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Home My Public Portal About6333 SALTER AVE_Plumbing__ WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT rjl het saffirm that I have a certificate 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.) l COUNTY OF LOS ANGELES BUILDING AND SAFETY P❑olicy%CO4z a� 2QZ"Company m orgy,," e'OY` 11� 41a'Nu I Certified copy is hereby furnished. ❑ FOR APPLICANT TO FILL IN.(PRINT OR TYPE) BUILDING / �s Certified copy is filed with the county building inspec- ADDRESS YQ tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Appilgant�; WATER CLOSET NEAREST rv.e� i CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. �` y COMPENSATION INSURANCE SHOWER OWNER ` / •f,V M, (This section need not be completed if the work involved by MAIL ff��the - the permit Is for one hundred dollars($100)or less.) LAVATORY ADDRESS a �Y"e� wp I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY .�le r.V1 i +. TEL.NOW / . so as to become subject to the Workers'Compensation Laws. DISHWASHER ! v CONTRACTOR V 4 N ea a,le S Iry G Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making this Certificate of ADDRESS a �Ka C r" c.-A c.-A + 0-4 Exemption, you should become LAWN SPRINKLER SYSTEM ome subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- CITY TEL. NO.CR�_� with comply with such provisions or this permit shall be STATE // LIC. deemed revoked. WATER HEATER LICENSE NO. b C'� 6 CLASS G� LICENSED CONTRACTORS DECLARATION DISTRICT NO. PRO ESSED BY GAS SYSTEM OUTLETS e I hereby affirm that I am licensed under provisions of Chapter 9 / `.J c VLJ �. (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL. V (DATION O License Number S7"6 1 SO d Lic. Class �!`2" �- / of FIN O .� S'a I�5 S{a e - / ��+ Contractor B�h�� BY � I'am exempt under Sec. � B.BP.C. for this reason Plan cheek fee Date: PLUMBING PERMIT ISSUING FEE$, 5.1 8,.1 A Signature TOTAL FEE # 0 0 0 0 0 5 SINGLE FAMILY Pion check applicant A.?,o 1 u 5 0 HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's Licemse Address r 0 0 0 16,5 0 C5 Law for the following reason (Section 7031.5, Business and Professions Code): City Tel. No. Q a Q 4 t 8 6 ❑ 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 authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. n � . � SEE REVERSE FOR EXPLANATORY LANGUAGESignature of Permitfee Dae • 76PLOO7 17 a-so it. APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING�� •� COUNTY OF LOS ANGELES WILLIAMJ. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN. DISTRICT NO: GROUP ZON PE MI NO. A� n ] d� ��f PLUMBER 4 R GO. &V M I3 / Af Ct. RECEIVED BY EADY F DATE ISSUED S-1- �. l�� ' FIRST INSPECTION ADDRESS S 1-- Y/ v� /6.�� ` ",�- T BUILDING- .L C" n L /f�MREADTHIS CITY "'/(W�wv7 � TEL. NO.�/ �?�V 3�y � ADDRESS J i7 � COUNTY f I LOCALITY kLICENE NO. Q EXPIRES NEAREST PERMIT FEES CROSS ST. TYPE OF FIXTURE OR ITEM FEE OWNER - MAIL WATER CLOSET (TOILET) @ 0:.50 S ADDRESS BATH TUB. ® 0.SO 6ITY TEL. NO. SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT .I HAV LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THA)'THE ABOVE 16 CORRECT AND AGREE tO COMPLY WITH ALL .COUNTY ORDINANCES AND KITC14EN SINK @ 0..50. STATE LAWS REGULATING PLUMBING. 