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HomeMy Public PortalAbout6426 TRELAWNEY AVE_Plumbing__ vaABevw(ceenBl nnB II APPLICATION FOR PLUMBING PERMIT JJSS BUIL.DIN DSAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING NUMBER FIXTURE OR ITEM O FEE ADDRESS WATER CLOSET LOCALITY BATHTUB NEAREST CROSS ST SHOWER OWNER DC7, cs/{� LAVATORY MAIL �, ADDRESS ,,pp p p SINK QTY l-Q' TEL NO'?4?-S7S2- DISH WASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR QTY TEL NO LAWN SPRINKLER SYSTEM STATE LIC WATER HEATER LICENSE NO CLASS GAS SYSTEM OUTLETS DCCT t RCXJPT �^ Y y SOPERSVSTEMR INDUSTRIALA07910J--- h /e WASTE APPROVAL O �'` INSPECTION RECORD v GO W d Plan check fee — PLUMBING PERMIT ISSUING FEE$ D� TOTAL FEE Plan check applicant Name APPROVALS DATE INSPECTOR S SIGNATURE UNDER SLAB WORK Address ROUGH PLUMBING City Tel No GAS PIPING I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLIWTION AND STATE GAS VENT TIIAT THE ABOVE 6 CORRECT AMD AGREE Ta COMPLY WRH ALL CW NTY ORDINANCES AND STATE LAWS REGULATING PLUMBING HOT WATER HEATER I HEREBY CERTFY THAT I AM PROPERLY REGISTERED ANI)/OR LICENSED AS PLUMBING FIXTURES REWIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED SIGNATURE ' C LT.K V OFPERMITTE FIN IN AL PLAN CHECK VALIDATION CN M GSH PERMIT VALIDATION o CASH 15 Ir-AUG 11 5 9 9.0 0 •�d TION WO IR t I have a TIONcate of corse APPLICATION FOR PLUMBING PERMIT I hereby a rm that 1 have a certificate of convent to self 76A667A insure, o certificate of Workers Compensation Insurance, CE 817(REV 10/81) or a cer ied copy thereof (Sec 3800 Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Pah No Ccmpar' Certified copy is her y fu shed FOR APPLICANT TO FHL IN(PRIM OR TYPE) BUDDING /J/ —Z]rjy"� �'7/�, �/ K Cendl c y is filed it uddmg in"c ADDRESS G(O 172aj 4Q1A) 7 do en NUMBER FIXTURE OR ITEM ® FEE C/�! L Date WATER CLOSET NEAREST © A CERTIFICATE OF E I F KERS' BATH TUB CROSS ST COMPENSATIO URANCE SHOWER OWNER (This section need not be completed H the work Imrelved by the permff Is for one hundred dollen($100)or loss) LAVATORY q AIL v \ x ' I certify that in the performance of the work for which this - — _ — - `• — permit is Issued, I shall not employ any person in any manner SINK CITY TEL NO so as to become subject to the Workers Compensation Laws DISHWASHER COHfRACfOR OA_,1_ �(/•Ar u, `/v/! Dote Applicant CLOTHES WASHER ��f�/ T�/1t �TYTr`�VV'C. NOTICE TO APPLICANT If after making this Ceinficate of ADDRESS AYG. 7W r Exemption, SWIMMING POOL RECEPTOR CITY 4's/�'1 TEL N �'' � p you should become subject to the Workers' !//hr Compensation provisions of the Labor Code you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE No CLCL ASS 14 LICENSED CONTRACTORS DECLARATION DISTRICT NO SSED BV I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS O Q (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER o and Proiessro Code and my license is in full force and effect 5 PER SYSTEM � onh VALIDATION 60 License Number Lic Class , V FIN 09 Contractor Dote BY o ❑ I am exempt under Sec W d N B 8P C for this reason = Plan check fee Signature Dote 3 31 9 4 A PLUMBING PERMIT ISSUING FEE$ TOTAL FEE V6 150 # • • • • • 5 SINGLE FAMILY Pion check applicant ( • • 1 b 5 0 HOME OWNER BUILDER DECLARATION Name, �(�,[� / _ I hereby affirm that I am exempt from the Contractor s License • • • 1 Q 5 0 t=i Law for the following reason (Section 7031 5, Business and Ages Z �A��/ Professions Code) CityTel No ( Q 1 6—8 5 Elas owner of the property, will do the work and the structure is not intended or offered for sole (Section , 70" 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 z 60dress 1 certify that I have read this application and state that the ► I-Lhp-n.