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HomeMy Public PortalAbout6264-6276 ROSEMEAD BLVD_Plumbing__ .:r WORKERS'COMPENSATION DECLARATION • APPLDCAT0®N FOR PLUMBING PERMIT I hereby 'affirm that I have a ce',•tificatP of consent to self 76A667A , insure, or a certificate of Workers' Compensation Insurance, CE 817(REV 10/81) or a certified copy thereof (Sec 3800, Lab 'C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY &8QQ11088 Company Transamerica Ins. Co. ElCertified copy is hereby furnished BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS ❑ Certified copy is filedpwitcounty bui dinr, ec .6-2* N. Rosemead - tion department NUMBER FIXTURE OR ITEM a FEE/ LOCALITYDate5/15/85 gpp '� WATER CLOSET , / NEAREST CERTIFICATE OF EM WORKERS' BATH TUB CROSS ST •L'On. don. COMPE SAURANCE OWNER, Mr. SMaldinov (This section need not be ompleted if the work involved by SHOWER MAIL the permit is for one hundred dollars ($100)or less.) & LAVATORY N�`12 �QQ ADDRESS Same I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner j SINK ? CITY TEL NO so as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER NOTICE TO APPLICANT If, after making this Certificate of ADDRESS ' East GarveyAvenue - Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR p Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CIT 7821 CA.- 91770 TEL N0280-4201 with comply with such provisions or this permit shall be STATE LIC deemed revoked / d �`3p LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PRfflCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 i1/ GAS SYSTEM' OUTLETS (' J JI (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER ' (f >' and Professions Code,and my license is in full force and effect 5 PER SYSTEM tb / f '} DATEFINA/ VALI ATION u License Number }-14925 Lic Class_ 6 '� "FlS ' �7 FI O CohTAeR h Cadi11i PIbQ. DCt(?. 5/15/85' u ❑ I - am exempt under Sec � N - B&P C for this reason Plan check fee � � , Date PLUMBING PERMIT ISSUING FEE$ 2 2 3&0 A Signature ' TOTAL FEE 2 j # o o a o 0 5 SINGLE FAMILY Plan check applicant ° 0 8 2 5 0 HOME OWNER-BUILDER DECLARATION Name o - 825005 I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031 5, Business and 0 7,02-85 Professions Code) city Tel No ❑ I, as owner of the property, will do the work and the 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 above information is correct I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby author representatives of this County to enter upon the abo - entionedpr pert inspection p rposes SEE REVERSE FOR EXPLANATORY LANGUAGE n i Mt u r6 X P e ittee Date • ''r +� WORKERS'•COMREN$ATION„ APPLPCAT ON, FOR KUMBING PERMIT DECLARATION. , • t I h5 reby affirm that I have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, CE 817(REV 10/81) or a certified copy thereof (Sec 3800, tab C'`) COUNTY OF LOS ANGELES BUILDING AND SAFETY �� A' Policy NNC80011088campanyTransamerica Ins. Co. z Certified copy is hereby furnished tt FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ❑ Certified copy is filed with t county buildm spec- ADDRESS` r tion department NUMBER FIXTURE OR ITEM @ FEE LOCALITY !/1 } ' 5 �� A WATER CLOSET Date /�/ ,pp NEAREST = CERTIFICATE OF E ION F M WORKERS' BATH TUB CROSS ST /' C� COMPEN ON INSURANCE OWNER” Mr. Smald'ino + g SHOWER (This section need not be completed if the work involved by MAIL - the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS Same as, above ^� e I certify that in the performance of-the work for which this - permit is-issued, I shall not employ an erson in an manner SINK F c CITY, - TEL NO .tY ca• �Y P P Y Y P Y 1 c' OO so as to become subject to the Workers'Compensation Laws DISHWASHER , CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE'TO APPLICANT If, after 'making-this Certificate of 7221 Fast Garvey Avenue Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL NO Anni LAWN SPRINKLER SYSTEM 91770 with comply with such provisions or This permit•shall be STATE LIC deemed revoked WATER HEATER c LICENSE NO 13493 • CLASS - LICENSED CONTRACTORS DECLARATION 3 DISTRIC�NO y ROCESSED BY GAS SYSTEM OUTLETS f ! /J/t , I hereby affirm that am licensed'under provisions of Chapter 9 ��6 X001' v tJ (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions.Code,and my license is in full force and effect 5 PER SYSTEM a FINAL VA DATION 02 Fl o'arrS�i,n ks `12 'OO' DATE License Number X4935 Lic Class C-3h oe J - ✓ r a FI O. Cadilli Mg Cowe 5/l5/fi5 , .