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Home My Public Portal About9542 WEDGEWOOD ST_Plumbing__ 78A 887.-CE#817 10-82 1� APPLICATION FOR PLUMBING PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS -- WILLIAM A.JENSEN, SUP'T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST ir 4CROSS ST. ric fie &f— NUMBER FIXTURE OR ITEM EACH FEE OWNER WATER CLOSET $1.25 SHOWER 1.25 CITY TEL. NO. Z LAVATORY 1.25 r D CONTRACTOR SINS . 1.25 ADDRESS DISHWASHER 1.25 CITY _ A.`A TEL. NO. CONTRACTOR'S STATE g LAUNDRY TUB 1.25 REGISTRATION NO. Q 0OUNTY ❑ CLOTHES WASHER 1.25 L DISTRICT NO. GROUP I ZONE OCESSE0 BY WATER HEATER 1.50 ® S— GAS SYSTEM_OUTLETS 1.50 d INDUSTRLRL � WASTE APPROVAL —/—fOUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD ®C u AAA N z APPROVALS 17ATF7INSPEC OR'S SIGN _bl�jf PERMIT S 2 00 s UNDER SLAB WORK ROUGH PLUMBING —ft `P, TOTAL FEE GAS PIPING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY rp 6 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER A �u PLUMBING. _ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES SIA `rS`� w LICENSED AS REQUIRED BY LOS ANGELES.COUNTY AND STATE OF GAS TEST �3 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO RESIDE IN,THE ABOV ESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED SIGNATURE OF PERMITTE LIDATION ROBERT A.WOOD " CK. M.0. CASH SUPERVISING MECHANICAL ENG'R 1.9 -9,212 M10 5 D 1 6.25~ s v WO ERS'COMPENSATION DECLARATION I herq affirm that I Have a certificate of consent to self in- 20-00 A PW 4/87 �P��,��®� �®� �� PERMIT sure;Yor a certtf.icate of Workers'Compensation Insurance,ora CE 817(REV. 8/86) 6ertified copy thereof (Sec. 3800, Lab. C.) Policy No. Company COUNTY OF LOS ANGELES DEPT. OF PUBLIC WORKS Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING .� Certified copy is filed with the county building inspection ADDRESS department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date Applicant WATER CLOSET.(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. fP ' COMPENSATION INSUCE SHOWER OWNER �yro S fG (This section need not be complete f fhe work involved by MAIL r•.— fhe permit is for one hundred doll s($100)or less.) LAVATORY ADDRESS I certify that in the performance of t war for which is per- mit is issued, I shall not employ any ers n in a a ner so SINK CITY rTELJ � as to become subject to the Workers' 'o pen n ws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER NOTICE TO APPLICANT: If, after making t}iis Certificate of Ex- ADDRESS emption,you should become subject to the.Workers,Compen- SWIMMING POOL RECEPTOR CITY •� `' TEL. NO.. safion.provisions of the Labor Code,you must forthwith comp- LAWN SPRINKLER SYSTEM t ' ly with such provisions or this permit shall be deemed revok- STATE LIC.. ed. WATER HEATER LICENSE NO. CLA8S LICENSED CONTRACTORS DECLARATION DISTRICT NO. P OCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS , 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER. and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL IDATION fect: DATE C License.Number Lic..Class. O FINAL cccc Contractor Date BY O I am exempt under Sec. + �, lU B.&P.C. for this reason Plan check fee z Date: PLUMBING PERMIT ISSUINGFEE$ Signature TOTAL FEE y; ;2 0 61-8 A SINGLE FAMILY 0 0 0 0 0 HOME OWNER-BUILDER DECLARATION Plan check applicant �'�T-, 5 I hereby affirm that I am exempt from the Contractor's LicenseName ( °'O 1 6,50 Law for the following reason (Section 7031.5, Business and Professions Code): Address o 0 -16.5 0 I; as owner of the property, will do the work and the City Tel. No. 0 9 0 7.-!-8 8 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 L(dinance is A�ddress 1tify that I have rid this application and state that the ae info is ct-I a ree to comply with all County O os�and State awsre afing,Plumbing, and hereby aorize repre�nv fLves—of'this County,to enter upon tae-mentioned ra erty for inspection purposes.