1 CERTIFY THAT\,I POSSESS THE ABOVE, VALID LOS LAUNDRY TUB OR TRAY 0 0.60 ANGELES COUNTY LICENSE. OR 1 AM. THE LEGAL' OWNER OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE. GAS SYSTEM -COUTLETS @ 0.50 SIGNATURE OF . WATER HEATER 0.50 PERMITTE SLOP SINK 0:50 INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN 0.50 DISHWASHER 0.50 DRINKING FOUNTAIN. CgT 0.50 URINAL @ •0.50 J HOUSE SEWER Q 0.50 Z MISCELLANEOUS (' - E 0 APPROVALS .I DATE INSPECTORS NAME ..ROUGH PLUMBING U7,tS-,l ) GAS PIPING. - GAS VENT �I •il✓ • CESSPOOL 1,00 .CESSPOOL SEPTIC TANK: SEPTIC TANK' DRAIN ( ).PIT ( ) (�. 1.00 SEWER PERMIT: 1.01�� GAS TEST �; • '. UTILITY CO. NOTIFIED /s1/1 't': A r f. j FINAL TOTAL FEE S v I v! ! � 76ASS7 DBS 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILLAI�N I R C P ZONE 6 Z3 [ADDRESS LUMBE - . —wil.4 RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION BUILDING CITY V/��/ � /�1�j TEL.�NO�,,/�f+ A�,�� ADDRESS �'j'� ,JrJ COUNTY LOCALITY,.%; � -S al:; LICENRE NO. EXPIRES J NEAREST PERMIT FEES CROSS ST.r., Id CROSS NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER.✓J-.s 7 /�i,_%�J1 �5� MAIL U v K WATER CLOSET(TOILET) 0.50 # ADDRESS BATH TUB @ 0.50 CITY TEL No. SHOWER @ 0.50 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) Ct9 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOB LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE. OR4 AM THE LEGAL OWNER OF THE RESIDENT L PROP DESCRIBED ABOVE. GAS SYSTEM OUTLETS 6 0.50 ' BIGNATL P RMIIITEF WATER HEATER 0 0.50 IRE Or SLOP SINK 0 mm INSPECTION RECORD FLOOR SINK @ 0.50 FLOOR DRAIN @ 0.50 DISHWASHER 0 O.SO DRINKING FOUNTAIN 0 0.50 URINAL 41) 0.50 J HOUSE SEWER 0 0.50 j _Z MISCELLANEOUS L7 Q' O APPROVALS DATE INSPEDTGRIB NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL 1:00 7 D CESSPOOL SEPTIC TANK. SEPTIC TANK DRAIN ( ) PIT ( ) 1.00 SEWER PERMIT I 1.00 GAS TEST TOTAL FEE �r6+ UTILITY CO.NOTIFIED ��/ FINAL I J6 V" COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1008240020 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: I 1 ON FILE I I 6333 SALTER AV I (FEE DESCRIPTION: QUANTITY: DOM: AMOUNT:[ TEMP CA 917801429 I (ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: LONGDEN 15383-020-026 01 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: Al LOCALITY: TEMPLE CITY, C 147 WATER HEATER(S) 1.00 WTH 16.30 I (TENANT: I TOTAL FEES 44.10 [ISSUED ON: PROCESSED BY: PLAN BY: 1 I 108/24/10 SR (OWNER: TEL. NO: I DATE F CODE: [ ILEE, HUNGPARK (626) 683-3938- I 16333 SALTER AVE [ ITEMPLE CITY I [D SCRIPTI N OF WORK I I (REMOVE/REPLACE GAS WATER HEATER SAME LOCATION [ [APPLICANT: TEL. NO: I I I (FAST WATER HEATER COMPANY (425) 636-7084- [ [ I 112601 132ND AVE 1 1SPECIAL CONDITIONS: 1 1KIRKLAND, WA 98034 [ I I I 1CONTRACTOR: TEL. NO: [ [APPROVALS LATE INSPECTOR SIGNATURE IFAST WATER HEATER CO. (425) 636-7084- [ I [ 112601 132ND AVE NE LIC. NO [ (UNDER SLAB WORK I [ [KIRKLAND WA 98034 931237 C36 *[ I I [ I IWATEF SERVICE I 111PLASTIC Y/N METAL Y/N ] 1 [ARCHITECT OR ENGINEER: TEL. NO: - [ ]ROUGH PLUMBING [ I LIC. NO: I I I 1 1GA3 2IPING I 1 1 GAS VENT I II I 1 