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Home My Public Portal About5105 SERENO DR_Plumbing__ MRS 17 Ia 94 APPLICATION FOR PLUMBING PERMIT N.n 'DM&ON OF BU=ING AND SAFETY D"xwba nt of Conutr SBelesfe �• Countr o! Laf Angelef VIM J FOX. COUNTY Emash"E ° BUILDING O O AGGRESS CAffATT D GRIFFIN,fuF T OP BunOIMO LOCALITY / gor L FOR APPLICANT TO FILL IN NEAREST OWNER /-dNA! I DISTRICT NO GROUP ZONE REARY FOR INSPNCTIDN MAIL O MAIL D S CITY �' ANINDUSTRIAL 0 PILE, WASTE APPROVAL UMBER INSPECTION HECORD ADDRESS CITY TEL NO S.A I, _ LICENSE NO -r- ULAc, 44,4 NUMBNN TIT°OF FIIITURM OR ITKM FEE WATER CLOSET (TOILET) S `I _ BATH TUB N BROW! _ I LAVATORY (WASH AKIN) KITCHEN SINK DISHWASHER I LAUNDRY TUB OR TRAY CLOTHES WASHER TOTAL NO 0 O BO APPROVALS DAT! �IHSPE#AOR! SIGNATURE Is GAS SYSTEM. OUTLETS 100 WATER HEATER 100 UNDER BLAB WORK Cf-LY'tt ROUGH PLUMBING Z PERMIT f 7 CO GAS PIPING TOTAL FEE GAS VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ TRIS APP IWTIOM HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES PLUMBING I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR OAS TEST LICENSED AS REOUIREO S ANGELES CUM" AND STATE OF UTILITY CO NOTIFIED CALIFORNIA OR TH AM HE LEGAL ER HE ABOVE DESCRIBED RESIDE TY SIGNATURE OF PERM I FINAL WILLIAM J PDX. COUNTY ENGINEER VALIDATION 160 4 9_Swv23 3 700 4 BY I �� DEPUTY. WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT �7A I hereby afFrm that I have a certificate of consent to self in 20-OM U90 sure,or a certificate of Workeri Compensmlon Insurance,ora [, I certified copy thereof(Sec 3Lab C ) COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ILfI Policy No-Company ny F] Certified copy is hereby furnished - ❑ ) BUILDIG � ��yss Certified copy is filed with the county building inspection FOR APPLICANT TO FILL IN(PRIM OR TYPEADDRENSS � � V s department NUMBER FIXTURE OR ITEM ® FEE LOCALITY Dale Applicant WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST COMPENSATION INSURANCE SHOWER OWNER n4aylps C (This stolon need not be completed if the work Involved by MAIL 1 t`,, the permff Is for one hundred dollar($100)or less) LAVATORY ADDRESS pc 7-' Ave' I certify that in rhe performonce of the work for which this per- SINK �07 mit is issued, I shall not employ any person in any manner so CRY TEL NO in to become subject to the Workers Compensation Laws DISHWASHER CONTRACTOR Date Appncant CLOTHES WASHER - NOTICE TO APPLICANT If after making this Certificate of Ex- - ADDRESS emption,you should become sub act to the Workers'Compen- SWIMMING POOL RECEPTOR CITY TEL NO lysation with provisions po of the Labor C e,you must forthwith comp- LAWN SPRINKLER SYSTEMS ly wdh such provisions or this permit shall be deemed revok- STATE LIC ' ad WATER HEATER - LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS a� 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER G and Professions Code and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fact HOSE BIB DATE License Number Lic Class FINAL (� Contractor Date BY ¢ 1 am exempt under Sec V B 8P C for this reason Plan check fee W Date PLUMBING PERMIT ISSUING FEE f , - Signature TOTAL FEE -1 SINGLE FAMILY r ACc) IF HOME OWNER-BUILDER DECLARATION Plan check applicant _a�? yi•_5 1 hereby off irm that I am exempt from the Contractor s License Name _ Law for the following reason (Section 7031 5 Business and 1 ITEM_ _ Professions Cade) Address ]I ITFE - 41 - 85 1 as owner of the property will do the work and the City Tel No structure is not intended w offered for sale(Section 7044 CHECK Y 1. Business and Professions Code) ` 011, :HAN'iE it 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 00011-cl.)o 1 6.G4/44 (Sec 3097, Civ C ) 5b 1 FM Lenders Name NII FEE Lender s Address I certify that I hove read this application and state that the above information is correct I agree to comply with oil County ordinances and State laws regulating Plumbing, and hereby 5665 4 F'h 5:32 authorize representatives of this County to enter upon the above-mentioned property for inspection purposes - ` 4_lK SEE REVERSE FOR EXPLANATORY LANGUAGE li a of Permittee Date �" ' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT • DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9807160006 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE (818) 285-0488 EXT LEGAL ID: FEES PAID BUILDING ADDRESS BK 56 PG 12 PC 33 5105 SERENO DR FEE DESCRIPTION: QUANTITY UOM AMOUNT: TEMP CA 91780 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET ROSEMEAD 53BB-017-014 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE GRID LOCALITY TEMPLE CITY 07 BATHTUBS/SHOWERS 1 00 FIX 16 20 TENANT 25 LAVATORIES/SINKS 2 00 FIX 32 40 ISSUED ON PROCESSED bY PLAN UT EXPIRES ON 45 WATER CLOSET/URINAL 2 00 FIX 32 40 07/16/98 UT 07/16/99 47 WATER HEATER(S) 1 00 WTH 16 20 CHANG CHARLES (626) 449-3090- TOTAL FEES 124 95 5105 4ERENO DR TEMPLE CITY CA 91780 DESCRIPTION uv wuRK PLUMBING FOR BATHROOMS (REMODEL APPLICANT TEL No SAME AS OWNER - SPECIAL CONDITIONS �NGELES CO CONTRACTOR TEL NOSAME AS OWNER APPROVALSOS A�' LIC NO SLAB WORK WATER SERVICEi ARCHITECT OR ENGINEER. TEL NO PLASTIC Y/N METAL Y/N ROUGH PLUMBING LIC- NO7L — GLJ) GAS VENT U o COCA TV(D GCCCCC HOT WATER HEATERg o o 4� WI Ci 0 eg 0 GAS TEST A \`l! ✓ 5 CWV c Service ThaQ GRAY WATER SYSTEM REPORT ID OPR263 ROUTE TO BS0508