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Home My Public Portal About5334 TEMPLE CITY BLVD_Plumbing__ 4 1 TewaeT •CMOB IT 'APPLICATION FOR PLUMBI G PERMIT COUNTY OF LOS ANGELES DEP�AR��TMEjNNT/�{� OF CppO�IIN'TyyY ENGINEER smcaDra 22 B o-FT�t�GLAM>�I of u vrrNo?seEOn� wasrJ,s ✓ M l tv C $�V COLEMAN W JENKINS. SUPT OF SUILDI.0 LOCALS FOR APPLICANT TO FILL IN C NEAREST NUMBER FIXTURE OR ITEM EACH FEE CROSS WATER CLOSET sl 95 NER A�li� •K BATH TDB 125 aAa ms 6"3 3 4, TE c,[r 63/`u SHOWER 125 a�• CITY TEL NO LAVATORY I95 uZ5 CONTRACTOR 4. BIN[ 195 ADDS 1 DISHWASHER 195 CRT TEL NO p20660 LAUNDRY TDB 195 REGISTRTRATION NO /6 COUP cLOn�e WASHER 195 ' DIT$1LT NO ORP ]JON' PROLE WATER HEATER 150 �� O 1: K y -GAS Rr87Dx ODTLETB I - 6 WASTE APPROVAL li OUTLETS OVER s PER BTST'Ee5 90 INSPECTION RECORD V 9c r o in C O W 9L V! 2 r ' APPROVALS DATE INSPE O ee1GNATpRE PERMIT j p OO UNDER SLAB WORK ROUGH PLUMBING TOTAL FEE GAS PIPING 1 HERSEY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 4.A$VENT ANO [TAT[ THAT THE ABOVE IE CORRECT AND AOR[[ TO COMPLY WITH ALL COUNTY 011DINANCf[ AND [lwiL LAWS R[OpLATIMp HOT WATER HEATER PLUMBING 1 HERESY C[RII Fv THAT I AM PROP[Rly R[OI[TER[D AND/OltPLUMBING FIXTURES LICENSED AS REQUIRED INT LOB ANGELES COUMYY AND STATE OF GAS TEST / CALIFORNIA OR THAT 1 AM TH[ LEGAL OWM[R OP AND IIREMO TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROP[RTI UTILITY CO OTIFIED SIGNATURE1 OF PERMITTEE Lt/ FINAL i (�ATION ROBERT A WOOD cK M o CASH SUPERVISING MECHANICAL ENG R LACo3 7 7 ',J-� .Ja27 5 0 1 025' ..WORItERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT _I hereby,offirm that I have a certif¢9te of consent to self 20-0026 DPW 6/87 Insure Ur a ceruf,cole of Workers Compensation Insurance, 7BA667A or a certified copy thereof (Sec 3800 Lab C ) COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS Policy No Company Certified copy is hereby furnished ❑ FOR APPLICANT TO FILL IN(PRIM OR TYPE)pecADDRLDING ESS £ C�7y B41(/d Certified copy IP filed with the county building Ins - tion deportment NUMBER FIXTURE OR ITEM ® FEE LOCALITY .�"''� Gtr t Date AppllSont I WATER CLOSET NEAREST /uJ/ r CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB F� CROSS ST VC COMPENSATION INSURANCE SHOWER J OWNER - (This section need net be completed if the work In"hied by AA the permit Is for one hundred dallars(6100)or leu) LAVATORY 'ADDRESS y �l� 17 I certify that In the performance of the work for which this G permit Is issued, I shall not employ any person In any manner SINK CITY C17-7TEL NO 06- yr so as to become subject to,the Workers'Compensation Laws DISHWASHER CONTRACTOR Date ^ 9- 9� A.pplicanl CLOTHES WASHER NOTICE TO APPLICANT If, offer making this Certificate of ADDRESS Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth CITY ` TEL NO with comply with such provisions or this LAWN SPRINKLER SYSTEM , P Y a Permit shall be STATE " lK doomed revoked WATER HEATER LICENSE NO -' CLASS LICENSED CONTRACTORS DECLARATION DISTRICT f, BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS E5. �I t 177 (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER !/ y and Professions Code,and my license Is in full force and effect 5 PER SYSTEM FINAL VALIDATION D1 LicenseNumber 1¢ Clans DATE 8 FINAL Contractor Date BY O ❑ I am exempt under Sec ! D W B BP C for this reason Plan check fee 3�IS�� f� V) Date Z PLUMBING PERMIT ISSUING FEE$ a Signature TOTAL FEE SINGLE FAMILY Plan check applicant 5 HOME OWNER BUILDER DECLARATION Name ACCT.* I hereby off irm that I am exempt from the Contractor s License Address I Law for the following reason (Section 7031 5, Business and 330] - 50.5J.1 Professions Code) City . Tel No 1 ITEM Jar I, as owner of the property will do the work and the structure is not Intended or offered for sale (SectionpopTOTAL 50.50 70", Business and Professions Code) CONSTRUCTION LENDING AGENCY CNECK 50.50 1 hereby affirm that there Is a construction lending agency for CHANCE .001 the performance of the work for which this permit Is Issued (Sec 3097 Civ C ) Lender s Name 001010-0001 3/13/90 Lenders Address 9,01 t 1 AN 9:0:' I certify that I have read this application and state fbm the ► above Information Is correct I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby nut orize repre?;ematwes of this County to enter upon the ab e-mentions props y for ecnon purposes SEE REVERSE FOR EXPLANATORY LANGUAGE r O gnat of Perml tee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 IAS TUNAS PL 0508 1302190021 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 'PHONE (626) 285-0488 EXT LEGAL ID I FEES PAID TR 15531 IT 4 I BUILDING ADDRESS 1 5334 TEMPLE CITY BL FEE DESCRIPTION OpANTITY DOM AMOUNT TEMP CA 917803148 ASSESSOR INFORMATION NUMBER I STREET NEAREST CROSS STI3SET OLIVE 8589-001-004 - 101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID A4 LOCALITY TEMPLE CITY CAI 113 DISHWASHERS) - 1 00 FIX 16 20 1 TENANT25 LAVATORIFS/SINKS 1 00 FIX 16 20 (ISSUED ON PROCESSED BY PIAN BY 1 127 PRESS REG DEVICE(S) 1 00 DEV 16 20 102/19/13 SR 147 TATER HEATER(S) 1-00 W 1 16 20 1 - 0 TEL NO 151 IOW PRS GAS 5 OUTLET 1 00 SYS 16 20 1FINAL DATE FI BY CODE IRINGO JOSEPH A KIMBERLY L (626) 286-4477- TOTAL FEES 108 BO I 5334 TEMPLE CITY BL TEMP 917803148 ID, PTI 'OF WORK IMDVE WATER HEATER OUT SIDE, INSTALL DISHWASHER, PRV, SINK, APPLICANT I IGAS COOK TOP AND GAS LINE I SAME AS OWNER TEL NO I ISPECIA* CONDITIONS I I I I I CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE I (SAME AS OWNER LIC NO _ UNDER SLAB WORK I WATER SERVICE (ARCHITECT OR ENGINEER TEL NO PLASTIC Y/N METAL Y/N - I LIC NO I IROUGH PLUMBING GAS PIPING I 1 _ I 1 t 1GAS VENT 1 I (HOT WATER HEATER 1 1 I I I PLUMBING FIXTURES 1 (LAWN SPRINKLERS (GAS TEST (UTILITY COMPANY NOTIFIED I I 1 ICwV I 1 [GRAY TATER SYSTEM I I I ' I I I I I 1 I I I I 1 I I 1 I I I I _ REPORT ID OPA263 . ROUTE TO 880508