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Home My Public Portal About6409 TRELAWNEY AVE_Plumbing__ I . l `)eAeeTAA u•17 IRIEV epel APPLICATION FO PLUM G PERMIT COUNTY OF LOS ANGELES BUILDING AND AFETY FOR APPLICANT TO FILL IN(PRINT OR TYPEI BUILDING 0 y NUMBER FIXTURE OR ITEM • FEE WATER CLOSET LOCALItt / NEAREST BATHTUB CROSS ST SHOWER OWNER i LAVATORY MAIL ADDRESS SINK CITY TEL NO DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESSaiVa / SWIMMING POOL RECEPTOR CITY E(� TEL NO r LAWN SPRINKLER SYSTEM $TATE LIC /� WATER HEATER LICENSE NO �- CLASS/6 GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR 5 SIGNATURE OUTLETSo VER UNDER SLAB WORK I 5 PER SYSLEM ROUGH PLUMBING GAS PIPING 0 GAS VENT V MOT WATER HEATER PLUMBING FIXTURES G GAS TEST Z Plan check fee UTILITY CO NOTIFIED _ PLUMBING PERMIT ISSUING FEE$ �+ TOTAL FEE FINAL Plan check appLconr �PLLA�N CHECK VALIDATION Nome bZ""� •5"L^-Vq Address w y 7 7 z0 9L CITY Tel No ` I HEREBY ACKNo NUDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AHD"HE TO COMELY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS A 5 0 S 5 A eEOUIREp BY LOS ANGELES COUNTY AMD TATE Of CALIFORNIA OR THAT AY THE L[WL OWNER OF AND INTEND TO E THE ABO RIBED RESIDENTULL # • • e • • 5 PROPERTY SIGNATURE 2 • • 1 3005 3 0 0 OFPERMITTEE • • 1 3 0 0 5 DISTRICT NO ES$ED Y U�i 0621 INDUSTRIAL WASTE APPROVAL WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affr that I have a cendicote of consent to self 76.Ae67A insure, M cerhFicate of Workers Compensation Insurance, CE 817(REV 10/81) or a c ied copy thereof(Sec 3800, Lob C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY cy No Company Certified copy is here u i ed ADDRESS O ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified c Is fled w budding mspec- hon NUMBER FIXTURE OR ITEM IOCAUTV E Cl —1—Y Datezri Applitan WATER CLOSET NEAREST CERTIFICATE OF EXEM ON RKERS' BATH TUE CROSS ST L MA COMPENSATION RANCE OWNER (This section need net be comploMd If the work itwolved by SHOWER the ponnit Is for one hundred dollars ($100)or less) MAIL LAVATORY ADDRESS.L I certify that in the performance of the work for which the t permit is issued, I shall not employ any person in any manner SINK CITY ` TEL NO' so as to become subject to the Workers Compensation Laws DISHWASHER CONTRACTOR 4A5M1/- 14A<iN/ovL'�%/ Dote Applicant CLOTHES WASHER NOTICE TO APPLICANT/ If, after making this Certificate of ADDRESS63 �L Tile ST Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CIry,40" QIA TEL 1400"-7 j/8 with comply with such provisions or this permit shall its STATE tC deemed revoked WATER HEATER LICENSE NO �� CIASs A LICENSED CONTRACTORS DECLARATION DISTRICT rlq SSED I hereby offam that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS o (commencing with Section 700D) 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 VA ATION d License Number Lic Class DATE V 00 FI O Contractor Date BY C 111 am exempt under Sec W OL B 8P C fa N this reason Plan check fee = Date PLUMBING PERMIT ISSUING FEE f O D Signature TOTAL FEE D Plan check applicant ;23168A SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name E• PLJS4�-+4 CGL 72=.e GTO # 69 - 5 1 hereby affvm that j exempt from the Contractor'sssLicense1 • • 1650 E �L/'�Oit/']]�/,t/ (//EI/M Law for the followingg reason (Section 7031 5 Business andd Address'3723 • • • 1 6,506 Professions Code) ❑ City Pp,Zgg6aiq Tel No74349L/ 1Q16-85 1 as owner of the property will do the work and the 01111,structure a not intended or offered for sale (Section 70", Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby offnm that there is a construction lending agency far 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 lave read this application and state that the ► above information a correct I agree to comply with all County dinances and State jaws regulating Plumbing and hereby e representatives of this Caunly to enter upon the 0 1 ed properly for inspection Aur SEE REVERSE FOR EXPLANATORY LANGUAGE Sig t is Da COUNTY OF LOS ANGELES TEMPLE CITY >i 0508 PLUMBING PERMIT • DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0206240016 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID _ — PAID BUILDING ADDRESS TR 12706 LT 11 6409 TRELAWNEY AV FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917801314 NEAREST CROSS STREET LEMON 5382-020-064 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J1 LOCALITY TEMPLE CITY 07 BATHTUBS/SHOWERS 2 00 FIX 32 40 TEff"T — 25 LAVAIGRIES/SINKS 1 00 FIX 16 20 MUM ON PROCESSED BY PLAN BY EXPIRES 6W_ 45 WATER CLOSET/URINAL 1 00 FIX 16 20 06/24/02 JK 12/21/02 TOTAL FEES 92 55 WN_ER TEL NO FIITAAL DATE FINAL BY CODE 6409WILKERSONTREE BILLY H CO TR WILKERSON T (626) 447-0462- la //"7 — 6409 917801314AWNEY AV 7 TEMP 917801314 EP)L 72 PNIK"F RUA6AAEf� PL BIM FOR ADDITION APPLICANT -TEL NO SAME AS OWNERSPECIAL CONDITIONS - CONTRACTOR Tn__0_ APPROVALS DATE jNsFEETdVTr6ffXT9ffr— SAME AS OWNER - LIC NO UNDER SLAB WORK WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER- TEL NO. LIC NO ROUGH PLUMBING GAS VENT HOT WATER HEATER PLUMBING FIXTURES UTILITY COMPANY NOTIFIEU CwV GRAY WATER SYSTEM REPORT ID DPR263 ROUTE TO BS0508