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Home My Public Portal About6403 TRELAWNEY AVE_Plumbing__ "ABB' APPLICATION FOR PLUMBING PERMIT DDR I'IRDMMON OF BUnZING AND SAFETY Depoxhneat of Cooat7 F�aM1oees Coutdy of f.0e �Bde6 BUILDING WN J FOX COUNTY ENGINES71 ADDRESS CABSATT D GRIFFIN SUPT OF BUILDING nm• LOCALITY,FOB APPLICANT TO M IN NEAREST CHOSE;ST OWNER X /e. DISTRICT NO GROUP ZONE A[ADY FOR IRRFEcr IaR MAILZI T AD2R s v� � INDUSTRIAL CITY 5o ja N C7a4 Tgh WASTE APPROVAL iwwr sewn PLUMBER VALLEYBOULEVARD PLumblNu (;u INSPECTIRECORD RD ADDRESS 8900 EAST VALLEY BLVD. CITY ROSEMEAD q TEL NO AT. / ! LICENSE NO NUMBER TYPE OI FIXTYRII OR IYEM FEE / WATER CLOSET (TOILET) S BATHTUB SHOWER _ LAVATORY (WASH BASIN) KITCHEN SINK DISHWASHER LAUNDRY TUB OR TRAY CLOTHES WASHER TOTAL NO ® 080 APPROVALS DATE INSPECTOR S SIGNATURE OAS SYSTEM- OUTLETS 1 00 UNDER SLAB WORK WATER HEATER 100 ROUGH PLUMBING PERMIT $ t 00 OAS PIPING Ro TOTAL FEE awe VENT I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGMLATING PLUMBING FIXTURES PLUMBING G/N� 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/Op GAS TEST r LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF UTILITY CO NOTIFIED CALIFORNIA OR THAT 1 THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL ERTT e 816NATU RE OF PERMITTEE L WILLIAM J FOX, COUNTY ENGINSER V N _CDS 1 7 7r Rnr29 3 9.4 O p BY DEPUTY " C/ /ocerifficate S COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT that I have a certificate of consent to self 76A667A cate of Workeri Compensation Insurance CE 817(REV 10/BI) y thereof (Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Company py is hereby furnished ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING vc': p fit w n uddmg iropec- ADDRESS NUMBER FIXTURE OR ITEMDatepl an WRIER 0.0IX T NEAREOF F�pl KERS' BATH TUB CROSSSr COMPENSATION NCE SHOWER OWWR (This section need not be completed R the work In"I"d by MAIL the permit Is for one hundred dollen($100)or less) LAVATORY ADDRESS.. _ 1 certify that in the performance of the work for which this _ permit is issued I shall not employ any person in any manner i SINK CITY TEL NO so as to become subject to the Workers'Compensation Lows DISHWASHER caNTRncraR�.t';4rAQW--A,fAS;4A/0Wel/ Date applicant UO7HE5 WASHER NOTICE TO APPLICANT If offer making this the Wok of SWIMMING POOL RECEPTOR Exemption you should become subject to the Workers- Off, ^�C^D/� TEL _.yV;51(6 withComcomply provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM �LCfL��'�,/ with comply with such provisions or this permit !hall be deemed revokedWATER HEATER LICENSE NO CLASSA LICENSED CONTRACTORS DECLARATION DISTRICT, D BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER Y and Professions Code,and my license is in full force and effect S PER SYSTEM FINALV LIDATION d License Number Lic ClassDATE V FIN cc Controctor Date BV 0 ❑ I am exempt under Sec W O. H B 8P C for the reason Plan check fee 1100 = Dote PLUMBING PERMIT ISSUING FEE$Signature 231 6 3 A TOTAL FEE Plan check applicant e e e e e 5 SINGLE FAMILY &- �� iQ l e e 1 IS 5 0 HOME OWNER-BUILDER DECLARATION Name �� Q 1 hereby affirm that I am exempt from the Contractor's License Addreu �[. /T-(Q[) ��'�/ • e e 1 6505 Law for the following reason (Section 7031 3 Business and G Professioro Code) City Tel No��,36/87 I Q 1 6-8 5 C__1I as owner of the property will do the work and the structure is not intended or offered for sole (Section , 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby oHirm 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 Addre 3 1 certify that I have read this application and state that the Poo information is correct I agree to comply with all County 4=!iW s regulating Plumbing, and herebyof the County to enter pen they for mapection p rSEE REVERSE FOR EXPLANATORY LANGUAGE Dote \� CITY OF TEMPLE CITY WORKER haveCOMPENSATION DECLARof consent BIS APPLICATION FOR PLUMBING PERMIT Ta18a]A I hereby eHum that 1 have a certificate