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Home My Public Portal About9622 VAL ST_Plumbing__ 3 ; APPLICATION FOR PEUM DEPARTMENT OF BUMDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER AA'1 FOR pA/�PPL�IICIyA�NT pT1O��IFIL5L1 IN/1/� DISTRICTNO GROUP ZONE PERMITNO PLUMBERVRLLIY BOULEVARD PLUMBING CO. RECEIVED BY READY FOR DATE ISSUED G FIRST INSPECTION ADDRESS 900 EAST VALLEY BLVD. .Z -/ -fp CITY RO:EMEAD TEL NO AT.2.2719 ADDRESS C U a NO 9311 1 630--5-1 LOCALITYzz EXPRES NEAREST PERMIT FEES CROSS ST NYMEG TY![OI vi T m OR ITEM FEE OWNER MAIL WATER CLOSET (TOILET) a O SO • LSO ADDRESS Y7 YJ" BATH TUB a O SO O CITY TEL NO SHOWER O EO 1 HEREBY ACKNOWLEDGE THAT I HAVE Rl'D IS LAVATORY WASH BASIN O SO O APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND KITCHEN SINK O SO STATE LAWS REGULATING PLUMBING I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY O SO ANGELES COUNTY LICENBE OR 1 AM THE LEGAL OWNER OF THE RQSIDSNTIAL R PERTY DESCRIBED ABOVE GAS SYSTEM-1—OUTLETS 0 O SO S7& SIGNATURE OP WATER HEATER a O SO U FERMITTQ SLOPSINK ob OED INSPECTION RECORD FLOOR SINK a O SO FLOOR DRAIN a O SO DISHWASHER a 050 DRINKING FOUNTAIN O SO , URINAL W O SO .l HOUSE SEWER O SOitri P,7 _ MISCELLANEOUS (f It O Z1 F P L APPROVALS DATE INSPECTOR R NAME ROUGH PLUMBING GAB PIPING GAS VENT CESSPOOL / 00 D O CESSPOOL SEPTIC TANK SEPTIC TANK DRAIN I I PIT I 11 DO SEWER PERMIT 1 DO GAB TEST Ir 1 UTILITY CO NOTIFIED TOTAL FEE • r O V FINAL r sBAeBT +T B-BG APPLICATION FOR PERMIT DEPARTMENT OF BUILDING AND SAFETY PLUMBING COUNTY OF LOS ANGELES WILLIAM J FOX CHIEF ENGINEER FOR APPLICANT TO FILL IN DISTRICTNO GROUP ZONE PERMITNO S 910,ccy- lr I-LUMBER VALLEY BOULEVARD PLUMM C& RECEIVED BY READY FORDATE ISSUED \ PIRST NDFEC'fION ADDRESS 8300 EAST VALLEY BLVD '-3 G-s/ ROSEMEAD AD R®8 CITY TEL No AT 2.2719 /[ q COUNTY 93M 6.30-J�/ LOCALI fJ V LICENSENO REB NEAREST Pi�pt•tY! . CROSUST NUMBER TY"OF FIKTURE B OR ITEM PEE OWNER MAIL f� WATER CLARET TOILET O EO S ADORERS BATH TUBO CITY L Meg SHOWER a 050I HEREBY ACKNOWLEDGE THAT 1 HAVE READ TH S LAVATORY WASH BASIN 050 APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING KITCHEN BINK O I CERTIFY THAT I POSSESS THE ABOVE VALID LOS LAUNDRY TUB OR TRAY @ O SO ANGELES COUNTY LICENSE OR I AM THE LEGAL OWNER OF THE RESIDENTIA P OPERTY DESCRIBED ABOVE. OAS SYSTEM OUTLETS O 80 SIGNATURE OF � r WATER HEATER O BO PERM ITTE `� `+ ;?2 GLOP SINK o 80 INSPECTION RECORD FLOOR BINK O BO FLOOR DRAIN O 80 DISHWASHER a 050 DRINKING FOUNTAIN Q O BO URINAL 0 O 80 J HOUSESEWER O 80 D Q Z MISCELLANEOUS Q APPROVALS DATE INBPX=OR B NAME ROUGH PLUMBING GAS PIPING GAB VENT CESSPOOL 100 4:0--O CESSPOOL SEPTIC TANK SEPTIC TANK DRAIN I I PIT I I 0 1 00 SEWER PERMIT 1 00 GAS TEST UTILITY CO NOTIFIED TOTAL FEE 1Nx FINAL I I_lV �' UN WORKERS COMPENSATIONDECLARATION of once APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 70A667A insure, or a certificate of Workers'Compensation Insurance CE 817(REV 10/61) or alce�r�uf�ied copy thereof (Sec 3f10D lab C ) yrs COUNTY OF LOS ANGELES BUILDING AND SAFETY ,�ic1o! agaV311 ompony� IAII/ LJ Certified copy is hereby furnished FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING �/7J Certified copy is fled with the county budcl,n nspec ADDRESS 4-` —r Si— lion depaEOFE nt a NUMBER FIXTURE OR ITEM ® FEE LOCALITY !tj f,( t Dote 5 E� ant WATER CLOSET NEAREST ^�'-jG [ I VCz