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Home My Public Portal About9532 WEDGEWOOD ST_Plumbing__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT • DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0405180002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: GA ID: FEES PAID- BUILDING ADDRESS: TR: 13806 LT: 7 9532 WEDGEWOOD ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802516 ASSESSOR INFORMATIO NUMBER: NEAREST CROSS STREET: CLOVERLY 8588-005-007 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 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: 05/18/04 VG 11/14/04 OWNER: TEL. NO: FINAL DATEFINAL BY: CODE: LY, VICTORIA ( 9532 WEDGEWOOD ST TEMP 917802516 DESCRIPTION OF WOR GAS FOR FAU APPLICANT: TEL. NO: PHAM (323) 528-4489- SPECIAL-CONDITIONS: CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE PHAM, HOA NGOC (323) 528-4489- 2453 RICHELIEU AVE. LIC. NO UNDER SLAB WORK LOS ANGELES, CA 90032 634800 C20 WATER SERVICE ARCHITECT OR ENGINEER: TEL. NO: PLASTIC Y/N METAL Y/N ROUGH PLUMBING LIC. NO: GP.S PIPING GAS VENT HOT WATER HEATER PLUM13ING-FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508 DEPARTMENT OF COIIll= ENGINEER PLUMBING t •DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION - COVXTY OF LOS ANGELES BUILDING PV � 1�/ WILLIAM J.•FCIX, COUNTY ENGINEER ADDRESS / I ?-PV E If,16, rj//boC 0 QR APPLICA T TO FILL IN LOCALITY G BUILDING CROSS ST. G 4. ®l/NEAREST tf: ADDRESS •y � / 10. „� DISTRICT NO. GROUP ZONE PERMIT NO. LOCALITY NEAREST /► l� CROSS ST. �jL�}.t,pti1� �jRECEIVED BY Ready for Inspection DATEISSUED OWNER MAIL INOUSTRIAL ADDRESS WASTE APPROVAL CITY TEL.NO. INSPECTION RECORD PLUMBER �-� � s� ! 1.4 C iT`- .T ADDRESS ^ ' CITY ! TEL.NO. �I �rf r7 do AL%r- kzm mcs LICENSE NO. (/? ��® v r �7a COUNTY J PERMIT FEES a z •IUMEER TYPE OF FIXTURE OR ITEM FEE Ve WATER CLOSET(TOILET) @ 0.80 $ O BATH TUB @ 0.80 SHOWER @ 0.80 LAVATORY(WASH BASIN) @ 0.80 KITCHEN SINK @ 0.80 LAUNDRY TUB OR TRAY @ 0.80 SLOP SINK @ 0.80 FLOOR SINK @ 0.80 FLOOR DRAIN @ 0.80 DISHWASHER @ 0.80 DRINKING FOUNTAIN @ 0.80 URINAL @ 0.80 GAS SYSTEM-... OUTLETS @ 1.00 k/ WATER HEATER @ I.00 Q MISCELLANEOUS APPROVALS DATE INSPECTOR'S SIGNATURE UNDER SLAB WORK PERMIT $ `I- 00 ROUGH PLUMBING O ,h. •�� y!� yiQ a , TOTAL FEE GAS PIPING I HEREBY ACKNOWLEDGE THAT I HAVE READ THI$AP Ll- GAS VENT CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVE DESCRIBED R SIDENTI PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTEFINAL ! R al -1 s f_8f rI/I.vt^A •"� 76AG67 DBS 17 &f53 •:'WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I.h%eby, offirr'n that I have a certificate of consent to self in- 6��A DPW 4/87 n suge,or a eti ificate of Workers'Compensation Insurance,or o CE 817(REV.8/86) cul t:ertifed copy thereof(Sec. 3800, Lab. C.) r Policy No. Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS ❑ Certified copy is hereby furnished. BUILDING CbW� � j p_q NUMBER FIXTURE OR ITEM FOR APPLICANT TO FILL IN(PRINT OR TYPE) A cjC Certified copy is filed with the county building inspection ADDRESSon department. @ FEE LOCALITY Date Applicant l WATER CLOSET(TOILET) NEAREST C�ov� S CERTIFICATE OF EXEMPTION FROM WORKERS' ...�BATH TUB CROSS T. Hq COMPENSATION INSURANCE SHOWER OWNER Ma rq l7CoB l(OL y.Ct (This section need not be completed if the work involved by MAIL e^� the permit is for one hundred dollars($100)or less.) , LAVATORY °�' ADDRESS q63' D` I certify that in the performance of the work for which this per- ^ SINK CITY / TEL. mit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR emption,you should become subject to the Workers'Compen- CITY TEL. NO. sation provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM ly with such provisions or this permit shall be deemed revok- STATE LIC. ed. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. OCES Y I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM �+ OUTLETS �. 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER 62 and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL• 91ALIDATION fect. �! C DATE License Number Lic. Class (� FINAL Contractor Date BY O F- 1 am exempt under Sec. W CL B.BP.C. for this reason Plan check fee Date: PLUMBING PERMIT ISSUING FEE'$ 71 Signature TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check.applicant 3307 64.50 I hereby affirm that I am exempt from the Contractor's License Name (Y7/J/eV ; r� ITEMS Low for the following reason (Section 7031.5, Business and Professions Code): Address '763a LtJe�Gl�voo.D TOTAL 64&o 50 I, as owner of the property, will do the work and the City �� 1 a. �� Tel. HECIS 64°51I structure is not intended or offered for sale(Section 7044, oQ� Business and Professions Code). CHANGE CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for 0000—mol 10/31/89 the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). 6467 1 Ali 8;32 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 im1pection purposes. ✓// /zzw 1-03, E7 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of 6rmittee Da e