1 1HOT WATER HEATER 1 1 - I [ I [PLUMBING FIXTORES [ [ 1LAWN SPRINKLERS [ [ I [ 1GAS TEST I I [ ] LUT LITY COMPANY NOTIFIED( 1 1 I 1 ICWv [ I 1 IGRAY WATER SYSTEM 1 I 1 I I 1 1 I 1 I I I I I I I 1* ADDITIONAL DATA ON FILE I I I I I I I I I I 1 1REPORT ID: DPR263 ROUTE TO: BS0508 I I I I I I I I I f i COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0408/90008 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-04tZ I:::T: LEGAL D: FEES P ID BUILDING ADDRESS: ON FILE ! 6333 SALTER AV FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801429 ASSESSOR Ih 0 -ATIO NEAREST CROSS STREET: LONGDEN 5383-020-026 01 PERI4IT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: Al LOCALITY: TEMPLE CITY, C 07 BATHTUBS/SHOWERS 1.00 FIX 16.20 _ TENANT: 25 LAVATORIES/SINKS 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PAN BY: EXPIRES 0 45 MATER CLOSET/URINAL 1.00 FIX 16.20 08/19/04 JK 02/15/05 OWNER: fEL. N0: TOTAL FEES 76.35 FINAL DATE FINAL 6Y: CODE: LEE, HUNG PAK (626) 683-3938- 6333 SALTER AVE �- �( �A TEMPLE CITY ESC^IPiI0N OF WORK PLUMBING FOR NEW BATHROOM APPLICANT: TEL. N0: SAME AS OWNER - �I SNECIAL CONDITIONS: '- COi:TRACTOR: TCL. NO: !APPROVALS DATE INSPECTOR SIGNAI URE SAME AS OWNER - LIC. NO DOER SLAB WOR WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OP —FORNEER: TEL:N0: � ,E. MELr CO. DESIGNER, %bee 202-6548- I fi:)UG:I PLUM3ING 2427 W. MAIN ST. #3 LIC. NO: ALHAMBRA, CA 91801 NONE CT TR i GAS VENT HOT WATER HEATER- PLUMBING FIX LiRE5 LAWN S R.I ERS I _ GAS TEST TiLI COMPANY NOTIFIED C6fti+ I GRAY WATER SYSTEM i REPORT ID: DPR263 ROUTE TO: BS05O8 781887 CE 617 BAPPLICATION FOR PLUMBING PERMIT ;1 _BUILDING AND SAFETY DIMION ' Department of County Engineer r County of Los Angeles BUILDING ` C e JOHN A.LAMBIE,COUNTY ENGINEER ADDRESS J CASSATTD.GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN I NEAREST CROSS ST. OWNER / X) Q 'DISTRICT NO. GRO . I ZONE I READY FOR INSPECTION MAIL ADDRESS TC J CITY TEL.NO. � INDUSTRIAL / WA TEAPPROVAL PLUMBER INSPECTION RECORD ADDRESS CITY .^ TEL..NO. LICENSE NO. Jy� NUMBER TYPE OF FIXTURE od ITEM FEE y!= -' /j ,F�'/// ��J 7•��' WATER CLOSET (TOILET) @ $1.00 $. " �'n n.;[y 1 BATHTUB @ $1.00 Z � ��Y� SHOWER @ $1.00 �' nr/) LAVATORY (WASH BASIN) @ $1.00 +. �- KITCHEN SINK @ $1.00 �► . DISHWASHER @ $1.00 LAUNDRY TUB OR TRAY @ $1.00 J. i y �• �xr n�'��j 601111 CLOTHES WASHER @ $1.00 / WATER HEATER @ $1.00--4 - GAS 1.00 -GAS SYSTEM @ $1.00 /./7-r - wo 00F ArY14.611AI APPROVALS ' DATE INSPECTOR'S SIGNATURE UNDER SldB WORK �/'/a �'J 'i r• '+;j�.� � PERMIT $ 1 00 ROUGH.PLUMBING- '� •r�i.SE .lA&!A!•' I GAS PIPING TOTAL FEE 11010 GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOTVI(ATER HEATER _2 AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES _ I HEREBY 'CERTIFY THAT 1 AM PROPERLY REGISTERED AND/ORGAS TET, � •y7/ ! '? f`:Y(vel ,.�: LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF �y CALIFORNIA OR THAT I AM THE LEGAL OWN OF THE ABOVE UTILITY CO.NOTIFIED X' 7 (r.U� DESCRIBED RESIDENTIA 0 ERTY. r p SIGNATURE F PERMITTEE FINAL. ROBERT A.WOOD, JOHN A.LAMBIE,COUNTY ENGINEER ALTATION SUPERVISING•MECHANICALENG'R CASH H. R.0.H. O 4262 Kov13' - 3 1200 v