• / SEE REVERSE FOR EXPLANATORY LANGUAGE ig ature" Permittee ' l Da e s WORKERS'COMPENSATION DECLARATION LRI&PUCAT900 FOR PLUMBING PERMIT I hereby affirm that I have a certificate of consent to self 20-Od26 DPW 6/87 ' unsure, or a certificate of Workers'Compensation Insurance, 76AS67A ti or a.;certified t opy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS �❑olicy No. :Q Company Certified copy is hereby.furn!shed. ❑ FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING Certified copy is filed'with the county building inspec- ADDRESS tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET Date Applicant. NEAREST / CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. 1/// Cleo& COMPENSATION INSURANCE 0 OWNER ia---o (This section need not be completed If the work involved by SHOWER the permit is for one hundred dollars $100 or less. MAIL p (. ,) ) �- LAVATORY DO� ADDRESS I certify that in the performance of the work for which this SINK CITY TEL. NO.. permit is issued, I shall "not employ any person in any mariner � so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should'become'subject to the Workers' SWIMMING POOL RECEPTOR 1 Compensation provisions of the Labor Code, you must forth- LAWN SPRINKLER SYSTEM CITY TEL. NO. with comply with such provisions or this ,permit shall be STATE . LIC. deemed revoked. 'WATER HEATER LICENSE NO.. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS yt D (commencing with.Section.7000)of Division 3 of the Business OUTLETS OVER !/Q and Professions Code,and my'license is in full force and effect. 5 PERS STEM- FINAL VALIDATION DATE e License Number Lic. Class. C FINAL /� Ilk Contrbctor Date BY /W O ❑ I cim exempt under Sec. C B,BP.C. for this reason V Plan check fee Date: PLUMBING PERMIT ISSUING FEE$ &0 • Signature TOTAL FEE QQ Plan check applicant SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Name 5 I hereby affirm that I am exempt from the Contractor's License Address f r•r r z 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 -`'�I, _'''UiJ strudture is not intended or offered for sale (Section j I TEM, 7044, Business and Professions Code). _ _ CONSTRUCTION LENDING AGENCY ;l IL 5.m I hereby.affi►m that.there.is a construction lending agency for 1Uayi the performance of the work for which this permit is issued (Sec..3097, Civ. C.). CHANG .111; Lender's Name i.Il1--QOJ 1 h/'i a Lende s ddress � �: Icer fy hat. I have read this application and state that the , a)a i formation is correct. I agree to comply with all County 36i ri{l :+,r ord' a ccs and .State laws regulating Plumbing, and hereby aut o ze rep®resent of this County to enter upon the , ob v -mentioned' perty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of Permittee Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1410070015 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: ILEGAL ID: FEES PAID I BUILDING ADDRESS: I 9542 WEDGEWOOD ST I ON FILE [FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:I TEMP CA 917802516 I ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: I 8588-005-030 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY CAI 147 WATER HEATER(S) 1.00 WTH 16.20 1 (TENANT: TOTAL FEES 44.00 (ISSUED ON: PROCESSED BY: PLAN BY: I 110/07/14 SR 1OWNER: TEL. N0: 1FINAL DAT FI CODE: I IMAESALA, TED ( 1 I 19542 WEDGEWOOD ST 1 I TEMP 917802516 ID SC&IPTION bF WORK 1 (INSTALLING WATER HEATER (APPLICANT: TEL. NO: 1 I ITODHUNTER, STACY (626) 858-9884- 1 I 1475 E ARROW HWY [SPECIAL CONDITIONS: I IAZUSA CA 91702 , ICONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE I IRESCUE ROOTER (626) 858-9284- 1 I 1475 E ARROW HWY LIC. NO } IUNDER1SLAB WORK I I I IAZUSA CA 91702 765155 * I 1 I I I IWATEP. SERVICE [ I I I IPLAST.IC YIN METAL YIN (ARCHITECT OR ENGINEER: TEL. NO: I I [ I I - IROUGH PLUMBING I [ [ LIC. NO: I I I I I 1 IGAS FSPING 1 I I I I I I V!� IGAS VENT I I I IHOT WATER HEATER 1 1 IPLUMBING FIXTURES I 1 I (LAWN tiPRINKLERS 1 I 1 I [GAS TEST I I I 1UTILITY COMPANY NOTIFIED I I i ICWV I I I IGRAY WATER SYSTEM I I I I I I I I I I I I I * ADDITIONAL DATA ON FILE I I 1 I I I I I I REPORT ID: DPR263 ROUTE TO: BS0508 I