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Home My Public Portal About5092 SULTANA AVE_Plumbing__ 96A6E9C ICE/1I N 11/96 ,/1 / a APPLICATIONIFOR PLUMBING PERMIT ' • COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN WRINTORTYPEI BUILDING IdA NUMBER FIXTURE OR ITEM • FEE ADDRESS /V�/ WATERCLOSET LOCALITY BATHTUB NEAREST CROSS ST SHOWER OWNER LAVATORY MAIL ADDRESS D N SvL �✓ SINK CITY TEL NO DISHWASHER CONTRACTOR ,4 CLOTHES WASHER 00 ADDRESS t SWIMAUNG POOL RECEPTOR CITY _ TEL NO _ S LAWN SPRINKLER SYST EAR STATEq WATER HEATER UCENSE NO CLd V / LIF, LION /1 GASSYSTEM OUTLETS �" DISTRICT NO GROU ZONE GL DBY p ET py a" o g .:�. i2. y 5 PER SYSTEMR INDUSTRIAL 16 WASTE APPROVAL Q ' INSPECTION RECORD V 00 6 Plan Check fee PLUMBING PERMIT ISSUING FEE$ 7 TOTAL FEE 3 Plan check applicant Nome APPROVALS DATE I BPE oR S SIGNATURE UNDER SLAB WORK Address ROUGH PLUMBING Q�. Cary Tel No GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ ttHM APPLIGTIOR AND STATE GAS VENT THAT THE A60VE IS CORRECT AMD AGREE TO COMPLY WITH ALL COUNTY ORDINANCES An STAR LAWS REGUUTING PLUMBING w HOT WATER HEATER 1 HERESY CERTIFYVIMERLY REGIS D /OR LIC[MSED AS PLUMBING FIXTURE$ REQUIRED BY LOS AMG[ STATEOF G OR TINT I AM THE GAS TESTLEGAL OWNER OF AMD I E A60VE D EED RESMENIIAL PROPERTY UTIUTYCO NOTIFIED S GNATURE OF PERMITTEE FINAL PLAN CHECK A ATION CK No cAv1 I' PERMIT MWATION CK MD CASK 5 3 6 x'04 2 5 1 3.0 0 e9a W C. ;L DEC TION WORKERS'that Ihave COMPENSATION cafe of corse APPLICATION FOR PLUMBING PERMIT I hereby affirm shot I have a certificate of consent to self ]Mee7A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV 10/81) CITY OF TEMPLE CITY or a certified copy thereof (Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Pal cy No 201916 Company SCIF 19340 Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed with the county budding,nspec- ADDRESS 5092 No. Sultana tion department NUMBER FIXTURE OR ITEM ® FEE Date 4/1/83 Applicant 1. General Install WATER CLOSET NEAREST LOCALITY Temple Cit CERTIFICATE OF EXEMPTION FROM WORKERS BATHTUB CR055 ST >( Rosemead COMPENSATION INSURANCE OWNER C . Radwan (This secffon need not be completed if the work linvolved by SHOWER file permit Is for one hundred dollars ($100)or loss) LAVATORY MAILRESS same ' I certify that in the performance of the work for which this permit is awed I shall not employ any person in any manner SINK CITY TEL N0286 0389 so as to become subject to the Workers'Compensation Laws DISHWASHER CONTRACTOR General Installation Date Applicant CLOTHES WASHER NOTICE TO APPLICANT If after making this Certificate of ADDRESS 6558 West Blvd. Exemption you should become subject to the Workers SWIMLING POOL RECEPTOR Compensation provisions of the Lobar Code, you must forth- LAWN SPRINKLER SYSTEM Cin' LOS Angeles TEL N0753-2541 with comply with such provisions or this permit shall be STATE UC deemed revoked IUCENSEN WATER HEATER O 151839 CIASs C 3 6 LICENSED CONTRACTORS DECLARATION DISTRICT NO D BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS �Q (commencing with Section 70D0) of Division 3 of the Busmen OUTLETS OVER and Professions Code and my Incense is in full force and effect 5 PER SYSTEM FINAL _ O License Number 151839 Lic Class C36 DATE VALIDATION�� m FINALO Contractor W _ Tl _ Drnvi n Date /S/SS BY 1{{—d ❑ I am exempt under Sec B&P C for this reason Plan check fee sVhis, Date - / SSignatured PLUMBING PERMIT ISSUING FEE s L!/ TOTAL FEE IrGs 0 SINGLE FAMILY Plan check applicant oCc 61) 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 S Business and Professions Code) City Tel No ❑ I as owner of the property will do the work and the :2764 0 0 A structure is not intended or offered for sale (Section 5 7044 Business and Professions Code) �1• • • • • 11I�^ r CONSTRUCTION LENDING AGENCY I 2 • • 1 250 I hereby affirm that there Is o construction lending agency fee b/1—'—+ the performance of the work for which this permit ,s issued •rs • 1 2506 (Sec 3097 Civ C ) 0923=82 Lenders 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 Stole jaws regulating Plumbing and hereby authorize representatives of this County to enter upon the above mentioned property for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE moi/. il_ /1 ��- Signature of Permittee Dote ' COUNTY OF LOS ANGELES r TEMPLE CITY 8 0508„ PLUMBING PERMIT - DRPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0508100004 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 385-0488 EST ` LEGAL ID PEER PAID BUILDING ADDRESS _ ON PILE 5092 SULTANA AV PEE DESCRIPTION QUANTITY DOW AMOUNT TEMP CA 917803045 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET PENTLAND 5388-017-020 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID R5 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 08/10/05 VG 02/06/06 OWNER TEL NO PIN DATE FINAL BY CODE RADWAN CHESTER P CO TR RADWAN TRUST (626) 286-0389- - - ��-`� 5092 SULTANA AV _ XX TEMP 917803045 DESCRIPTION OF WORK GAS FOR PAU APPLICANT TEL NO BRYANT HEATING AND A/C (626) 286-1141- SPECIAL CONDITIONS CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE BRYANT HEATING AND A/C (626) 286-1341- 1350 E LAST TUNAS DR LIC NO UNDER SLAB WORK SAN GABRIEL, CA 91776 22175IC20H WATER SERVICE PLASTIC Y/M METAL Y/N ARCHITECT OR ENGINEER TEL NO _ ROUGH PLUMBING LIC MO GAS PIPING • GAS VENT HOT WATER HEATER PLUMBING FIXTURES LAWN BPHIHXLERB GAS TEST UTILITY COMPANY NOTIFIED CKV GRAY WATER SYSTEM REPORT ID DPR263 ROUTE TO BS0500