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Home My Public Portal About5027-5029 SULTANA AVE_Plumbing__ t 2�BENT OF BUUMING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES P`��'�� WN J. FOX.CHIEF ENGINEER OF INSTALLMON ROUGH FDTTURm PR.ETf _ HEATER CElOPODI. OtPTRO TANK E�j1/�/� READY POR 1 BY FIRST INYPECTH7N DATE W Ed I'maulms APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLYJOB y. NAME ADDREYt � �� S • V �H d G ADDRESS LOCALITY aS C �H Q J NEAREST G'`7 �R7 G em Ta No CROSS ST COUNTY LICENSE NO EXPIRES C NAME LOCATION OF C TANK, OR CESSPOOL 'DDREYS / �O . !/t Cal NORTH O CITY CSI TE.NG I AM THE LEGAL POYOYSYOR OF THE ABOVE LOS ANQE.EO COUNTY CERTIFICATE OF QUALIFICATION. PN.VMSOI ' I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. ONMQ CORRECnONS !O u SOUTH J DESCRIPTION OF WORK - z ATN TUB "RNACE _ O a HOWER L ^IYHWAYMER - O -LAVATORY v REFRIGERATOR NEN BINK WATER BOFTEIEI R OINK 9ANDTRAP OINK _FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKINGPOUNTAIN DATE I^NVSCTOR'a NDN[ WATER 7101 DOMTAL LAVATORY ROUGH PLUMBING !a 6"U9 Lf FOUNTAIN GAY PIPING OUTL =�ou3� Tew4► GAS VOMT n CE/SPOOL TOTAL NUMBER OF FIXrURSOF�:, .�+U SEPTIC TANK ESSPOOI�YE'TIC TAN .,`Q SEWN UTILITYCO NOTIFIEDTOTAL FEE FINAL ' Oia TF MBI QTR IHY V/ `J }r DEPARTMENT OF BUILDING AND SAFETY - ; APPLICATION FOR PERMIT COUNTY OF LOS ANGELES �L��BI�� 1 ~ WM J FOX,CHIEF ENGINEER rRROUGHMum OF INSTIODDET-W IT NO. RDRURts CONPLETK _ Y FOR KM CEBSPOOL SEPTIC TANK RECEIVED FIRST INSPECTIONDATE IDEUED /O -4j APPLIC FILT IN HEAVILY OUTLINED(�PORTLY job ADDRESS 6 LOCALITYNEAREST EL No. CROSO EXPIRES NAME OF SEPTIC TANK, OR CESSPOOL MAILADDRESS NORTH CRY TEL Mo 1 AN THE LEGAL POSSESSOR DP THE wBov LOS ANGELES COUNTY CKRTMALI TION PI.UKRMI ' 1 AM THE LEGAL OMMPROPKWff DESCRIBED ABOVL owRo CORRECTIONS BDUTH J DESCRIPTION OF WORK z z ATH TUB FURNACE 9 HOWER - DISHWASHER C O VATORY REFRIGERATOR ITCHEH GIME WATER SOFTENER R SINK RAND TRAP SINK -FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE IKRPECT011•NAYX WATnt HEATER DENTAL LAVATORY ROUGH PLUMBING 6TSR a" R^DA FOUNTAIN OUTL OAK PIPING GAS VENT rr TOTAL NUMBER OF FIXTURES SEPTIC TANK CESSEODI REPTICTANK SKWER S UTILITY CO NOTIFIED TOTAL FEE IN 76A667 (CE-617) - 6/73 / O yT E P APPLICATION FOR PLUMBING PERMIT' COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND,SAFETY DIVISION C� /1 MAKE CHECKS'PAYABLE TO BUILDING 7 - ADDRESS oY/.- LC) WTAAuA UIF - HARVEY T BRANDT, COUNTY ENGINEER ocnun ^A /T FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST �^ CROSS ST EN / NUMBER FIXTURE OR ITEM ® FEE l WATER CLOSET 1 75 OWNER O AAJ _ MAIL BATH TUB 1 75 ADDRESS ' SHOWER 1 75 CITY TEL NO LAVATORY 1 75 CONTRACTOR�Qe C1 SINK 175 ADDRESS 1o9J` En ^AdL DISHWASHER 175 CITYTE /1C ` TEL'NO (/� 707Q CLOTHES WASHER 1 75 STATE- LIC 'SWIMMING POOL RECEPTOR 1 75 LICENSE NO .2 CLASS DI ICT NO GROUP ZONE FR ESSED BY )AWN SPRINKLER SYSTEM 1 75 LISTpIL OCT AL[_ WATER HEATER 1 75 /7S �yASTE APAPROVAL ` GAS SYSTEM OUTLETS 1 75 ' °INSPECTION RECORD OUTLETS OVER 30 5 PER SYSTEM O 1-- U a W d 1 Z Plan check tee See Re",s. PLUMBING PERMIT ISSUING FEE S 3 00 TOTAL'FEE 7 APPROVALS DATE INSPECTOR 3 SIGNATURE Plan check applicant UNDER SLAB WORK + Name (' ROUGH PLUMBING Address GAS PIPING Qty Tel NO GAS VENT ' HOT WATER HEATER I I HEREBY THAT TEOAACKNOWLEDGE THAT HAVE READ THIS APPLICATION AND STATE TNAT THC ABOVE IE CORRECT AND AGREE E COMPLY PLUMBING FIXTURES WITH ALL COUNTY ORD)NAMCl9 AND STATE