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Home My Public Portal About6341 TEMPLE CITY BLVD_Plumbing__ DEPARTMENT OF COUNTY ENOIIITEER PLUMBING 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDING ? ff� WILLIAM J. FOX, COUNTY ENGINEER ADDRESS i GI LOCALIFOR APPLIC T TO F�L NEARETr Cp e BUILDING NEAREST ` 0 d t/ ADDRESS CROSS ST ` fit /& T NO 6ROLP ZONE PERMIT NO NEAREST LOCALITY NEAREST J ceosa ar P�'N 0 4 '{— O k10'40 tj o ItErEIV Ready for Io.w.Deo 4D;1�y OWNER O15 P P. NAIL INDUST 4 � ADDRESS 6341 y wABTEA YAL. CITY` OS I.r TEL MOO le-'G 11402 O INSPECTION RECORD PLUMBER ADDRESS CITY TEL NO ❑STATE LICENSE NO rl COUNTY J PERMIT FEES i VIIMOCq TY'C or rl T .c OR mm FC[ Q WATER CLOSET(TOILET) @ 000 i C 0 BATHTUB 0 000 SHOWER ® 080 LAVATORY(WASH BASIN) 0 000 KITCHEN SINK f 080 LAUNDRY TUB ORTRAY ® 080 SLOPSINK 0 080 FLOORSINK 0 080 FLOOR DRAIN 0 Oto DISHWASHER 80 000 DRINKING FOUNTAIN 0 080 URINAL 0 080 GASSYSTEM _ _ OUTLETS 0 Ito WATER NEATER 0 100 MISCELLANEOUS APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT f 1 00 ROUGH PLUMBING _ TOTAL FEE ff BAS PIPING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ TRIG APPLI GASVENT CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUM BINE PLUMBING FIXTURES I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GASTEST AND STATE OF CALIFORNIA OR THAT 1 AM THE L.EGAL OWN. ER OF THE AS DESCRIBED SIDEI IAL PR B UTILITY 00 NOTIFIED SIOOF PE UR MI OF PERMITTEE IIIYYY�� _ - FINAL — 76A88T DSS 17 1^3 D e 17 2 3 12-43 APPLICATION FOR PERMIT DEPARTMENT OFNG AND SAFETY ��'�� COUNTY OFF LOS LOS ENGINEER ANGELES X. WM d POCXICHIEFmiGINE NATURE OF INSTALLATION PMMIT p . ROUGH RDRUgtO MPLET[ _ — Po HEATER CESSPOOL SEPTIC TANK R�ETVm 6Y READY FOR DATE ISSIIm /IRBT INSPECTION N -3 _ APPLICANT IN HEAVILY OUTLINED PORTION ONLY NAY[ *7ak. A. GL�ILtiJ M �1 ADDRESS Z 1 tiC.I_ 6 CRY T6 NO COUNTY CERT No 1"INES LOCATION OF SEPTIC TANK, OR CE&"NORTH TEL No 1 AM THE LEGAL POSSESSOR OR THE AB [ LOS ANGELES COUNTY CERTI►I OF OVAL IC/1TI0 102 FWgEEq 1 AM THE LEGAL OWNER OR THE PROPERTY DESCRISm ABOVE. OMIIOI CORRECTIONS SOUTH DESCRIPTION OF WORK < z Tx TUB FURNACE O ROWER DISHWASHER p -------.LAVATORY REFRIGERATOR ITCXEN SINK WATER SOFTENER �r LOCR SINK - GAND TRAP SINKFLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DAT[ IR3'[CTM•MwM[ WATER HEATER DENTAL LAVATORY ROUGH PLUMBING 3T13t GASSODA FOUNTAIN .R OUOAS PIPING GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES BEPTIC TANK ES[POOI SEPTIC TANK SEWER S TOTAL FEB /. Q'v TILVRY Co.NOTnl= /! IO CE 817(REV 11/78) !lISSS APPLICA N F R PLUMB ERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN[PRINT OR TYPE[ BUILDING KamcI.nPL� C UO NUMBER FIXTURE OR ITEM ® FEE ADDRESS WATER CLOSET LOCALITY L C\--P NEAREST BATH TUB CROSS ST SHOWER OWNER CLoLz O ` 0 LAVATORY ADDRESS 1 JO SINK CITY ` 1! CV-q TEL NO DISHWASHER CONTRACTOR N j N CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITY TEL NO LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER LICENSE CLASS GAS SYSTEM OUTLETS MASPIPING ROVALS DATE INSPECTOR S SIGNATURE OUTLETS OVER B WORK $PER SYSTEM T MBING 4I— v G 1 N \O V R HEATER �FIXTURES N Plan check fee UTILITY CO NOTIFIED Z PLUMBING PERMIT ISSUING FEE$ TOTAL FEE iD FINAL Plan check applicant PLAN CHECK VALIDATION Name Address _�t`IV SSL CV O ;90004A C"—'k�m�'Lct TBI No e3 -2a {� . . . . . 5 THAT LHE ABOVE HERESY IS CORRECT ANDT KNMILEDGETAGREE TO COMPLYWTIH ALL COUNTY ORDINANCESHAT I HAVE RETHS APPLICATION AND STATE2 f Q00 AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION .,, 0005 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LDS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AN THE p LEO ,An 'I 1L OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL O & G 1 -80 0 PROPERLY SIGNATURE ,tel OFPERMIT'T DISTRICT NO ED BY INDUSTRIAL WASTE APPROVAL Gel en(RBV enn mT APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY (� FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING C(\� � �� [JL_TIO NUMBER FIXTURE OR ITEM • FEE 1 WATER CLOSET no LOCALITY r NEAREST BATHTUB CROSS$T C SHOWER 0 O OWNER LAVATORY 36& ADDR65 J \ C LUfl SINK OTY"� mP TEL NO DISHWASHER CONTRACTOR 1 CLOTHES WASHER O ID ADDRESS OAIVX SWIMMING POOL RECEPTOR CITY TEl NO LAWN SPRINKLER SYSTEM STATE v LIC WATER HEATER a LICENSE NO CLASS