HomeMy Public PortalAbout6371 SULTANA AVE_Plumbing__ (2) 78A887•CE#817 9/63
APPLICATION FOR PLUMBING PERMI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND-SAFETY DMSION - FNEAREST
DING
JOHN A.LAMBIE,.COUNTY ENGINEER RESS T to 17,_W} ,..
WILLIAM A.JENSEN,SUPT OF BUILDING /
AMT[Y F� br �/7
FOR APPLICANT TO FILL IN SS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25
BATH TUB 1.25' ADDRESS
SHOWER 1.25
CITY TEL. NO.Id7,-
LAVATORY 1.25 CONTRACTOR
SINK 1.35 ADDRESS + / *1
DISHWASHER 1.25 cITT,,,Z. g�E TEL.NO.ZdSTATE
LAUNDRY TUB 1.25 CONTRACTOR'S f 0�0 COUNTY'
REGISTRATION.NO. �.�1J ❑'
CLOTHES WASHER 1.25 DISTRICT NO. OUP ;?E P O S BY
WATER HEATER 1.50
GAS SYSTEM. OUTLETS 1.50 INDUSTRIAL a
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30• INSPECTION RECORD U
0
_ V
� W
0.- y
.Z
APPROVALS .11ATE., INSPECTOLI'S sIGNgTupE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING f
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION'S GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND,AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
-
1 HEREBY CERTIFY THAT 1 AM ROPER REGI RED AND/OR PLUMBING FIXTURES
LICENSED AS REQU BY LO3 N ECE C NTY NO STATE OF GAS TEST
CALIFORNIA ORT T 1 M THE N OF, NO INTEND TO
RESIDE IN,THE AB VE D SCRIB R IDE 1 PRO Riv. UTILITY CO'.NOTIFIED `.
SIGNATURE !Zr�
OF PERMITTEE
FINAL ylly r '
ALMATION ROBERT A.WOOD v ry
CK. M.O., CASH SUPERVISING MECHANICAL ENG'R
LX09 5 1 TZ MAY29 5 D 3.25m q
V.S.S.17 2SM SETS 2-47 - APPLICATION FOR PERMIT
DEPARTMENT..OCOMM OF ANGELES SAFETY
WM.J.FOX..CHIEF ENGINEER PLUMBING
NATURE"OF INSTALLATION DISTRI-T NO. GROUP ZONE
P/xRl I O.
ROUGH a FIXTURES COMPLETE
HEATER CESSPOOL SEPTIC TAN RECEIVED BY READY FOR TE ISSUED
K FIRST INSPECTION `
GAO MISCELLANEOUS ��� % 17
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
Joe
d, NAME J ADDRESS /�V //• t /•t-L!. t �s„ i�
W
® ADDRESS LOCALITY_
sp
NEAREST
CITY
CITY /Vt/ TEL.:No. CROBB-ST.
COUNTY (% I
CERT.No. EXPIRES NAME •
LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAILa I�'�73��� y
NORTH O ADDRESS f �fl�.�.A •�
CITY €4i "riY TEL.No.
I AM 'THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
PwweER
I AM THE LEGAL OWN q,6F THE PROP /.•ADESCRIBED
ABOVE.
6..�/�1117/�/9�1••I� w
3 m I
gin
owNeil
CORRECTIONS
SOUTH
J
DESCRIPTION OF WORK z
z_
BATH TUB./ FURNACE 0
DISHWABHER
ROWER"
O
VATORYI/ REFRIGERATOR
IrCHEN SINK WATER SOFTENER-
-FLOOR SINK SAND TRAP c u
LWA
P BINK FLOOR DRAIN
H TRAY /� URINAL APPROVALS
ER CLOSETr DRINKING FOUNTAIN DATE INSPECTOR'S HAMS
ER HEATER DENTAL LAVATORY ROUGH PLUMBING � _rJ 7
ER GAS SODA FOUNTAIN GAS PIPING I I
OUTL
GAS VENT
CESSPOOL I
AL NUMBER OF FIXTURES SEPTIC TANK I
8P001 SEPTIC TANK SEWER I
B .rte
UTILITY CO.NOTIFIED
TOTAL FEE Lf �"(�
RINAL
D.B.S.-1T 25M SETS 6-46 APPLICATION FOR PERMIT
DEPARTAJENT OF BUILDING AND S
COUNTY OF LOS ANGELES PLUMBING
W.M.J. FOX.CHIEF RNGINEER
NATURE OF INSTALLATION- DlWrRICT NO. I GROUP ZONE PERMIT NOg.
ROUGH FIXTURES I COMPLETE
HEATER CESSPOOL I-`SEPTIC TANKRE6�IVED HY READY FOR DAMNISSUED
GAB•
MISCELLANEOUS
L FIRST INSPECTION V /
- APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
!; JOB �( a
Ir NAME 1 c y� q� ADDRESS'
ADDRESS, LOCALITY 41? Z d•.�I_i4!' IFL a1
J ///f k� NEAREST' 1/1 n
0. CITY / ..�,;.;.1..�7.d rTEL.No. CROBSST. J sfi'�L�
COUNTY (� F
CERT.No. EXPIRES 6' NAME �`S .%! s►ns►si..