LAWS REGULATING PLUM Bi No I GAS TEST 1 HEREBY CERTIFY TBAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED LICENSED A6 REOUIRED 6Y LOS ANGELES COUNTY AND STAT! 01 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO RESIDE IN THE ABOVE D RI RESI E TIAL PROPERTY FINAL SIGNATURE OF PERMITTEE PERMIT VALIDATION CK M G CASH I PLAN CHECK VALIDATION cK M D CASH 4 a 59Ja1N 5 0 i" 4.7 5 t l� 1�WORKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I heraeP affirm that I have a certificate of consent to self 76A667A I nsure bra certificate of Workers'Compensation Insurance, CE Bre(REV 10/8I) or o 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 N tion department artment NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Applitont WATER CLOSET �� ,L CERTIFICATE OF EXEMPTION FROM WORKERS' BATH NB CROSS ST '`r COMPENSATION INSURANCE OWNER — -�' (This secllon need not be completed If the work Inwlved by SHOWER the permit Is for one hundred dollars ($100)or Ins) LAVATORY r MAA 5 -� ADDRESS I certify that m the performance of the work for which this ` permit is issued I shall not employ on pe in any manner SINK O CITY TEL NO so as to became subject to the Work s' sari n Laws DISHWASHER �` O CONTRACTOR Date Q—/�-,, SApphcant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT If after making tis Certificate of SWIMMING POOL RECEPTOR Exemption you should become subject to the Worker On, TEL NO Compensation provisions of the Labor Code, you must forth LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be M STATE LIC deemed revoked WATER HEATER ^ LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO Y I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS01) Jt_'^ D (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER a y and Professions Code and my license is in full force and effect 5 PER SYSTEM FINAL �y /� �/ALI TION d License Number Lic Class DATE `Z ( 3 FINAL Contractor Dote BY O I am exempt under Sec 6 B&P C for this reason Plan check fee Z Dote PLUMBING PERMIT ISSUING FEE$ Signature TOTAL FEE Plan check applicant - ;12 6 64 A SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name # e s s e e 5 ' 1 hereby affirm that I am exempt from the Contractor s License Address Law for the following reason (Section 7031 5 Business and KP, fP,of ions Code) City Tel No ( • • 2 a 5 Q , as owner of the property, will do the work and the structure is not intended or offered for sale (Section , • • • 2 a 5 d 704 Business and Professions Code) p a12-85 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency far the performance of the work for which this permit is issued (Sec 3097, Ctv C ) Lender's Name Lender s Address I certify that I have read this application and state that the Polls information n correct I agree to comply with all County ordinances and State laws regulating Plumbing and hereby outhorrz rep pentotwiss of this County to enter upon the abov ent, rop h for inspechon purposes SEE REVERSE FOR EXPLANATORY LANGUAGE -12.8 s _Mture-AfWrri Date WORKERS' that have COMPENSATIONDECLARATION of corse APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 7E 817( insure, ora certificate of Workers Compensation Insurance, CE BI7(REV to/BI) or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES / BUILDING AND SAFETY Policy No Compony Certified copy la hereby furnished❑ BUILDING FOR APPLICAM TO Flll IN(PRINT OR TYPE] ADDRESS 7 C I N S V LTA IJ q V Certified copy a filed with the county buildingmspec- tion