HomeMy Public PortalAbout6005 SULTANA AVE_Plumbing__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 FL-OMBM-P'E'RM
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL-0508 991.2270.0
BUILDING•AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
' LEGA ID: FEES PAID BUILDING-ADDRESS D
TR: 5904 LT: 300 LTANA AV
FEE DESCRIPTION: QUANTITY: UDM: AMOUNT: -EMP-EA-9.1-7801.550
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: HERMOSA
5384-016-030 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY
51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20
TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
12/27/99 UT 06/24/00
OWNER: TEL. NO: FINALiDATE FINAL B CODE:
MISTRETTA MICK C;DEBRAH I (818) 286-3305-
6005 SULTANA AV Z3ro
TEMP 917801550 DESCRIPTION OF WORK
MOVE GAS LINE
APPLICA T: TEL. 0:
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER UNDER SLAB WOR
LIC. NO
Jr � \ � WATER SERVICE
��`I ��, i PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TEL. N0:
G B ARCHITECTS (909) 949-6999;;, �/ �I I I �Ly L i -I -` � ROUGH PLUMBING
275 CANTERBURY CT. LIC. NO:�� r� -
UPLAND, CA 91784 NONE :C, GAS PIPING
;r GAS VENT
f I _J.I ?j I 1 �i li•�� ;';� s 0 WATER HEATER
--- - - — - -— A PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
/ qd
UTILITY COMPANY NOTIFIED
GRAY WATER SYSTIW
REPORT ID: DPR263 ROUTE TO: BS0508
I J
ISS-17
7 Ik. APPLICATION FOR PLUMBING PERM-IT
DVSf6N 1
OF BUILDMG AND SAFETY
Deportment of County Engineer
'County of Los Angeles BUILDING
JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN,SUPT OF BUILDING.
LOCALITY
FOR RPLICANT TO FILL IN NEAREST
- CROSS ST. .I r
OWNER _ / DISTRICT NO. GR.O ZON(E' READY FOR INSPECTION
MAIL
ADDRESS
INDUSTRIAL
CITY WASTE APPROVAL
PLUMBER � INSPECTION RECORD
ADDRESS
7— e
CITY.
LICENSE NO. ,o k::J/�?r-0 AW112
1 n ,R_ LO6 S
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 .$ 1 Z ,L,EA& FR,5,04 &Q"1i} Ok
BATHTUB @. $1.00U$ ")F Gi9�
SHOWER @ $1.00 �' Z, CH-d-5-El' &,;AP
LAVATORY (WASH BASIN.) @ $1.00 d
KITCHEN SINK @ $1.00f�/�/'•
DISHWASHER @ $1.00 xJ��4 ffjw-f_-p
LAUNDRY TUB OR TRAY - @ $1..00 p Phry
CLOTHES WASHER @. $1.00 }y
WATER HEATER @ $1.00 ALE-7WR PROPER Agrt )wr,
GAS SYST_E @ $1.00 L /S Pa VI.A p p, 13FP
Co nae,T C�i p nlrE �i�ls
P, er I
APPROVALSPh,.
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
ROUGH PLUMBING b
PERMIT $ 1 ,00
GAS PIPING D J'I 1.1 �'
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS'CORRECT AND AGREE TO COMPLY p
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES S P.
U f
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/Olt GAS TEST Y r'
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT IAM THE LEGAL OWNFR OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE
OF PERMITTEE " FINAL
OHN A.L.AMBIE,COUNTY ENGINEERAIMATION ROBERT A.WOOD;CHIEF PLBG. INSPECTOR
ff
N,.O. CASH
�.�o 4. 5 JAN 31 3 5-00 �
";i WORKERS aveNSATION DECLARATION APPLICATION FOR PLUMBING PERMIT
•�� ' " �
I her% •by,,"affirr>? that I have a certificate of consent to self in- 20-0026 DPW 4/87 76A667A
sure,pr aacertifitate of Workers'Compensation Insurance,or a CE 817(REV.8/86)
certified copy thereof(Sec. 3800, Lab. C.) ,
Pol'icy,No.' Company
COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
,
Certified copy is hereby furnished. BUILDING ��� '
' FOR APPLICANT TO FILL IN(PRINT OR TYPE) ` •�' �
❑ Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM ADDRESS W005 . 5V 1
department. C FEE
LOCALITY w) [„ c
Date Applicant I l WATER CLOSET(TOILET) DD NEAREST w A
CERTIFICATE OFVEMPTION FROM WORKERS' BATH TUB CROSS ST. � N!
COMPENSATION INSURANCE SHOWER OWNER Mley— JAI -rPC%tA
(This section need not be completed if the work involved by MAIL
,rye
the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS (ACOS 5014ANN
I certify.that in the performance of the work for which this per- SINK p`� ��+ TEL. NO.
mit is issued, I shall not employ any person in"anmanner so D CITY r as to'become subject to the WorAs
s. DISHWASHER
3^, CONTRACTOR
Date_; ApplicaCLOTHESWASHER ADDRESS ;
NOTICE TO APPLICANT: If; afterertificate of Ex- SWIMMING POOL RECEPTOR
emption,you should become subject to the Workers'Compen- CITY TEL. NO.
sation provisions of the Labor Code,you must:forthwith comp- LAWN-SPRINKLER SYSTEM
ly with such prov'isiohs or this permit shall be deemed revok= 1. STATE LIC.
ed. ` WATER HEATER LICENSE.NO. CLASS.
'LICENSED CONTRACTORS DECLARATION DISTRI T NO. OCEtSSED BY
I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS O �/ f�S
9(commencing with Section 7000)of Division'3 of the Business OUTLETS OVER a
and Professions Code, and'my license is in full force and ef- 5 PER SYSTEMVP
fect. DA TEL
/ ® 'VALIDATION
et
License Number Lic. Class :t FINAL
� O
• - rJ
Contractor Date BY (:1C'Ifa4 I O
I am exempt under Sec. 3307 34.50 w
CIL
B.&P.C. for this reason Plan check fee
Date-.—
PLUMBING PERMIT ISSUING FEE$ d TOTAL 3La''4 m 50�
TOTAL FEEH 34.5'.0SINGLE FAMILY �C �i
I
HOME OWNER-BUILDER DECLARATION -Plan check applicant CHANGECIO
I hereby affirm that I am exempt from the Contractor's License Name. , ��(� W`�5� I
Law for the following reason (Section 7031.5, Business and ,
Professions Code): Address 6(1 i5 N- 5w LSA 009[I-0-901 3/14189,
I, as owner of the property, will do the work and the City E� •} Tel. 1872 1 AM
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 i
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 lead 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
obov -m ntione ro ert for inspection purposes.
?;-10. 9 SEE REVERSE FOR EXPLANATORY LANGUAGE
Si naturb bf P rmittee Date