The URL can be used to link to this page

Home My Public Portal About5928-5934 TEMPLE CITY BLVD_Plumbing__ 76AS67 nee 17 11-50 APPLICATION FOR PERMIT DEPARTMENT OFNG AND SAFETY PLUMBING COIINTY OFF LOS LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER GROUP . FOR APPLICANT TO FILL IN l PLUMBER e4lif� a t t.1t tr 1 REC�,ED BY READY FOR DATE ISSUED C/, q �{. FIRST INSPECTION ADDRESS -! y _ �� , c1/P.1 ti-(! Bill, {.. I BUILDING r� �•�, CITY ('�1+ 111 CA17i TEL.NO' O A -;1�7 ADDRESS � f 1 COUNTY LOCALITY o11."a's'e �t.lff LICENSE NO. ct EXPIRES , NEAREST Y PERMIT FEES CROSS ST. NUMBER TYPE OF FIXTURE OR ITEM FEE OWNERLMAILap- tt� t' l.I u 010't4Ar WATER CLOSET(TOILET) (p 0.50 R ADDRESS ry �!a o 1 ern s r1.' .fie. 61,/ ¢¢ I � BATH TUB (I� 0.50 CITY `Z : ;;'; Nt f TEL No. SHOWER @ 0.50 I HEREBY' ADICN13WLEOME THAT 1 HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES KITCHEN SINK 0.50 ` AND STATE LAWS REGULATING PLUMBING. I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER GAS SYSTEM- �UTLETB 0.50 OF THE RESIDENT RO E DEB BE ABOVE. SIGNATURE OF / WATER HEATER . 0.50 PERMITTE SLOP SINK 0.50 INSPE TION RECORD FLOOR SINK 0.50 FLOOR DRAIN 41 0.50 DISHWASHER 0 O.SO DRINKING FOUNTAIN Q 0.50 URINAL @ 0.50 J a HOUSE SEWER 0.50 Z MISCELLANEOUS 0 O APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING GAS VENT CESSPOOL 0 1:00 CESSPOOL SEPTIC TANK.* SEPTIC TANK DRAIN ( ) PIT ( I @ 1.00 SEWER PERMIT 1.130 GAS TEST UTILITY CO.NOTIFIED TOTAL FEE B 1 :50 7-7 FINAL �.L o. 8. 17 4-40 10M APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY j�� j�T COUNTY OF LOS ANGELES PLUMBING WM. J. FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO.. GROUPZONE PERMIT No. ROUGH I PLUMBING FIXTURES COMPLETE RECEIVED BY READY FORDATE ISSUED HEATER I CESSPOOL I SEPTIC TANK J/: FIRS INSPECTION GAS / MISCELLANEOUSL 4°�'+'st�.r pa�.1,.�- ✓' 7 �� APPLICANT FILL IN.HEAVILY OUTLINED PORTION ONLYJOB , NAME ' V ADDRESS 190 ADDRES$"1. � / � LOCALITY ' d C1. u �-t7EL N r`I I• CROSSSST. COUNTY CERT. NO. EXPIRE SQf/ ' E ff'_rf yl NAME 2=9 [Ff Z MAIL LOCATION OF SEPTIC TANK, OI/CESSPOOLO ADDRESS. NORTH CITY TEL No. 1 AMTHE' LEGAL POSSESSOR OFjI E ABOVE LOS F7 ANGELES COUNTY CERTIF UGLIFICATION. tF'.IiE Pr MY 1 AM THE LEGAL OWNE � T E �D SERIBED ABOVE. // 3 OWNER CORRECTIONS SOUTH _ J (DESCRIPTION OF WORK BATH'Tus FURNACE ROWER DISHWASHER n 0 ' 11 VATORY REFRIGERATOR a KITCHEN SINK WATER SOFTENER' --FLOOR SINK SAND TRAP LOP SINK FLOOR DRAIN - WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE RVaPECTOB'S NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING ETER GAS SODA FOUNTAIN GAS PIPING OUTL GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES �J SEPTIC TANK CESSPOOL SEPTIC TANK SEWER $ UTILITY CO. NOTIFIED TOTAL FEE 10A-/ f,G;� FINAL 7SA667 17 2SM SETS 7-4B •• 'APPLICATION FOR PERMIT DEPARTMENT OF 'BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING 1 WILLIAM J. FOX, CHIEF ENGINEER NOTTINGHAM D GROUP O P . FOR APPTLICANrnT�TO' FILL IN• �• 1T®T1 A Alm � --_ --- ��/-/s,PLUMBER RECEIVED BY READY FOR. DATE ISSUED ADDRESS 123 No �• �1v5 0-0� FIRST INSPECTION CITYTEMPLE a00 �yp ADDRESS / t•6/ COUNTY � • . LICENSE NO. EXPIRES LOCALITY I CERTIFY THAT I POSSEEIB THE ABOVE VALID LOS NEAREST ANGELES' COUNTY LICENSE. � CROSS ST. Y bet- OWNER Ado • 9A MAIL p1 uMe :ADDRES PERMIT FEE IS $1.00 FOR THE FIRST FIXTURE OR CITY TEL. No. . ITEM LISTED BELOW, PLUS SOO FOR EACH ADDITIONAL I AM THE