� j u 1. -S. S:i,nk. r A r� 1 am exempt under Sec a B 8P C for this reason zPlan check fee Date PLUMBING PERMIT ISSUING FEE$ 1.O •5O ' Signature TOTAL FEE, ;P 2 3 8, 1 A Plan check applicant # o o'o 0 0 5 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name o ° 5 2 5 I hereby affirm that I am exempt from,the Contractor's License • Address 0 Law for the following reason (Section 7031 5, Business and ° ° °'5 2 5 0 U Professions Code) City Tel No ' ❑ I, as owner of the property, will do The work and the O 7,0 2-7'8 5 structureis not intended or offered for sale (Section 7044, Business and Professions Code) Rol 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, Gv 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 aut ize representatives of this County to enter upon the a e- mentioned property f inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 4etur%P/eKi t t e Date WORKERS'COMPENSATION DECLARAT'I'ON d APP�pCATp®N ®R PLUMBING PERMIT "a 1 hereby affirm that I have a certifrcate'of,tpnsertt tq self i 7bA667A " /Q ,insure; or a certificate of Workers Cori pevsdtion Insurance, 'I CE 817(REV 10/81) or a certified copy thereof (Sec 3800, Lab C ) . COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No �•TCompany AAM- G. .eA4AYA-VC,+ ., ❑' Certified copy is hereby•furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING'I'lul / � t Certified copy is filed with the county building inspec- ADDRESS tion department C�,�j,.�_, ,��`—/_, + NUMBER FIXTURE OR ITEM @ FEE LOCALITY r. Date 3-�9-'^� Applicant ��VyQSC `7'/ATERCLOSET NEAREST e - CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB - CROSS ST COMPENSATION INSURANCE OWNER (This section need not be completed if the work Involved by SHOWER the permit is for one hundred dollars $100 or less. MAIL P ( I I 'LAVATORY , ADDRESS I certify that in'the performance of the•work for which this , permit is issued, I shall not employ any person in any manner SINK CITY TEL NO so as to become subject to the Workers'Compensation Laws% DISHWASHER COI}TRACTOR Date Applicant ti CLOTHES WASHER ADDRESS NOTICE TO APPLICANT, If,'after making this Certificate of 730 L.9 �T Exemption, you should 'become subject to .the WorkersSWIMMING POOL RECEPTOR p Compensation provisions of the Labor Code, you must forth- CITY jj& O-7o TEL NO LAWN SPRINKLER SYSTEM Do with comply with such provisions or this permit shall be 1 STATELIC deemed;revokedWATER HEATER LICENSE NO 27472 72 CLASS C 2- 7 LICENSED CONTRACTORS DECLARATION DISTRICT PjROCESSED BY I hereby,offum that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER u and Professions Code,and my license is in full force and effect 5 PER SYSTEM FINAL VALIDATION C 1.7 DATE ' V License Number 37 7Z Lir Class Contractor 494NAS' Date BY O ❑ I am exempt under SecLU B 8P C for this reason Plan check fee Z. Date /O ®" .1 729 A PLUMBING PERMIT ISSUING FEE$. Signature TOTAL FEE # 'o o o o,•o.5, Plari check applicant (•o 0;1 650 SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name a -,,o 1-6 5,0-5 I hereby affirm that I am exempt from the Contractor's License Address Low for the following reason (Section,7031 5, Business and Q 32 1 -:7 8 5 Professions Code) City Tel No ❑ ' I, as owner of the property, will do the work,and the structure is not intended or offered for sale (Section 7044, Business and Professions Code) Pr 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 