HomeMy Public PortalAbout6349 TRELAWNEY AVE_Plumbing__ DEP „ s MEETCOUNTY OF LOS ANGELES , I APPLICATION FOR PEBffiT
DEPARTMENT OFF LOS NG AND SAFETY PLUMBINGWM.J FOX,CHIEF ENGINEER
NATURE OF %. ` DISTRICT NO. GROUP ZONE PERMIT
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UGH IUITUR[8 COMPLETE ��
COOL CeTIC.TANK READY POR DATE IBBIIRD
FIRST INGP[OTIoN
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"PLICA" FILL IN HEAVILY OUTLINED PORTION ONLY
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NO /� p[PIR[H ' NAM[ C OF SEPTIC TAN$ OR CESSPOOL ADD"'nmR If r7 -t /d w+t B
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CITY C I jr TEL No
• 1 AM TNR LEGAL OF THE ABOVE LOG
ANG/ILIDI COUNTY CETTIPICATE OF QUALIFICATION
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1 AM THE LEGAL OWNER OF THE PROPERTY DIOCRIBRD
ABOVE.
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CORRECTIONS
BOOTH J
DESCREMON OF WORK i
ATM TUB FURNACE C3
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VATORY REFRIGERATOR
ITCHEN BINK WATER GOPTU HIR
R LINK �AMNO TRAP
ENK FLOOR DRAIN
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WARN TRAY URINAL APPROVALS
WATER CLO[[T DRINKING FOUNTAIN DATE
WATER MAL LAVATORY , ROUGH PLUMBING
RTRR��
OUTLa"DOOA FOUNTAIN OPIPING
GAG VENT
• C[G[POOL
TOTAL NUMBRR OF FIXTURES 8XPTIC TANK
[BBPOOE RIM-TIC TANK 1 � B[WER
••; � vraln co NOTIFIm
TOTAL FEE
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7e 7 DUG 19 v-EI APPLICATION FOR PERIIM
DEPARTMENT OF BUILDING AND SAFETY PLUMBING
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN 5� 33da
UMBER' RLO[IVm RLADY FOR
FIRST INSPECTION ��^ [
PI
ADOR[BB l
CITY TL NO J ADDR[RY
E /^-
COUNTY LOCALITY
PERMIT FEES
OWNER r— `P _
MUMEEp TYR OF II%Ttl pE Op IRM FCL
MAIL o wu Q\
WATER CLOSET(TOILET) @ O OO O ADDRESS /� e
BATH TUS ® O OO CITY TEL NO/ 9�
SHOWER @ 600 1 HERESY ACKNDWLEDDL THAT 1 HAV[ READ THIS
LAVATORY (WASH BASIN) @ O 50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AAND
ND AGREE
ORDINANCES
LAWS R[CULATING PLUMSINa
KITCHEN BINK @ 060 1 CERTIFY THAT I PCdBLSY THE ABOVE VALID LOS
-- LAUNDRY.TUB OR TRAY @ 060 ANOELEB COUNTY LIC[ 04 OR 1 THE LEGAL OWNER
OF THE R®IDENT,AL O ISED OVL
/ GAR SYDTEIh' ^UTL[TS @ O 6D SIGNATURE OF
WATER HEATER @ 0513
P[RMI
SLOP BINK @ DSD INSPECTION RECORD
FLOOR SINK @ 0.00
FLOOR DRAIN @ GOO
OISHWABHER @ O 114:1 /
DRINKING FOUNTAIN @ Goo _
J
URINAL @ C.SO =
HOUSE S[W[R O.SG
O
MISCELLANEOUS
13
APPROVALS
DATE INM4RFRIP[ MAIf
ROUON PLUM•INO
II PIPING
OAS VENT - 2-a
O[S•POOL @ 1.00 0[SSPOOL
SEPTIC TANK$ SEPTIC TANK
DRAIN ( ) PIT ( @ 100 0[WER
DS OAS T�
uTlurY DD NDTIFI[o
TOTAL FEE • �� FINAL 1ZL
DEC
TION
—r-
WORKERS'
theIhave COMPENSATION cafe of corse APPLICATION FOR PLUMBING PERMIT
I hereby affirm That I have a certificate of consent to self 7oP.667A
insure or a certificate of Workers'Compensation Insurance, CE 817(REV 10/6I)
or a certified pt'thereof (Sec 3800 tab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY
%COMPEUNSATIU pony e fishedFOR APPLICANT TO FILL IN(PRINT OR TYPE)i c reit'bwldmg mapec NUMBER FIXTURE OR REM ® FEEDatep i WATER CLOSETNEAREST � L�� ��^^E I M ORKERS' BATH TUBCROSS 57 L.+GM/'-FSATI U SHOWER OWNER
(This section need not be completed H the work Involved by MAIL `
the pormit Is for ono hundred dollen($I00)or less) LAVATORY ADDRESS '\ 'i \ r•' i . .\ .K •�'. - - Y�,�•,`