LEGAL OWNER OF THE RESIDENTIAL PROP- ITEM. FOR EACH SEPTIC TANK AND PIT OR DRAINFIELD ERTY DESCRIBED ABOVE. $1.00. MINIMUM FEE FOR ANY PERMIT $1.00. EACH GAS SYSTEM IS A SEPARATE ITEM. OWNER NUMBER TYPE OF FIXTURE OR ITEM WATER CLOSET (TOILET) CORRECTIONS BATH TUB SHOWER LAVATORY (WASH BASIN) KITCHEN SINK LAUNDRY TUB OR TRAY GAS SYSTEM OUTLETS WATER HEATER SLOP SINK Q FLOOR SINK Z FLOOR DRAIN DISHWASHER O DRINKING FOUNTAIN URINAL MISCELLANEOUS APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING „ OAS VENT CESSPOOL SEPTIC TANK - DRAIN ( ) PIT ( ) $ ' SEPTIC TANK CESSPOOL $ SEWER HOUSE SEWER $ GAS TEST w� UTILITY CO.NOTIFIED TOTAL FEE' FINAL D.6.5:17 ZSM.SETs-12:44 - APPLICATION FOR PERMIT 1 DEPARTMENT OF BUILDING AND SAFETY _ COUNTY OF LOS ANGELES - �� ' - WM.J. FOX.CHIEF ENGINEER NATURE OF INSTALLATION 015TR7NO. GROUP ZONE , PE ItMIT NO. ROUGH FIXTURES I-I'COMPLETE HEATER CESSPOOL SEPTICTANK RE IVSD Y READY FOR DATE ISSUED �j ff FIRST INSPECTION GAS MISCELLANEOUS `! { �j APPLICANT FILL IN HEAVILY OUTLINED'PORTION ONLY JOB d, NAME(/` ./ / / f�.-ffr"�e" "', L ADDRESS X _ ADDRESS J �v—�Q...,. LOCALITY �J �] JJ- NEAREST j 'CITY `'�at- -yf/L�yE,-t;:� � TEL.No. - CROSS ST. COUNTY — CERT.No. EXPIRES NAME LOCATION OF SEPTIC TANK, OR R CESSPOOL -Z• MAIL- NORTFI O ADDRESS CITY TEL.No. 1 AM -THE LEGAL POSSESSOR OF THE ABOVE LOS - ANGELES COUNTY CERTIFICATE OF QUAtfACATION. ,.. ' PLUMBER. ' 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED 14 ABOVE. OWNER . CORRECTIONS _ SOUTH DESCRIPTION OF WORK ' ATH TUB FURNACE " aHOWER ^.ISHWASHER O LAVATORY' REFRIGERATOR ITCHEN SINKWATER SOFTENER• ' - FLOOR-SINK aANA TRAP - LOP SINK - -FLOOR DRAIN WASH TRAY - URINAL c APPROVALS WATER CLOSET DRINKING FOUNTAIN• DATE iNepeeToe's riwMe WATER HEATER ^ENTAL LAVATORY ROUGH PLUMBING ( " METEo ZAB SODA FOUNTAIN OUTL 6A8 PIPING I i �. GAS,VENT CESSPOOL Ii AM tJ74��r0 TOTAL NUMBER OF FIXTURES - ( I U ��j "SEPTIC TANK - -CESSPOOi SEPTIC TANK ' t C/�/ SEWER F. I. F 6tn UTILITY CO.NOTIFIED I TOTAL FEE - I FINAL 7SASS7 17 z5M BETS 7-48 APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING i COUNTY OF LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FCR APP_LICANT'TOFILL IN DISTRIM ..�-- OFEULIP ZONE P . ry PLUMBER M. Cd NOTTINGHAM CO. � IcW ii�� T a RECEIVED BY READY FOR DATE ISSUED ADDRESS 163 lel®. �il .V A FIRST INSPECTION CITY TEMPT,F. CITAo. JOB � S' ADDRESS 65, may' COUNTY LICENSE NO. EXPIRES LOCALITY 1 CERTIFY THAT I POSSESS THE ABOVE VALID Lob NEAREST ANGELES COUNTY LICENSE. CROSS ST. �.• D ��' � 1.91 OWNER leewv�v MAIL PLUWBW ADDRESS PERMIT FEE 19 $1.110 FOR THE FIRST FIXTURE OR CITY TEL. No. ITEM LISTED BELOW, PLUS 500 FOR EACH ADDITIONAL I AM THE LEGAL OWNER OF THE RESIDENTIAL PROP- ITEM. FOR EACH SEPTIC TANK AND PIT OR DRAINFIELD ERTY DESCRIBED ABOVE. $1.00. MINIMUM FEE FOR ANY PERMIT $1.130. EACH GAS SYSTEM IS A SEPARATE ITEM. OWNER NUMBER TYPE of FIXTURE OR ITEM WATER CLOSET (TOILET) CORRECTIONS BATH TUB SHOWER LAVATORY (WASH BASIN) KITCHEN SINK LAUNDRY TUB OR TRAY GAS SYSTEM OUTLETS WATER HEATER SLOP SINK J a FLOOR SINK _Z FLOOR DRAIN 19 DISHWASHERm _ O DRINKING FOUNTAIN URINAL MISCELLANEOUS APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING GAS PIPING • GAS VENT CESSPOOL SEPTIC TANK - DRAIN ( .)'PIT ( ) $ SEPTIC TANK CESSPOOL $ SEWER H13USE SEWER $ GA TEST TOTAL FEE $ UTILITY CO.NOTIFIED FINAL VGAG67 17 s-as(D APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES PLUMBING 1 WILLIAM J.,FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRTNO. GROIJ P I ZONE I MI NO. j 3 U FADDRESS �� RECEIVE BY READY FOR DATE ISSUE FIRST INSPECTION /✓ ! 