LOCATION OF SEPTIC TANS; OR CESSPOOL z MAIL .,
3 ADDRESS
NORTH O _
CITY TEL.NO.
I AM THE LEGAL" POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFI &OF Q LIFIgA�TION.
• Blw
PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY'DESCRIBED
ABOVE. i
OWNER.
CORRECTIONS
SOUTH J
DESCRIPTION -OF WORK z
HATH TUB FURNACE
SHOWER DISHWASHER O
AMATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
L__FLOOR SINK - SAND TRAP
SLOP SINK FLOOR DRAIN '
WASH TRAY URINAL APP ALS
WATER CLOSET DRINKING FOUNTAIN TE INSPECTOR'S NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING
a
METER+• GAS gODA FOUNTAIN
OUTL GAS PIPING
GAS VENT I e
LN
CESSPOOLTOTAL NUMBER OF FIXTURSEPTIC TANK
ESSPOOR aEPTlC • SEWER I
S UTILITY CO.NOTIFIED 1 I
TOTAL.FEE
FINAL
D.B.B.17 25M BETH 1D-47 APPLICATION FOR PERWr
DEPARTMENTOF
O LOS ANGELES
SAFETY PLUMBING1
WM.J. FOX.CHIEF ENGINEER
NATURE O INSTALLATION DISTRI Ho. o E PIMIT NO.
ROUGH }� FIXTURES COMPLETE �. �
HEATER I CESSPOOL -I SEPTIC TANK READY FOR
REC FIRST INSPECTION DATE 1680
AS• M18CELLANEOUB o "��
APPLICANT FILL IN HEAVILY OUTLINED oe PORTI�ON ONLY
G NAME JA
ADDRESS d /y !Z12�;y/
hl
m ADDRESS
g LOCALITY
NEAREST
0CITY TEL.NO. CROSS 8T. D g-
G.
COUNTY
CERT.NO. EXPIRES m NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL a MAIL ��^^
NORTH O ADDRESS Z
��++ L A
CITY r.D)7 U"'d b-lr TEL.N.
IAM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
PLUMBER
I AM THE LEGAL OWNER OF THBPROFTY DESCRIBED
ABOVE.
OWNER
CORRECTIONS
SOUTH J
DESCRIPTION OF WORK _i
BATH TUB FURNACE E
Q'
SHOWER —DISHWASHER O
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
GLOP BINK FLOOR DRAIN
WASH TRAY URINAL APPRO ALS
WATER CLOSET DRINKING FOUNTAIN ISA E IN9PUCTOR-0 NAME
k:�WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I
METER—L--GAS SODA FOUNTAIN
OUn GAS PIPING I �'
GAS VENT
CESSPOOL
TOTAL NUMBER OF FIXTURES SEPTIC TANK I
CESSPOO SEPTIC TANK SEWER
S •'/
TOTAL FEE
UTILITY CO.NOTIFIED
- �- � � „• � i
FINAL
,'{ WORKERS'COMPENSATION DECLARATION 20,0026 DPW 4/87 APPLICATION FOR PLUMBING PERMIT
A herebyy affirm that I have a certificate of consent to self in- 76A667A
sura,or a certificdte of Workers'Compensation Insurance,or a CE 817(REV.8/86)
.;ertified copy th reof(9�c�3800, Lab. C.)
Policy+No� mCompany��&- O COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS
0 Certifi9d copy is hereby furnished. BUILDING
FOR APPLICANT TO FILL IN(PRINT OR TYPE)
Certified copy is filed with the county building in pection ADDRESS -G
department. NUMBER FIXTURE OR ITEM @ FEE
LOCALITY `
Date a Applica 2i WATER CLOSET(TOILET)
NEAREST _
CE IFICATE OF EXEMP O FROM WORKERS'
BATH TUB CROSS ST..
COMPENSATIO NSURANCE SHOWER OWNER
(This section need not be completed if the work involved by
MAIL
the permit is for one hundred dollars(;100)or less.) LAVATORY ADDRESS �.
1 certify that in the performance of the work for which this per- SINK
mit is issued, I shall not employ any person in any manner so CITY ti TEL. NO
as to become subject to the Workers'Compensation Laws. DISHWASHER
CONTRACTOR
Date Applicant CLOTHES
WAS ,ADDRESS
NOTICE TO APPLICANT: If, after making this Certificate 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 provisions or this permit shall be deemed revok- STATE LIC.
ed. 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 fJ
9(commencing with Section 7000)of Division 3 of the Business OUTLETS.OVER
fe a, Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL /��qy VALIDATION a
DATE [ // O
License Number Lic. Class V
FINAL p 9C
Contractor ate BY Ci O
H
❑ I am exempt under Sec. W
I
d
B.BP.C. for this reason Plan check fee U)
Date: PLUMBING PERMIT ISSUING FEE$
Signature
TOTAL FEE
SINGLE FAMILY
1-101M/0W1ER-BUILDER DECLARATION Plan check applicant
I hereby affirm that I am exempt from the Contractor's License Name
Law for the following reason (Section 7031.5, Business and r•r. a
Professions Code): Address
C0
'''-' �
I, as owner of the property, will do the work and the City CQ
Tel. No. °•.
structure is not intended or offered for sale(Section 7044, i T _ ,��.e
Business and Professions Code).