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner SINK CITY v` TEL NO
so as to become subject to the Workers'Compensation Laws DISHWASHER
CONTRACT U�C�ty
Data Applicant CLOTHES WASHER �T
NOTICE TO APPLICANT If after making this Certificate of ADDRESS 70A 4 r
Exemption you should become subject to the Workers' SWIMMING POOL RECEPTOR r�yy /
Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY m.4 TEL �7S1O7
with comply with such provisions or this permit shall be STATE ` LIC
deemed revoked WATER HEATER LICENSE NO -3�Z�J
LICENSED CONTRACTORS DECLARATION DISTRICT BY
I hereby affirm that I am licensed under Provisions of Chapter 9 GAS SYSTEM OUTLETS
(commencing with Section 7000) of Division 3 of the Business OUTLETS OVER
and Professions Code and my license n in full force and effect 5 PER SYSTEM Is'
4FINAATEL _ LIDATION
License Number Lic Class V
/fe I
Contractor Date O
❑ 1 am exempt under Sec gelW
d
B 8P C for this reason N
Plan check fee =
Date
PLUMBING PERMIT ISSUING FEE$Signature ;131 8 4 a
TOTAL FEE
Plan check applicant # e e ' e e 5
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Name C— , .4 A 0./`}742-3t eo 1 - - 1650
1 hereby affum that I am exempt from the Contractor's License
Low for the following reason (Section 7031 5 Business and Addresss • • 1 6 5 Q 6
Professions Code) City Tel Tel No 3c/ 1 016-85
❑ I as owner of the property, will do the work and the
structure is not intended or offered for sale (Section 007044, 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 )
Lenders Name
Lender s Address
I certify that I have read this application and state that the ►
above information is correct I ogree to comply with all Count'
4=!!
s regulatimbing and herebyof this Cto enter upon they for inspp rposesSEE REVERSE FOR EXPLANATORY LANGUAGE
t
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0707240016
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY G 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
TR 14263 LT 11 6349 TRELAWNEY AV 1
FEE DESCRIPTION QUANTITY DOM AMOUNT I TEMP CA 917801312
ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET
15382-020-060 101 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID S2 LOCALITY TEMPLE CITY, Cl
107 BATHTUBS/SHOWERS 3 00 FIX 48 60 1
TENANT 13 DISITYASHER(Sk 1 00 FIX 16 20 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
121 HOSE BIBB(S) 2 00 FIX 32 40 07/24/07 SR 01/20/08
25 LAVATORIES/SINKS 00 FIX— 48 60
OWNER TEL NO 145 WATER CLOSET/URINAL 00 FIX 16 20 FINAL DATE `, CODE
NO DANIEL/TRACY (626) 288-2171- 151 IOW PRS GAS 5.OUTLET 00 SYS T 16 20 1 1 j
6349 TRELAWNEY AV TOTAL FEES 205 95 c\ RM n
TEMP 917801312DESCRIPTION OF WURK
PLUMBING FOR NEW BATHROOM S REMODEL BATHROOMS
JAPPLICANT TEL NO
1MBUILDM (323) 478-0800-
4448 EAGLE ROCK BLVD SPECIAL CONDITIONS
1LOS ANGELES CA 90041 1
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SICNATVRS 1
JERRY PING CONSTRUCTION (562) 500-5020-
18442 HOLDER ST LIC NO 1UNDER SLAB WORK
BUENA PARK CA 90620 212879 B1 1
' WATER SERVICE
ARCHITECT OR ENGINEER TEL NO 1PIASTIC Y/N METAL Y/N 1
ROUGH PLUMBING i
LIC NO
GAS PIPING
GAS VENT
1 1HOT WATER HEATER
1PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
101'ILITY COMPANY NOTIPIID
CWV
GRAY WATER SYSTEM
1
1 1
1
1 REPORT ID DPR263 ROUTE TO BS0508 1