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Home My Public Portal About9509 WEDGEWOOD ST_Plumbing__ 78A887A (CE 81719) 4/77 a• • •. APPOCATION FOR PLUMBING PERMIT BUILDI ND SAFETY DIVISION FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING >y NUMBER FIXTURE OR ITEM ® FEE ADDRESS D WATER CLOSET LOCALITY NEAREST BATH TUB CROSS ST. SHOWER OWNER LAVATORY MAIL ADDRESS SINK CITY _4 AL.N DISHWASHER CONTRACTOR CLOTHES WASHER ADDRESS SWIMMING POOL RECEPTOR CITY gFft TEL.NO. LAWN SPRINKLER SYSTEM STATE LIC. WATER HEATER LICENSE NO. O CLASS GAS SYSTEM OUTLETS DISTRICT NO. IA<mp ZONEP ESSE Y 1-3 OPER TS OVER - C INDUSTRIAL WASTE APPROVAL I1• INSPECTION RECORD c CL v Plan check fee PLUMBING PERMIT ISSUING FEE$ TOTAL FEE Plan check app icant Name APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK Addressgift;tjROUGH PLUMBING City &TM C::53a42 Tel.NO. GAS PIPING_ JIL I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE GAS TEST 4 - '? LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATUREfQ OFPERMITTEE 1/V FINAL ? a. • '79-k ¢ a a.� PLAN-CHEEK-V DA-T-ION------=.c M.6 casH PERMIT VALIDATION M.O. CASH POLICY HOLDER: � 9 3 6 i:-JUL Z6 5 0 1 3.0 0 03 POLICY NUS DER: te03 YS-0 v-� WORKERS'COMPENSATION DECLARATION APPLICATION ION FOR PLUMBING PERMIT i.hereby, affirm that•1 have a certificate of consent to self. n, T4/B7 AA 67A n sure,•or a certificate of Workers'Compensation Insurance,or a CE 817(REV.8/86). ,ul certified copJ thereof(Sec. 3800, Lab. C.) •• Polity No: Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ' Certified copy is hereby furnished. BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) Certified copy is filed with the county building inspection ADDRESS b 7 department. NUMBER FIXTURE OR ITEM @ FEE/� LOCALITY -- Date Applicant f WATER CLOSET-(.TOILET) V NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS S I certify that in the performance of the work for which this per- m! er- !� SINK mit is issued, I shall not employ any person in any manner so �/ CITY TEL. NO. as to become subject to the Workers'C inpensa ion ws. DISHWASHER CONTRACTOR L `� Date Applicant 4CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after m ing t s Certificate of Ex emption,.you should become subject to the Workers'Compe - SWIMMING POOL RECEPTOR CITY` �.. 410 TEL. NO.. .. safion provisions of the Labor Code,you must forthwith co p- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. 9 CLASS LICENSED CONTRACTORS DECLARATION I RICT N.C�, PR CES BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business I OUTLETS OVER fed Professions Code, and my license is in full force and of-. 5 PER SYSTEM FINAL VALIDATION a DATE O License Number Z Lic. Class. Z!z — V � FINAL Q Contractor Dafe ?� BY O F- fam exempt under SecCL . I l (� W B.BP.C. for this reason Plan check fee V _ti 4 / t I PLUMBING PERMIT ISSUING'FEE$ Signature I TOTAL FEE S NGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION pp I hereby affirm that I am exempt from the Contractor's License Name Law for the following reason (Section 7031.5, Business and � 'mg Professions Code): - Address _ 3307 34u50 ❑ I, as owner.of the property, will do the work and the City Tel. No. structure is not intended or offered for sale(Section 7044, 1 ITEMS Business and Professions Code). TOTAL 34.50 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for CHECK 34.50 the performance of the work for which this permit is issued � � .110(Sec. 3097, Civ. C.). Lender's Name -0001 6/29/$9 Lender's Address ^f 4246 1 AM 80o41 1 certify that I have read this application and state that the ® above information is correct.I agree to comply with,all County ordinances and State laws regulating Plumbing, and hereby authori represent tives o thi County to enter upon the above a io' d p perty r' ection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Si azure of Permittee Date WORKERS' COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 76A667A insure, or a certificate of Workers' Compensation Insurance, CE 817(REV. 10 81 or a certified copy thereof (Sec. 3800, Lab. C. COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company_ Certified copy is hereby furnished. BUILDING ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified copy is filed with the county building inspec- tion department. NUMBER FIXTURE OR ITEM FEE LOCALITY Date . Applicant WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. COMPENSATION INSURANCE SHOWER OWNER (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars ($100) or less.) LAVATORY ADDRESS I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner SINK CITY TEL. NO. so as to become subject to the Workers'Compensation Laws, DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' SWIMMING POOL RECEPTOR CITY TEL. NO. w Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM with comply with such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO, PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS (commencing with Section 7000) of Division 3 of the Business OUTLETS OVER a and Professions Code, and my license is in full force and effect. 5 PER SYSTEM FINAL VALIDATION C DATE L License Number • Lic. Class - FINAL LU Contractor Date BY �y ❑ I am exempt under Sec. } B.BP.C. for this reason Plan check fee , t' � Date: 0 PLUMBING PERMIT ISSUING FEE$ ° ° s In. Signature :E TOTAL FEE 2 . + W E- Plan check applicant SINGLE FAMILY * • • HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address Law for the following reason (Section 7031.5, Business and , Professions Code): City Tel. No. ❑ I, as owner of the property, will do the work and the structure is not intended or offered for sale (Section , 7044, 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.). Lender's Name Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1102070005 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: I FEES PAID I BUILDING ADDRESS: I ON FILEI 9509 WEDGEWOOD ST 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802517 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I 18588-006-003 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, Cl 1 113 DISHWASHER(S) 1.00 FIX 16.30 1 ITENANT: 125 LAVATORIES/SINKS 1.00 FIX 16.30 (ISSUED ON: PROCESSED BY: PLAN BY: I 126 MISCELLANEOUS FIXTUR 1.00 FIX 16.30 102/07/11 SR I 1 145 WATER CLOSET/URINAL 2.00 FIX 32.50 1 10WNER: TEL. NO: [ TOTAL FEES 109.20 1FDATE FINAL BY: CODE: ICKI USA INC. ( 1 1 9178025171 IDESCRIPTION OF WORK I1 1 i (PLUMBING FOR KITCHEN REMODEL AND REPLACE TWO WATER CLOSETS [APPLICANT: I _ ICONTRACTOR: TEL. NO: I [APPROVALS DATE INSPECTOR SIGNATURE 1 ISBL CONSTRUCTION INC. (626) 512-5748- 1 1 1 19173 SOUTHVIEW ROAD LIC. NO ] ]UNDER SLAB WORK 1 [ 1 ISAN GABRIEL CA 91775 754301 B [ I I 1 ] 1 1 IWATER SERVICE 1 1 1 IPLASTIC YIN METAL YIN ]ARCHITECT OR ENGINEER: TEL. NO: 1 I I n I - i TROUGH PLUMBING 1R LIC. N0: 1 (GAS PIPINGPEI [ 1 GAS VENT 1 1 1 I 1 IHOT WATER HEATER I I I 1 1 IPLUMBING FIXTURES 1 ] 1 I I I 1 1 ILAWN SPRINKLERS 1 1 1 I I I 1 1 IGAS TEST 1 1 ] I I I 1 ] JUTILITY COMPANY NOTIFIEDI I ICWV I I I 1 I IGRAY WATER SYSTEM I 1 1 I I I I I I 1 1 I I 1 ] I I I I I 1 IREPORT ID: DPR263 ROUTE TO: BS0508 1 1 1 1 I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0405040010 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID ILD NG ADDR SS: ON FILE 9509 WEDGEWOOD ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802517 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8588-006-003 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, C 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 TENANT- TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 05/04/04 VG 10/31/04 OWNER: TEL. N0: FyNAL AATAL BY: CODE: PARKER RONALD E;MONICA J ( /✓� 9509 WEDGEWOOD ST TEMP 917802517 DESCRIPTION OF WOR GAS FOR FAU APPLICANT: TEL. 0: CONNOR AIR CONDITIONING (626) 286-3157- SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE CONNOR AIR CONDITIONING (626) 286-3157- 4931 ENCINITA AVE LIG. NO UNDER SLAB WORK TEMPLE CITY, CA 91780 403735 C20 WATER SERVICE _ PLASTIC Y/N METAL Y/N ARCHITECT-OR NGINEER: TEL. NO: ROUGH PLUMBING LIC. NO: GAS PIPING GAS VENT OT WATER EATER PLUMBING FIXTURES LAWN SPRI0. ERS GAS TEST i UTILITY CO ANY 0 I ED CW GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS05O8 t