CONSTRUCTION LENDING AGENCY ® TOTAL 587 . 5101
I hereby affirm that there is a construction lending agency for CHECK 56°5C
the performance of the work for which this permit is issued CHANGE 00.
(Sec. 3097, Civ. C.).
Lender's Name _
Lenders Address I AM ,?:1c
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
(GAorize representatives of this County to enter upon the
abo -mentioned propert for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
_y
ature o Permittee Dat
' - COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1201170004
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
[LEGAL ID: I FEES PAID [ BUILDING ADDRESS: 1
[ ON FILE 6374 SULTANA AV [
[ IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:[ SGAB CA 917752068 [
[ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LONGDEN
15382-019-024 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, CI
1 107 BATHTUBS/SHOWERS 1.00 FIX 16.30 [ [
IT 25 LAVATORIES/SINKS 1.00 FIX 16.30 ISSD
145 WATER CLOSET/URINAL 1.00 FIX 16.30 101/17/12N: PROCSSRSED BY: PLAN BY: [
[ I TOTAL FEES 76.70 I I
(OWNER: TEL. NO: [ IFINAL DATE FINAL BY: CODE:
IYUE BENTON S;MING M (626) 695-2155- I I I
16374 SULTANA AV [ I I
ISGAB 917752068 [ IDESCRIPTION OF WORK 1
I I IREPLACE 1 SHOWER, 1 LAVATORIE, 1 WATER CLOSET FOR BATHROOM I
IREMODEL I
APPLICANT: TEL. NO:
SAME AS OWNER
_ I
I [ ISPECIAL CONDITIONS: 1
1C0NTRACT0R: TEL. NO: 1 1APPR0VALS DATE INSPECTOR SIGNATURE 1
ISAME AS OWNER - I I I
[ LIC. NO i [UNDER SLAB WORK I I I
I I IWATER SERVICE
I I IPLASTIC YIN METAL YIN I I I
1ARCHITECT OR ENGINEER: TEL. NO: 1 1-1 [
I - I (ROUGH PLUMBING
[ LIC. NO: 1 1 I
[ I [GAS PIPING I I I
[ IGAS VENT
I I I
I I HOT WATER HEATER
I1-1 I
I I IPLUMBING FIXTURES I I I
1-1
I [ ILAWN SPRINKLERS [ 1 [
1 GAS TEST [ I [
[ [UTILITY COMPANY NOTIFIED[ I [
I I ICWV I I I
[GRAY WATER SYSTEM
F
O�u uh uiS�� [ I [ '� `� [
I I 1 I I I
I I I I I I
I I I I I I
I I I I I I
I IREPORT ID: DPR263 ROUTE TO: BS0508 1 1 1 1
I I I I I I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0904160014
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID 1 BUILDING ADDRESS: I
ON FILE I [ 6374 SULTANA AV 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:] SGAB CA 917752068 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LONGDEN 1
15382-019-024 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, Cl
1 107 BATHTUBS/SHOWERS 2.00 FIX 32.40 1 1
TENANT: 125 LAVATORIES/SINKS 2.00 FIX 32.40 11SSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I
145 WATER CLOSET/URINAL 2.00 FIX 32.40 104/16/09 SR 10/13/09 1
1 I TOTAL FEES 124.95 1 I
(OWNER: TEL. NO: I IFINAL DATE FINAL BY: CODE: 1
IYUE BENTON S;MING M (626) 905-3120- I I I
16374 SULTANA AV I
ISGAB 917752068 I IDESCRIPTION OF WORK I
I 1PLUMBING FOR 2 BATHROOMS REMODEL 1
]APPLICANT: TEL. NO: I
ISAME AS OWNER - I
I I ISPECIAL CONDITIONS: I
I I I I
ICONTRACTOR: TEL. NO: I ]APPROVALS DATE INSPECTOR SIGNATURE I
[SAME AS OWNER - I I I
LIC. NO 1IINDER SLAB WORK [ I I
I I I I I
(WATER SERVICE I I I
I IPLASTIC YIN METAL YIN 1 I I
]ARCHITECT OR ENGINEER: TEL. NO: - I 1ROIIGH PLUMBING [ I [
[ LIC. NO: 1 I [ I I
I I IGAS PIPING
_P_NG
I I ]GAS VENT I I I
[ [ IHOT WATER HEATER 1 I
I I I I I I
[ I [PLUMBING FIXTURES [ I I
1 I ILAWN SPRINKLERS I I I
I I IGAS TEST I I 1
] ]
INRED ]UTILITY COMPANY NOTIFIED] I ]
I I ICWV I I I
a.o o
IGRAY WATER SYSTEM I I [
I I I I I I
I I I I I
I
I I I
[ I ] I
I ! ] I I
] I I ] I I
IREPORT ID: DPR263 ROUTE TO: BS0508 1 1 I
I I I I I