CERTIFIPTIO FRtuo OM WORKERS BATH TUB 6 CROSS ST t- COMPENSATION I URANCE SHOWER OWNER s 1 21 (This section need not be completed if the work Involved by MAIL CV the permit Is for one hundred dollars;($100)or leu) ADDR LAVATORY Z r ESS J I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any monner SINK CITY TEL NO5' so as to become subject to the Workers'Compensation Laws DISHWASHER �p CONTRACTOR Dote A,pphcant CLOTHES WASHER /' NOTICE TO APPLICANT If, after making this Certificate of ADDRESS 3 CT �- Exemption, you should become subject to the Workers SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CRYL /,4 TEL NO 7 L(f with comply with such provisions or this permit shall be STATE LIC deemed revoked WATER HEATER LICENSE NO7�8 CLASS LICENSED CONTRACTORS DECLARATION DISTR NO BY 11 I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000)of Division 3 of the Business OUTLETS OVER ✓ Y and Professions Code,and my license is m full force and effect 3 PER SYSTEM FINAL Zy Q VALID ON / DATE (J License Number�CFUc Class Cbr1Ah'ct f(,(2Ah j;,& do ate�� BY O I am exempt under Sec W W N B dP C for ilio reason 916. Plan check fee = Signature Dote PLUMBING PERMIT ISSUING FEE$ 0 5V Noll 2 2 0 3 2 A TOTAL FEE s q . . . . . 5 SINGLE FAMILY Plan check applicant ILI-0 All s I HOME OWNER-BUILDER DECLARATION Name e e 5 8 5 0 I hereby affirm that I am exempt from the Contractor is License Address • • • 5 8 5 0 Law for the following reason (Section 7031 5 Business and 1 Professions Code) City A- Tel Na O 8 1 4-85 ❑ 1, as owner of the property will do the work and the structure is not intended or offered for sole (Section lop, Business and Professions Code) CONSTRUCTION LENDING AGENCY 1 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__�� Lender's Address I certify that I have read this application and swte that the ► above information is correct I agree to comply with all County ordinances and State jaws regulating Plumbing and hereby authorize representatives of this County to enter upon the a ve mentioned prop rty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE Sror Sign urs of Permittee pole • COUNTY OF LOS ANGELES TEMPLE CITY 9 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0006020009 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91760 PHONE (626) 285-0488 EXT LEGAL ID ---TM PAID BUILDING ADUR M-- TR 09285 LT 01 9622 VAL ST E FEE DESCRIPTION QUANTITY LION AMOUNT TEMP CA 91780 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET TEMPLE CITY 5383-014-005 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE GRID LOCALITY TEMPLE CITY 51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20 TENANT TOTAL FEES 43 95 ISSUED ON PROCESSED BY PLAN BY Effrffn�� D6/02/00 UT 11/29/00 OWNER TEL NO FINAL DATE FINAL BY E VARIA, VINCENT (626) 447-5548- 44�/ -� 9622 VAL ST 10�/ TEMPLE CITY, CA GESLIFIIITRSG-8P GAS LINE FOR HVAC APPLICANT TEL NO CONNOR AIR CONDITIONING (626) 286-3157- 4937 NORTH ENCINITA SPECIAL CONDITIONS TEMPLE CITY, CA CONTRACTOR TEL PNGELES CO APPROVALS DATE INSPECTOR SIGNATURE CON NOR AIR CONDITIONING (626) 286-3157- 4931 ENCINITA AVE LIC NOLINDER SLAB WORK TEMPLE CITY, CA 91780 403735 C20 WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER TEL NO RDWH PLUMBING LIC -NOP lil llu LGAS PIPING — GAS VENT LAWN SPRINKLERS q/ i A 0 ��w:�s orrrr, GG'Ic ServaeThat�o(` CWV GRAY WATER SYSTEM REPORT ID DPR263 ROUTE TO BS0508