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Home My Public Portal About6269-6271-6273-6275 ROSEMEAD BLVD_Plumbing__ ION DECLARATI a WOthat I have a certificate of consent to 76A666DPW 9/89 APPLICATION FOR PLUMBING PERMIT I ,er•,by affirm that I have a certificate of consent to self insure, 76A667A , or a certificate of Worker's Compensation Insurance, or a certified copy thereof(Sec. 3800 Lab. C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No. Company 0 Poli Certified copy is hereby furnished. BUILDING r_1 Certified APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS � AL , Certified copy is filed with the county building inspection department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY T EMPLE U! Date Applicant ✓ ' WATER CLOSET I� �� NEAREST f-0N�., G -X!:CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB ( CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the work involved by the SHOWER MAP BOOK PAGE PARCEL permit is for one hundred dollars($100)or less.) f LAVATORY �� OWNER FghN �GU I certify that in the performance of the work for which this permit MAIL '` is issued, I shall not employ any person in any manner so as to / SINK '„{.D `/.�- ADDRESS `3�] N!' PA U(,r�- become subject to the Workers'Compensation Laws. DISWASHER CITY PA SA.bE-s)� TEL.NO. .4.1-'1 Date G pplicant ' f"��l`� Jr / A' ,U/fes' CLOTHES WASHER CONTRACTOR `?T AJ P LU M'H I M' NOTICE 76 A LI ANT: If, after making this Certificate of Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR �� S n A provisions of the Labor Cade you must forthwith comply with such ADDRESS /X l�T A provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY �t f � 3 TEL.NO. r ZQ�_ } I hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER �� %, C• CL (commencing with Section 7000) of Division 3 of the Business and STATE LIC. Professions Code,and my license is in full force and effect. GAS SYSTEM OUTLETS LICENSE NO. 6 CLASS U OUTLETS OVER DISTRICT NO. PROCESSED BY r� pp h 5 PER SYSTEM 6 License Number 21068 Lic.Class_ � FINAL VALIDATION lad co FTN P L U M R l N�Date DATE •-'� I am exempt under Sec. ,,0 "`� O 'C"(`�li _ FINAL B.&P.C.for this reason Plan check fee , Date: Signature PLUMBING PERMIT ISSUING FEE$ '�4 S EJ Y_?FEE _? Oi S' SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and Professions Address __, _ _t Code): —r- ❑ 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 4L. —: and Professions Code). , y `ie_` = srua CONSTRUCTION LENDING AGENCY ::a.•;;-•; 1 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.) PJ 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 i spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Sig a ure of Per Itt at w WS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affiffirmrm that I have a certificate of consent to self 76A667A nsure, 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 Policy No. Company Certified copy is hereby furnished. ❑ 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 Date Applicant WATERT 4, 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 g .+MAIL the permit is for one hundred dollars ($100)or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER va 1 CONTRACTOR Date"— Applicant. A CLOTHES WASHER l NOTICE TO APPLICANT: If, after making t is Certificate of ADDRESS � ,S' � N P/b. AAL Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR �r�- Compensation provisions of the Labor Code, you must forth- CITY f TEL. N LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS � � T LICENSED CONTRACTORS DECLARATIONO DISTRICT NO. P ESSED BY I hereby affirm That I am licensed Under provisions of Chapter 9 GAS SYSTEM OUTLETSS7OX (commencing with Section 7000) of Division 3 of The Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL % Lf VALI TION r License Number L 3 ��0 �Lic. Classes �_ Contractor �'µ FIN 0 b ❑ I am exempt under Sec. B.&P.C. for this reason G+ l� 6 � Plan check fee ► Date: � `� /� PLUMBING PERMIT ISSUING FEE$ V S Signature TOTAL FEE SINGLE FAMILY Plan check.applicant 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 c 3 8 Q 8 A Professions Code): City Tel. No. ❑ I, as owner of the property, will do-the work and the # 0 0 0 o o 5 structure is not intended 'or offered for sale (Section , 7044, Business and Professions Code). o 0 2 250 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for 0 0 0 2 2.5 d 5 U the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). 3_8 6 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 pr erty for inspection purposes. rr ` SEE REVERSE FOR EXPLANATORY LANGUAGE S 6nature of Permittee Date A COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9702130031 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 5904 LT: 87 6275 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1TEMP CA 917801562 ASSESSOR INFORMATION NUMBER: iNEAREST CROSS STREET: 5384-003-023 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY 47 WATER HEATER(S) 1.00 WTH 16.35 TENANT: TOTAL FEES 44.10 ISSUED ON: PROCESSED BY: PAN BY: EXPIRES ON: CLASSY CUTS 02/13/97 TC 02/13/98 OWNER: TEL. NO: FINAL DATE FINAL BY: CODE: FELIKIAN MARTIN CO TR (310) 947-8118- 8112 STONERIDGE DR WHIT 906051372 DESCRIPTION OF WORK NEW WATER FOR BEAUTY SALON APPLICANT: TEL. NO: ni \:r\\ ��10_°r�l`�`/r� SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO UNDER SLAB WORK WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR.ENGINEER: TEL. N0: ROUGE. PLUMBING LIC. NO: GAS PIPING r � GAS FENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508 1 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0008170021 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 5904 LT: 87 6269 ROSEMEAD BL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801562 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN 5384-003-023 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY 47 WATER HEATER(S) 1.00 WTH 16.20 TENANT: 53 MED/HIGH GAS 5 OUTL. 1.00 SYS 67.35 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: PRO CLEANERS 64 WATER PIPNG <= 1 1/2 3.00 LIN 48.60 08/17/00 UT 02/14/01 TOTAL FEES 159.90 OWNER: TEL. NO: FIN�DATE FI1 ¢ BY: CODE: FELIKIAN MARTIN CO TR (310) 947-8118- ((/1j�� B////) 8112 STONERIDGE DR WHIT 906051372 DESCRIPTION OF WORK PLUMBING FOR DRY CLEANERS APPLICANT: TEL. NO: GRIGOR OGANESYAN (323) 661-4911- 2027 N. VERMONT AVE. SPECIAL CONDITIONS: LOS ANGELES, CA CONTRACTOR: TEL. N0: ®� ��f� APPROVALS DATE INSPECTOR SIGNATURE GRIGOR OGANESYAN (323) 661-4911- DBA MGM PLUMBING CO. LIC. NO UNDER SLAB WORK 2027 N. VERMONT AVE. 703404 C36 LOS ANGELES, CA 90027 WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. NO: ROUGH PLUMBING LIC. NO: / 1111111 IL GAS PIPING GAS VENT PULO �U� HOT WATER HEATER �`�J IJ U LI ��J PLUMBING FIXTURES O O � LAWN SPRINKLERS es O _ '? GAS TEST 0 � d��y � UTILITY COMPANY NOTIFIED li CWV oce GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508