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Home My Public Portal About5825 ROWLAND AVE_Plumbing__ 17 CEE 817 B17(RM 51./'78) 1 APPL.ICATI® FOR P . ING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING .\ �) NUMBER FIXTURE OR ITEM ® FEE ADDRESS WATER CLOSET LOCALITY _ v NEAREST BATH TUB CROSS ST SHOWER OWNER LAVATORY MAIL ADDRES W SINK CITY �� TEL.NO. DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITY TEL NO. LAWN SPRINKLER SYSTEM STATE LIC. WATER HEATER LICENSE NO. CLASS GAS SYSTEM OUTLETS APPROVALS DATE. INSPECTOR'S SIGNATURE OUTLETS OVER UNDER SLAB WORK 5 PER SYSTEM ROUGH PLUMBING GAS PIPING 0 GAS VENT of HOT WATER HEATER Z 47 PLUMBING FIXTURES GAS TEST tA Plan Check fee _UTILITY CO.NOTIFIED PLUMBING PERMIT ISSUING FEE$ TOTAL FEE FINAL If —� 3 Plan check applicant PLAN CHECK VALID 4ATI0N Name _ Address — City, Tel.No. --p9825A 1 HEREBY A0KNeV9EEDGE THAT I HAVE READ THIS APPLICATION AND STATE THATTHE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES # o o 0 0 o 5 AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION ' I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS 2 ° ° 1 6.00 REOU IRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL F•AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL ° ° c 1 S C 0 PROPERTY. ( I 4 li SIGNATURE. ` 0 k 1 1 -80 OFPER TTEE �D TRICT NO. f RO ED BY VL� INDUSTRIAL WASTE APPROVAL WORKER'S COMPENSATION DECLARATION 200026 DPW 9/89 APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self insure, 7BA667A or a certificate of Worker's Compensation Insurance, or a certified copy thereof(Sec.3800 Lab.C.) L COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS DEPT.OF PUBLIC WORKS DIV. Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING �Q�� } / ❑ Certified copy is filed with the county building inspection ADDRESS tj department. NUMBER FIXTURE OR ITEM ® FEE f LOCALITY ,� 1e, C/ Date Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' CROSS ST. 1 • (/R �l� COMPENSATION INSURANCE BATH TUB ASSESSOR PAGE PARCEL BOOK _(J� 5 tJ,� tf (This section need not be completed if the work involved by the SHOWER MA permit Is for one hundred dollars($100)or less.) OWNER I certify that in the performance of the work for which this permit LAVATORY is issued, I shall not employ any person in any manner so as to SINKMAIL become subject to the Workers'Compensation Laws. (-fo ADDRESS DISWASHER CITY TEL.NO. Date Applicant CLOTHES WASHER CONTRACTOR NOTICE TO APPLICANT: If, after making this Certificate of Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR ADDRESS provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY TEL.NO. 1 hereby affirm that I am licensed under provisions of Chapter 9 WATER HEATER (commencing with Section 7000)of Division 9 of the Business and GAS SYSTEM OUTLET CT �LI Professions Code,and my license is in full force and effect. OUTLETS OVERAll DISTRICT NO. PROCESSED BY cc 5 PER SYSTEM License Number Llc.Class f` FINAL DATE /�� VALIDATION a Contractor Date Cn ❑ _ INAL Z I am exempt under Sec. BY B.&P.C.for this reason 5 Date: Plan check fee PLUMBING PERMIT ISSUING FEE$ � I�a �(� Signature "'); i' TOTAL FEE `.,)1ti. { a ❑ SINGLE FAMILY Plan check applicant ITEMS HOME OWNER-BUILDER DECLARATION Name I OTAL 70- 65 I herebyaffirm that I am exempt from the Contractor's License Law CHECK I lam. for the ollowing reason(Section 7031.5, Business and Professions Address _ CoCode): City Tel.No. �4�(i�151t.t. 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). ® 06/22/9,,• CONSTRUCTION LENDING AGENCY 13311 1 AM 8;135 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.) 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 representatl sof this County to enter upon the above-mentioned ZAIrinktilre ty fo inspection purpos s. SEE REVERSE FOR EXPLANATORY LANGUAGE Of p rmittAn Date • COUNTY.OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0505240003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 6561 LT: 409 5825 ROWLAND AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802239 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 8587-030-006 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, C 07 BATHTUBS/SHOWERS 2.00 FIX 32.40 TENANT: 25 LAVATORIES/SINKS 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 45 WATER CLOSET/URINAL 1.00 FIX 16.20 05/24/0 JK 11/20/05 TOTAL FEES 92.55 OWNER: TEL. NO: FI L 8 FINAL BY: CODE: GEORGINO BETTY M TR GEORGINO TRUST (626) 376-3052- 5825 ROWLAND AV TEMP 917802239 DE RIP N OF WORK P BING FOR NEW BATHROOM APPLICANT: TEL. NO: SAME AS OWNER SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO UNDER SLAB WORK WATER SERVICE PLASTIC YIN METAL YIN ARCHITECT OR ENGINEER: TEL. NO: ROUGH PLUMBING / LIC. NO: ( — ------ GAS PIPINGcje� V GAS VENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED " CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508 COUNTY1NGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENz ELIC WORKS 9701 LAS TUNAS PL 0508 0507120002 BUILDING AND SAFETY LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 6561 LT: 409 5825 ROWLAND AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802239 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 8587-030-006 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, C 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 07/12/05 JK 01/08/06 OWNER: TEL. NO: FINAL DAT FIY CODE: GEORGINO BETTY M TR GEORGINO TRUST (626) 287-9213- 5825 ROWLAND AV TEMP 917802239 DESCRIPTION OF WORK INSTALL NEW GAS LINE FOR POOL HEATER APPLICANT: TEL. NO: CRAYPO'S POOL & SPA (626) 303-4868- 225 MONROE PL SPECIAL CONDITIONS: MONROVIA 91017 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE CRAYPOS POOL SERVICE (626) 303-4868- P. 0. BOX 2186 LIC. NO UNDER SLAB WORK MONROVIA, CA 91017 801805C53 WATER SERVICE PLASTIC YIN METAL YIN ARCHITECT OR ENGINEER: TEL. NO: ROUGH PLUMBING LIC. NO: GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST '7 UTILITY COMPANY NOTIFIED CJ CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508