1 �e. fy !�/ BUILDING CITY A,4 4 Zi A—, TEL. NO. a ADDRESSCOUNTY / y r LICENSE NO. .. EXPIRES//f~ 7®'�7 LOCALITY �r� s r PERMIT FEES cRoss r. J{ NUMBER TYPE OF FIXTURE OR ITEM FEE OW ER - a MAIL WATER CLOSET (TOILET) @ 0.50 8 IY ADDRESS BATH TUB @ 0.50 CITY TEL. NO. SHOWER 0.50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND ✓ KITCHEN 31NK 0.50 STATE LAWS REGULATING PLUMBING. I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE. OR I AM THE LEGAL OWNER OF THE RESIDE Ft L PROPERTY DES BED ABOVE GAS SYSTEM �� OUTLETS @ 0.50AEL -- '--- - ——.- 11, - -- I SIGNATURE OF ^� WATER HEATER @ 0.50 PERMITT SLOP SINK o.so INffPECTIffN RECORD FLOOR SINK 0.50 FLOOR DRAIN @ 0.50 /I , y �,�y� _ 1�� — - =DISHWASHER @ 0.50 C♦ /I_I�,N" DRINKING FOUNTAIN @ 0.50 �L� J� URINAL @ 0.50w-�. :7_ � W ,•° +�f�'Q`�.L�� Q HOUSE SEWER @ 0.50 �;9•i!L^I L r.f 4G7 !,/��i�l�� a Z MISCELLANEOUS - fr4�� Lam. •Q c Aw APPROVALS DATE INSPECTOR'S NAME ROUGH PLUMBING � _ // GAS PIPING \i GAS VENT CESSPOOL @ 1.00 CESSPOOL SEPTIC TANK: SEPTIC TANK DRAIN ( ) PIT ( ) @ 1.00 SEWER PERMIT . 1,o0 GAS TEST UTILITY CO. NOTIFIED TOTAL FEE S y� 0 FINAL .� V J _ �)rD �(,r,,./�• WORKERS'COMPENSATION DECLARATION 76AG67A I. hereby, affirm that I have ir certificate of consent to self ` C19817 (2-60) APPLICATION FOR PLUMBING PERMIT insure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) COUNTY OF LOS ANGELES J BUILDING AND SAFETY Policy No. Company I Certified copy is hereby furnished. I' FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING ADDRESS � +►.�{rl f Certified copy is filed with the county building inspection NUMBER FIXTURE OR ITEM • FEE department. I WATER CLOSET LOCALITY ..� Date Applicant NEAREST J � BATH TUB CROSS ST. r/ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE I SHOWER OWNER E (This section need not be completed if the work involved I LAVATORY MAIL 01—J by the permit is for one hunred dollars ($100) or less.) ADDRESS / ��l 0 SINK CITY TEL.NOy.7JV-%wif V I certify that in the performance of the work for which this DISHWASHER permit is issued, I shall not empl any erson in manner CONTRACTOR U AJ 3 0 so a o become subject to the rke ' Comp on Laws. , CLOTHES WASHER ADDRESS q JAA �� U Dat r Applicant SWIMMING POOL RECEPTOR 1 ^ LL NOTICE TO APPLICANT: ter making this Certificate of CITY TEL.N .Exemption, you should bei me subject to the Workers' LAWN SPRINKLER SYSTEM STATE LIC. Compensation provisions VMe Labor Code, you must forth- WATER HEATER LIC NSE NO. . :? CLASS C 3 with comply with such provisions or this permit shall be deemed revoked. GAS SYSTEM OUTLETS DISTRICT NO.. P CESSED Y LICENSED CONTRACTORS DECLARATION OUTLETS OVER i Jr i U g I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM (commencing with Section 7000)of Division 3 of the Busi- FINIAL , VALIDATION/ ness and Professions Code, and my license is in full force and DATE " effect. FINAL License Numb v Lic.Cla�s+s' fir► BY ontracto l� Date x I am exempt from the licensing requirements as I am a Plan check fee I C licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$ ,5-0 / y 7 acting in my professional capacity (Section 7051, Bus- iness and Professions Code). TOTAL FEE Lic.or Reg.No. Date Plan check applicant HOME OWNER-BUILDER DECLARATION