Nome 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 authorize representatives of this County to enter upon the ' above-mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Aig-nature of Permittee Date WORKERS'COMPENSATION DECLARATION hk?FR (C !n �f'� DN FOR PLUMBING MBING PERMIT I hereby affirm that I have a certificate of,` onsent to self 76A667A IT IT L� 6�1 B kl`Yl FOR l!'LSl4JJ ® 9 R1Y0 C insure, or a certificate of Workers' Com ensation In u5,ance, P rs CE 877,(REV 10% 1) or a certified copy thereof (Sec 3800, Lab C )• COUNTY OF LOS ANG-EL'ES" BUILDING AND SAFETY Policy NoC8W 001109&Pcny Transamerica Ins. Co. Certified copy is hereby furnished ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS 627446 Noeth Rosemead tion department NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date 3/5/85 Applicant 6 WATER CLOSET emple .City NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE OWNER (This section need not be completed if the work involved by SHOWER the permit is for one hundred dollars($100)or less.) LAVATORY [ ,� MAIL v I certify that m ADDRESS the performance of the work for which this, permit is issued, I shall not employ any person in any manner SINK CITY TEL NO so as to become subject to the Workers'Compensation Laws DISHWASHER" CONTRACTOR Joseph C di l l ' Plumbing Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT If, after making this Certificate of Exemption, you should become subject to the Workers', SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- - CITY TEL NO with comply with such provisions or this permit shall be LAWN SPRINKLER SYSTEM — STATE LIC deemed revoked WATER HEATER LICENSE NO CLASS — f LICENSED CONTRACTORS DECLARATION DISTRICT NO P ESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS !� (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect 5 PER SYSTEM DATE FINAL p VALIDATI 00 License Number Lic Class v Ix FINA O { Contractor Date BY ! F— U ❑ I LU am exempt under Sec �' �/j�^ y B 8P C for this reason t '',�yi�'b 2 A' z Plan check fee ® Wo,o o o'o 5 — Date PLUMBING PERMIT ISSUING FEE$ Sjj I I$ -'- 82 5 0 Signature TOTAL FEE ' SQ 0 ­ 82506 Plan check applicant SINGLE FAMILY - 0305" 85 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031 5, Business and' - - Professions Code) City Tel No ❑ _ 1 I, as owner of the property, will do the work and the , 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 above information is correct I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby autho representatives of this County to enter upon the abo e- entioned pr p orinspeptn purposes 17/ 3- 17 yA SEE REVERSE FOR EXPLANATORY LANGUAGE Si nature Pe itte Date WORKERS'COMPENSATION DECLARATION All—I!"U` Ali MIlV' FOR Pd41JM65NG PERMT hereF4 affirm* .that I have a•certificate of consent to self 76A667A nsure, or a'certificate of Workers' Compensation Insurance, CE 817(REV 10/91) or a certified copy thereof (Sec 3800, Lob C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY, Policy No Company d, , ❑ Certified copy is hereby furnished y// 4 ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county building inspec- ADDRESS tion department NUMBER FIXTURE OR ITEM @ FEE LOCALITY o Date Applicant WATER CLOSET NEAREST , ,y CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST y OS cji COMPENSATION INSURANCE• ` SHOWER OWNER• © D (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS' I certif that in the performance of the work for which this permits issued, I shall not em loy any person in any manner SINK CITY l 1 i�- TEL NO!! _J13 so as to become subj ct to the rkers' mper satwn Laws C �, DISHWASHER CONTRACTOR Date v pplica CLOTHES WASHER NOTICE TO,APP CANT If, a t aking this Certificate of ADDRESS 6:27M V1674 Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR 77 / Compensation provisions of the Labor Code, you must forth- CITY�j1/Aj/ / �/ TEL NO f lC��6�I LAWN SPRINKLER