROUGH PLUMBING PO BOX 930 LIC NO W TWIN PEAKS CA 92391 NONE GAS PIPING 14 (GAS VENT I I 1 HOT WATER HEATER IA I�J� PLUMBING FIXTURES LAWN SPRINKLERS I I GAS TEST I I UTILITY COMPANY NOTIFIED I cwv I I I 1GRAY WATER SYSTEM i 1 1 I I IREPORT ID DPR263 ROUTE TO SS0508 1 I I I