of consent to self Insure or a certificate of Worker a Compensation Insurance or a certified copy thereof(Sec / 1 Policy COUNTY LOSAtJ(i�LE3 ` DEPT OF PUBLIC WORKS DEPT OF PUBLIC WORKS DIV ❑ CarhHed copy le hereby furnished /- e13 Ip( FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDINO IJ�Y\ Certified Copy U filed with the comedy bull6rt9Jae action NUMBER FIXTURE OR ITEM ® FEE LOCALITY Data AWIc. t WATER CLOSET NEAREST CROSS ST CERTIFICATE OF EXEMPTION FROM WORMERS' BATH TUB COMPENSATION INSURANCE ASSESSOR MAP BOOT( PAGE PARCEL (This section need not be completed If the work Involved by the SHOWER permit Is for one hundred dollars(8100)or leu) OWNER O I canny,that in the performance of the work for which this permit LAVATORY Is Issued I shell not employ any person In any manner so as toSINK MAIL become subject to the Workers Compensation Lewy ADDRESS re DISWASHER CRY Date Applicant CLOTHES WASHER CONTRACTOR TO APPLICANT If after making this Candicela of Exemption you should become subject to the Workers Compensation SWIMMING POOL RECEPTOR provisions at the Labor Code you must fonhmth comply with such ADDRESS provisions or this permit shell be deemed revoked LANK!SPRINKLER SYSTEM / LICENSED CONTRACTORS DECLARATION WATER HEATER CITY ^ TEL � 0. I hereby affirm that I am licensed under provisions of Chapter 9 STATE (commencing with Section 7000) of Division 3 of the Business and OAS SYSTEM OUTLETS LICENSE NO CLASS C�7! Professions Cade and my license Is in full farce and effect OUTLETS OVER DISTRICT NO PROCESSED BV SPER SYSTEM O License Number Lic Gess] �D U vArEVALIDATIONLu Contractor a ❑ I am exempt u Sea FINAL Z BY B 8P C for this reeeon nate Plan check fee _ Signature PLUMBING PERMIT ISSUING FEE E - ❑ TOTAL FEE _ 3307 39.30 Plan crack applicant - - 1 ITEMS SINGLE FAMILY - 0 HOME OWNERR BBUILDER DECLARATION Name TOTAL 39 w 3 I hereby affirm that I am exempt from the Contractor s License Law - - .t�ry/ for the following reason(Section 7031 5 Business and Professions Address; 1�yECK 39.36 Code) CFIAhIGE .01) ❑ City Tel No 1 as owner of the property will da the work and the structure Is not Intended or offered for sale(Section 7044 Business norm—rte, and Professions Code) 0000-000 , 1 2/16/93 CONSTRUCTION LENDING AGENCY 8200 1 AMI10:59 I hereby affirm that there Is a construction lending agency for the performance of Bre work for which this Permit Is Issued(Sec 3097 CIV C) Lander a Name Lender s Addfms I cenity that I neve teed This application and state that the above , 1 Information is correct I agree to comply with all County ordinances and State laws regulating Plumbing and hereby authorize representatives oI County to enter upon the above mentioned ell pro any ar In I purpoess SEE REVERSE FOR EXPLANATORY LANGUAGE • COUNTY OF LOS ANGELES TEMPLE CITY M1 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0704230009 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS TR 12706 LT 10 BL 001 I 6403 TRELAWiEY AV FEE DESCRIPTION QUANTITY GUM AMOUNT TEMP CA 917801314 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LEMON I 5382-020-063 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J1 LOCALITY TEMPLE CITY, Cl I 51 IOW PRS GAS 5 DO= 1 00 SYS 16 20 1 ITEHANT TOTAL FEES 43 95 ISSUED ON PROCESSED BY PIAN BY EXPIRES ON 04/23/07 JX 10/20/07 I IOLTEL NO DA'TCy� PI�i(�9j CODE IOILLILILAND GEORGE W TR (626) M6-5184- _/Jl '- �I,■Y/ 6403 TRELAWNEY AV TEMP 917801314 (DESCRIPTIO OF 1- 1-(GAS LINE I I APPLICANT TEL NO I I (SAME AS OWNER I I SPECIAL CONDITIONS (CONTRACTOR TEL NOAPPROVALS DATE INSPECTOR SIGNATURE ISAME AS OWNER - I LIC NO UNDER SLAB WORK I I I WATER SERVICE I I 1 ARCHITECT OR ENGINEER TEL NO IPLASTIC YIN METAL YIN 1 I ROUGH PLUMBING LIC NO GAB PIPING I I IGAS vErr I I I HOT WATER HEATER PLUlB1ING FIXTURES I LAWN SPRINIU.ERS I I IGAs Tssx I 1 I PfILITY COMPANY NOTI FI EDI I I I CN+v I I I GRAY PATER SYSTEM I I I I I I I I I I I I I I I I I 1 I I I I I IREPORT ID DPR263 ROUTE TO 850508 I I I