pGAASS SYSTEM OUTLETS qGA APPROVALS DATE INSPECTORSSIGNATURE 5 PER SYSTEMR ER SLAB WORK GH PLUMBING PIPING O VENT V d WATER HEATER rO BING FIXTURES TEST Plan check fee ivCO NOTIFIEDPLUMBING PERMIT ISSUING FEE ETOTALFEE L Plan check applicant LAN CHECK VALIDATION Name Add,— X \ LUfl Cry GT Tel No ;28339A I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE {L C TIIAT THE ABOVE IS CORRECT ANW5 O AGREE TO COMPLY RH ALL COUNTY ORDINANCES H B B AND STATE LAWS REGULATI NG PLU M BIND PERMIT VALIDATION 2 B • 2500 ,HEREBY CERTIPY THAT I AM PROPERLY REGISTERED ANO/OR UCEN5ED AS IB REQUIRED BY LOS ANGELES COUNTY AND STATE G CAUPORNIA OR THAT I AM THE f LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY SIGNATURE OF PERMITTEE DISTRICT NO Y SLv i - . INDUSiR1Al WASTE APPROVAL e G E n Ew aA rE 11G APPLICATION FOR PERIM DEPARTMENTND OF BUILDING ASAF COETY PLUMBING ' COUNTY OF LOS ANGELES VIM J. pox CHIEF ENGINEER 7 r NATURE OF INSTALLATION 0107MICT an ZW4 plutuff No. TOUGH Pt%TUR/C COMPLETE �/ .5 v NEATER CESSPOOL SEPTIC TANK RECEIVmFIRST INVECTIOREADY PORN DATE ISSUED APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY .roe M NAME n ADDRESS / �7G ADDRESS u LOCALITY { NEAREST s CITY TEL No CROSS ST COUNTY CERT No 12 m[PIR[S NAMB LOCATION OF SEPTIC TANK, ORES CESSPOOL AMo R NORTH O _ CITY o I AM THE LEGAL EpOR OF E ABOVE LOG ANGELES COUNTY CERTIFICATE OF QUALIFICATION PLGIOO 1 AN THE LEGAL OWNER OF THE PF"URTY DESCRIS ABOVE. ORO CO CYTSOUTH ONS DESCRIPTION OF WORK z TN TUB FURNACE a IHowsR DIGHWAExo+ O VATORY R�IGERATOR T CHENN SINK WATERGOFTExER R SINK BAND TRAP p INK FOORDRAIN TRAY URINAL APPROVALS CLOSET DRINKING FOUNTAINDATE 11M►aaioll/Mwrt NEATER DENTAL LAVATORY ROUGH PLUMBING ^Ai d`DAPOUNTAAIINGAG PIPING OUTL GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES SEPTIC TANK pSP'00� /tPTIC TANK GRWei S M, UTILITY CO NOfIFIm TOTAL RHS / V v � WQRKERS COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT ' I b6re p(firm that 1 have o certificate of consent to self in 766657 DPW uB7 sure o o certificate of Workers Compensation Insurance or a C�REV 8ie6) certified copy thereof (Sec 3800, Lab C ) fl Policy No Company COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS MCertified copy is hereby furnished ❑ FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING / / Certified copy is filed with the county building inspection FOR 4 /V department NUMBER FIXTURE OR ITEM ® FEE LOCALITY Date Appicory R WATER CLOSET(TOILET) —InyNEAREST J CERTIFICATE OF EXEMPTION FROM WORKERS BATH TUB CROSS Si - COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed If the work Invohred by / AD � .,/ the permit Is for one hundred dollars({100)or less) N LAVATORY DRESS L & O//✓�/ 1 certify that in the performance of the work for which this per mit is Issued, I sholl not employ any person in any manner so SINK CITY & TEL NO�81� as to became subject to the Workers Compensation Laws plc/ DISHWASHER CONTRACTOR Dote Applicant CLOTHES WASHER ADDRESS NOTICE ,y APPLICANT If, cher making this CertifiWorkers Co of Ex- SWIMMING POOL RECEPTOR emptlOn,you should become subject to the Workers Compen CITY TEL NO cation 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 NOo ROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commenting with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code and my license is in full force and ef- 5 PER SYSTEM fect FINALDATE VALIDATION y O License Number Lic Class O FINAL _ W Contract orDate BY O I am exempt under Sec ACGTa ~ Uayy B 8P C for this reason Gd07 Plan check fee , 22 Date PLUMBING PERMIT ISSUING FEE SITEMS 1 Signature aO TOTAL 5L 0Q TOTAL FEE O SINGLE FAMILY Sy CHECK ,lt HOME OWNER BUILDER DECLARATION Plan check applicant LH�7� JI_ 1 hereby affirm that 1 am exempt from the Contractor s License Name ' Law for the following reason (Section 7031 5 Business and Professions Code) Address �I, as owner of the property will do the work and the City Tel No D(J�U-0001 61lMi structure is not intended or offered for sale(Section 7044, 7522 1 0 2:09 Business and Professions Code) Poo.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 Lenders 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 representaiw of this County to enter upon the abov tion rty n i In �;/ �2ZE� SELRIVERSE FOR EXPLANATORY LANGUAGE Signature of Perm Date