-cl miormationacorrectIagreSlatelowsegulatinentaeves of th, Cpropertyforinspection pu pas SEE REVERSE FOR EXPLANATORY LANGUAGE mlttee to COUNTY OF LOS ANGELES TEMPLE CITY A' 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TIBIAS PL 0508 0412070021 ` BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS TR 12706 LT 6 BL .001 6426 TRELAWNEY AV FEE DESCRIPTION OUANTITY- UOM AMOUNT TEMP CA 917801313 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LEMON 5382-022-024 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE: 596 GRID J1 LOCALITY TEMPLE CITY 07 BATHTUBS/SHOWERS 3 00 FIX 48 60 13 DISHWASHER(S) 1.00 FIX 16 20 ISSUED ON PROCESSED BY- PLAN BY EXPIRES ON 21 HOSE BIBB(S) 1 00 FIX 16 20 12/07/04 JK 06/05/05 25 LAVATORIES/SINKS 5 00 FIX 81 00 OWNER 45 WATER CLOSET/URINAL 2 00 FIX 32 40 FINAL DATE FINAL BY CODE BAKER JAMES (626) 253-6063- 47 WATER HEATER(S) 1 00 WIN 16 20 6426 TRELAWNEY AVE 51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20 TEMPLE CITY 91780 TOTAL FEES 254 55 DESCRIPTION OF WORK PLUMBING FOR ADDITION AND REMODEL APPLICANT TEL NO SAME AS OWNER (310) 403-3527- SPECIAL CONDITIONS CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC NO UNDER SLAB WORK WATER SERVICE ARCHITECT OR EMGTff M TEL NO PLASTIC Y/N METAL Y/N ROUGH PLUMBING LIC NO GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFM CWV GRAY WATER SYSTEM �n REPORT ID- DPR263 ROUTE TO BS0508 COUNTY OF L09 ANGELES TEMPLE CITY p 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 IAS TUNAS PL 0508 0710250017 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS ITR 12706 LT 6 BL 001 I 6426 TRELAWNEY AV FEE DESCRIPTION QUANTITY DOM AMOUNT I TEMP CA 917801313 I 1ASSESSORINFORMATION NUMBER NEAREST CROSS STREET LEMON 5382-022-024 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J1 LOCALITY TEMPLE CITY C 103 BACKWATER VALVES) 7 00 VAL 328 65 I ITSTANT 05 BACKFLOW DEVICE(S) 7 00 DEV 113 40 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 21 HOSE BIBB(S) 1 00 FIX 16 20 10/25/07 SR 04/22/08 TOTAL FEES 486 00 OWNER TEL IPI FI Y CODE ROFFELL, RRI9FHN (626) 945-5-5894- Ioni 16426 TRELAWNEY AVE I TEMPLE CITY CA 91780 iDESCRIPTION OF WORK I IPL[R4BING FOR BACKWATER VALVES BACKFLOW PREVENTION DEVICE 1 ISPRINKIAMS AND 1 HOSE BIBB 1APPLICANT TEL NO I I CONTRERAS (626) 445-0404- 1115 LA FORTE ST 1 SPECIAL. CONDITIONS ARCADIA CA 91006 I I APPROVALS DATE INSPECTOR SIGNATURE1CONTRACLIOR TEL NO 1PAUL M CONIRERAS (626) 445-0404- 1115 LA FORTE ST LIC NO UNDER SLAB WORK 1 I ARACADIA CA 91006 438974 1 I WATER SERVICE 1 I PLASTIC YIN METAL YIN (ARCHITECT OR ENGINEER TEL NO I I I HYNEX, WILLIAM (626) 622-0381- ROUGH PLUMBING I 116 BRENTANO DR LIC NO COTO DE CA 1822 (GAS PIPING OAS VENT I HOT WATER HEATER I PLUMBING FIXTURES I I LAWN 9PRINRLERS 1 I GAS TEST 1 I I ITPILITY COMPANY NOTIFIED( I CWv I I GRAY WATER SYSTEM I I 1 I I I I I I i I I I I I I i i I I i I I (REPORT ID DPR263 ROUTE TO 890508 I I I