SYSTEM r with comply with-such provisions or this permit shall,be STATE 2 LIC deemed revoked WATER HEATER LICENSE NO 6 6 CLASS LICENSED CONTRACTORS DECLARATION b DISTRICT NO PitciCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEMWemn�OUTLETS D(/ (commencing with Section 7000) of Division 3_of the Business OUTLETS OVER b and Professions Code,and my license is in full force/and effect 5 PER SYSTEM •FINAL VAL ATION License Number Lic Class r✓ DAT z� 0i F U Contract Date d' ❑ I am exempt under Sec F_ B 8P C for this reason W • - Plan check fee _ Date PLUMBING PERMIT ISSUING FEE$ asZ Signature _ TOTAL FEE SINGLE FAMILY Plan check applicant ' , HOME OWNER-BUILDER DECLARATION Name 6 5 7.4-A I hereby affirm that I am exempt from the Contractor's License Address # e,o 0 0•0 5 , Law for the following reason (Section 7031 5, Business and Professions Code) , City Tel No I o 0 5 a 5 0- 1, as owner of the property,-will do the work and the structure is not intended or offered for sale (Section Do'o 0'5 a 5 05 704'4, Business and Professions Code) CONSTRUCTION 0225-87. 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 jaws regulating Plumbing, and hereby authorize representatives of this County to enter upon the )*ove;e0nf1,onec1 prope�Iorspection urposes _ SEE REVERSE FOR EXPLANATORY LANGUAGE re Permittee D to f 4WORKERS' COMPENSATION DECLARATION t h%eb affirm that I have a certificate of consent to self m- 20-0026 DPW 4/87` APPLICATION FOR.-PL,UMBI N.G PERMIT Y• 76A667A , I sure,or a certificate of Workers'Compensation Insurance,ora CE 817(REV. 8/86) - • U certified copy thereof (Sec. 3800, Lab. C:) IC ' COUNTY OF LOS ANGELES- -DEPT. OF PUBLWORKS ' Rolicy Ejo"'`' Company. F_1' .Certified copy is heieby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ) �, Certified copy is fileo-yv e c �yil nt ct r ADDRESS department. 1// v1 `�� NUMBER FIXTURE ITEM Ca FEE ' _ o LOCALITY Date'/'L �� Applicant �i ! �� 'WATER'CLOSET(TOILET)1. NEAREST j CERTIFICATE OF EXEMPTION FROM WORKERS' ' BATH TUB CROSS ST. 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 less.) LAVATORY ADDRESS 6i I'certify that in the,performance of the work for which this per- mit is issued, I shall not employ any person in any manner so' SINK CITY - � TEL. NO. -7.•t`s� as to become subject to the Workers' Compensation Laws. DISHWASHER ( ~ CONTRACT Date Applicant CLOTHES'WASHER /9w NOTICE TO APPLICANT:If, after making this Certificate of Ex- ADDRESSr �� emption, you should become'subject to the Workers'Compen- SWIMMING POOL RECEPTOR sation provisions of the Labor Code, you*must forthwith comp- 6Z NO> LAWN SPRINKLER SYSTEM ly,with such provisions•'orthis permit shall be deemed revok- STATE t LIC. r+ ed. WATER HEATER LICENSE NO. �' ``-�/� CLASS LICENSED CONTRACTORS DECLARATION - DISTRICT NO. ROC S ED Y -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 5' and'Professions Code,,and my license is in full.force and ef- 5 PER SYSTEM FINALVALIDATION feet. zr - DATE ��jj License Numbert/� Lic. Class 'i d �ilil�l (7U j�:✓;, f'� .'�-F, � FINAL d Contractor iw— ,""Date BY 0 E• 1'am exempt under Sec. ------ — W B.&P.C. for this reason ► Plan check fee Date: PLUMBING PERMIT ISSUING FEE $ 50 Signature I.TOTAL FEE SINGLE FAMILY HOMEOWNER-BUILDER DECLARATION Plon.check applicant c I hereby affirm that I am exempt from the Contractor's:License Name ACC Law for the following reason (Section 7031.5, Business and Professions Code): Address 307 16.50 ❑ I, as owner of the property, will do the work and the City Tel. No. 1 IT Ella, structure is not intended or offered for sale(Section 704,4, Business dnd Professions Code). ► Ell f AL ® -- CONSTRUCTION LENDING AGENCY €`s°c=( I hereby affirm that there'is a construction lending agency for the performance of the work for which this permit .is issued CHANGE ° (Sec. 3097,•Civ. C.). ,y Lender's Name [l iQl j-�J[t01 10/20/8' rrt A Lender's Address 63 I A l �s 25 i I certify that I have read this application and state that the above information is correct. l agree to comply with all County , ord antes or' r d State laws regulating Plumbing, and hereby a th rize representatives of this County to enter upon the Vovb -mentsone property for insp`tion purposes. l SEE'REVERSE FOR EXPLANATORY LANGUAGE Signature of ermittee Date WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT F I hereby affirm that I have a certificate of consent to self 76A667A ,..��' insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81) 05 ora certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. BUILDING ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspec- ADDRESS . tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET d 7 Ery ` NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE OWNER SHOWER J. (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS +r / I certify that in the performance of the work for which this Permit is issued, I shall not employ any Person in any manner � SINK , . CITY .7/ ,,. � ' TEL NOt so as to become subject to the Wgrkers' mpensation Laws. DISHWASHER I CONTRACTOR , Date ` Applica � J + _ CLOTHES WASHER NOTICE T APPL CANT: If, a t (no ing this Certificate of ADDRESS Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY �) i; ( TEL. NO. LAWN SPRINKLER SYSTEM with comply with such provisions or Phis permit shall be STATE LIC. 1 deemed revoked. WATER HEATER LICENSE NO. ; i CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM',,, f„ r OUTLETS } (commencing with Section 7000 of Division 3 of the Business �= ' ( 9 ) OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL VALIDATION O 1 `*, DATE U License Number +,x1 -x Lic. Class A.-'• r, 1 FINAL J Contract p t Date BY LL ❑ I am exempt under Sec. B.&P.C. for this reason Plan check fee ► O Date: PLUMBING PERMIT ISSUING FEE$ C- Signature :ETOTAL FEE > LU hJ Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and a • Professions Code): City Tel. No. ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section 7044, Business and Professions Code). , a 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 authorize representatives of this County to enter upon the above-mentioned property for inspectio :purposes.` SEE REVERSE FOR EXPLANATORY LANGUAGE �tig' ;�.�P ure o Permittee DEte ` COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1301150013 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT ILEGAL ID FEES PAID BUILDING ADDRESS ITR 5904 LT 15 6272 ROSEMEAD BL I IFEE DESCRIPTION QUANTITY UOM AMOUNT. 1 TEMP CA 917801560 1 (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET LONGDEN I 15384-005-001 101 PERMIT ISSUANCE.FEE 27 80 I THOMAS PAGE 596 GRID H2 LOCALITY. TEMPLE CITY CAI I Ill CLOTHESWASHER(S) 1 00 FIX 16.20 I 1 ITENANT 117 FLOOR DRAIN(S) 1 00 FIX 16.20 (ISSUED ON PROCESSED BY PLAN BY 119 FLOOR SINK(S) 6 00 FIX 97 20 101/15/13 SR I 147 WATER HEATER(S) 1 00 WTH 16 20 1 1 TOWNER TEL NO 151 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20 IFINAL DATE FINAL BY CODE ILI, WAN XING (626) 623-2479- TOTAL FEES 189 80 1 `� i /j� 16272 ROSEMEAD BLVD I /�]` ` ITEMPLE CITY CA 91780 I ID RI TIO OF WORK IT/I PLUMBING CLOTHESWASHER, FLOOR DRAIN, SIX FLOOR SINKS, IWATER HEATER AND GAS LINE FOR NAIL SALON (APPLICANT TEL NO IZHENG, KEN (626) 674-2338- 11352 CARVTN AVE 1 ISPECTAL CONDITIONS 1 ROWLAND HTS CA 91748 ICONTRACTOR TEL NO 1 (APPROVALS DATE INSPECTOR SIGNATURE 1 IMIRACLE DEVELOPMENT INC (626) 674-2338- 1 11352 CARVIN AVENUE LIC NO j (UNDER SLAB WORK 1 ROWLAND HEIGHTS CA 91748 928751 1 IWATER SERVICE PLASTIC YIN METAL YIN (ARCHITECT OR ENGINEER TEL NO I- - ROUGH PLUMBING 1 I LIC NO Il IGAS PIPING 1 I I I I II IGAS VENT I IHOT WATER HEATER IPLUIDING FIXTURES I I I ILAWN SPRINKLERS I I I IGAS TESTI I I I (UTILITY COMPANY NOTIFIEDI I �CWV I I I I I (GRAY WATER SYSTEM I 1 I I I I I I I I I I I IREPORT ID DPR263 ROUTE TO BS0508 I I I I I I