department NUMBER FIXTURE OR ITEM ® FEE LOCALITY -rf-14 IT Dote ,3-�0� hGant ��"�s/✓'�- WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS ST PPW T 4A N COMPENSATION INSURANCE SHOWER OWNER V L F. S QL (This section need not be mmpletied IF the work In"Ived bill,bill,the permit Is for ons,hundred dollars($100)or Ins) LAVATORY ADDRESS L-1 N S V L 7LI JV,4 q V I certify that in the performance of the work for hick this permit,s issued, I shall not employ any n in nor SINK CITY .T- TEL NII 14 3 l/ so as to become subject to the Workers' mp aws DISHWASHER CONTRACTOR Dote pplicant CLOTHES WASHER ADDRESS OTICE TO APPU NT If aher ng this a ificate of SWIMMING POOL RECEPTOR Exemption, you should become subject to the Workers Compensation provisions of the Labor Code you must forth- CITY TEL NO with comply with such provisions or this permit shall be LAWN SPRINKLER SYSTEM STATE LIC deemed revoked WATER HEATER LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO 00OCIESSED BY 1 hereby affirm that I am licensed under provisions of Chapter 9 - GAS SYSTEM OUTLETS (commenting with Section 7000) of Division 3 of the Business OUTLETS OVER and Professions Code,and my license is in full farce and effect 5 PER SYSTEM FINALVALIDATIONVALIDATION V rS-License Number L,c Class DATE _7 K FINAL rO Contractor I�I J�. --Date-� BY W ❑ I am exempt under Sec N B 8P C for this reason Plan check fee PLUMBING PERMIT ISSUING FEE$ (� • Signature TOTAL FEE b Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name (y R NLl fi r. P AS 7-0 R �0 3 b 0 A I hereby affirm that I am exempt from the Contractor a License Law for the following reason (Section 7031 5, Business and Address N S U LTA Vj A A V .Professions Code) City T MPL I-ry Tel No Z8$: 5( 3 • • • • • 5 ❑ I, as owner of the property, will do the work and the 2".`. 3450 structua re not intended or offered for sale (Section 7044, Business and Professions Code) , • ' • 3 4.5 0;-J CONSTRUCTION LENDING AGENCY 0all 0-83 1 hereby affirm that there is a construction lending agency for the performance of the work for'which this permit to issued _ (Sec 3097, Civ C ) Lender's Name Lencier's-Address ` I certify that I hove read this application and store that the Ilio.above information is correct I agree to comply with all Count' ard'no nc s and State laws gulating Plumbing and hereby author, re a tahves orfethu ou Cnty to enter upon the aboy proper for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 3-tyn�y-t? Ignature of ermittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0501110012 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 ERT LEGAL ID FEES PAID BU= ADDRESS: ON FILE 5029 SULTANA AV ASSESSOR INFORMATION NUMBER FEE DESCRIPTION QUANTITY CON _ AMOUNT __ _ TEMP CA 917803046 NEAREST CROSS STREET PENTLAND 5388-021-009 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID H5 LOCALITY TEMPLE CITY, C 07 BATHTUBS/SHOWERS 1 00 FIX 16 20 TENANT 25 LAVATORIES/SINKS 1 00 FIX 16 20 ISSUED ON PROCESSED tsy PLAN ITT EXPIRES ON 45 WATER CLOSET/URINAL 1 00 FIX 16 20 01/11/05 JK 07/10/05 TOTAL FEES 76 35 FI I E FINAL BY CODE LAM MICHAEL (626) 319-2390- 502O SULTANA AV TEMP 917803046 DES PTIU — PL NG F NEW BATHROOM APPLICANT - TEL. NO SAME AS OYNER - SPECIAL CONDITIONS r , CONTRACTOR TEL NO: SAME AS OWNER - - ` - - - APPROVALS DATE INSPECTOR SIGNATURE LIC NO UNDER SLAB ARCHITECT OR ENGINEER PLASTIC Y/N METAL Y/M LIC NO GAS VENT PLUMBING FIXTURES GAS TEST CWV - -_ REPORT ID DPR263 ROUTE TO 850508