Name L I hereby affirm that I am exempt from the Contractor's Address License Law for the following reason (Section 7031.5, Busi City Tel.No. ness and Professions Code): `5 6 b 0 A ` I, as owner of the property, am exclusively contracting 44 with licensed contractors to construct the project 0 0 (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for 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 read this application and state that the above information is correct.I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE ordina s d State laws regulating Plumbing, and hereby a ori presentatives of this County to enter upon the bov tioned pro erty for inspe io urposes. ✓ r . : gna a of er itte Date WORKERS'COMPENSATION DECLARATION' APPLICATION FOR PLUMBING PERMIT I hereby, affirm that I,have a certificate of consent to self in- I 20-W26 q PW 4/90 -sure,or a certificate of Workers'Compensation Insurance,or a certifitypy t7�rr 101.c 800, Lab. C.) i l Poli y?V0. �� Company �ac l'�ewt /o e� �q �'p n! COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy is hereby furnished. BUILDING ILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ®/Certified copy is filed with the county building inspection t AD department. NUMBER FIXTURE OR ITEM Q FEE I LOCALITY JL _ 4 J Dtlte 1�'�" �6 Applicant �l ,1e� ScT�ga a WATER CLOSET(TOILET) (NEAREST BATH TUB CROSS ST. ' CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER COMPENSATION INSURANCE SHOWER e, .14 (This section need not be completed if the work involved by I MAIL the permit is for one hundred dollars($100)or less.) LAVATORY !ADDRESS 1, tW Ise 4 v C I certify that in the performance of the work.for which this per- SINK mit is issued, I shall not employ any person in any manner so I,CITY i TEL. NO as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR J d Date Applicant CLOTHES WASHER - ADDRESS �� < Ans </ NOTICE TO APPLICANT: If, after making this Certificate of Ex- ' SWIMMING POOL RECEPTOR odl emption,you should become subject to the Workers'Compen- CITY <121 TEL.NO. Vs - sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEMS ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. - CLASS �— c LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter, GAS SYSTEM OUTLETS �� `n 9(commencing with Section 7000)of Division 3 of the Business, OUTLETS OVER and Professions Code;and m license is in full force and ef- 5 PER SYSTEM FINAL fect. y HOSE BIB DATE 1/ALIDATION GG aLicense Number •C'7— 6 7(yLic. Class �° o. a , ,v FINAL ` °a O Cont aP'4fc�r .S u. Ps INC (n �c3 ,BY ?! 4 :6icc I am exempt under Sec. L ITEt-TS O - • V r— s B.&P.C. for this reason Plan check fee 3�1;A3 '`2 o`O` a • Date: PLUMBING PERMIT ISSUING FEE$ � �' Y(Ew�i Signature TOTAL FEE. 2 CHANGE .00 SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION � pP I hereby affirm that I am exempt from the Contractor's License Name l iz#?�-(.l[?Ij -1 ifil�t' Low for the following reason (Section 7031.5,-Business and Professions Code): Address `3�'29 ' AN 9'5; ❑ I, as owner of the property, will do the work and the City Tel.-No. 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 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 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 authorize representatives of this County to. enter upon the above-mentioned ropert for inspection purposes. J_ /�� SEE REVERSE FOR EXPLANATORY LANGUAGE k-i,gnature of Permittee Date