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Home My Public Portal About9712 WEDGEWOOD ST_Plumbing__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9702120004 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGALPAID G ADDRESS: TR: 21833 LT: 4 9712 WEDGEWOOD ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802535 ASSESSOR 0 NEAREST CROSS STREET: SARA MAR LANE 8588-010-010 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.35 TOTAL FEES 44.10 ISSU50 ON: PROCESSED N B : E P R S 02/12/97 TC 2/12/98 OWNER: TEL. NO: FINAL DATE FINAL BY CODE: KOLBERG E P;DIANA M TRS ( �.� `� 9712 WEDGEWOOD ST TEMP 917802535 WS-EIR17PION OF WORKt GAS LINE FOR NEW HEAT. AND AIR/Cbh/ SYSTEM APPLICANT: TEL. NO: CONNOR A/C (818) 286-3157- _" SPECIAL CONDITIONS: CONTRACTOR: TEL. N0: '�' APPROVALS DATE INSPECTOR SIGNATOR CONNOR AIR CONDITIONING AND REFRIG. (310) 286-3157- 4931 NORTH ENCINITA LIC. NO UNDER SLAB WOR TEMPLE CITY, CA 91780 403735 WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR L. 0: ROUGH G LIC. NO: S PIPING S VENT R L BI G FIXTUR-R----- LAWN SPRINKLERS GAS TESTZZ UTILITYC W GRAY-WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508 WORKERS'COMPENSATION DECLARATION ��PLICATI®N FOR PLUMBING PERMIT I hereby, affirm that I have a certificate of consent to self in- 76AA6667A PW 490 /-e PLUMBING sure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) Policy No. Company Gla t! . COUNTY OF LOkAN(`sMS DEPT. OF PUBLIC WORKS ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING �I� I -A Certified copy is filed with the county building inspection ADDRESS 7 EILV f PQ department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY Date '� Applicant �:5 ///� 71.Ada�t%ate WATER CLOSET(TOILET) NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. n 0 I dell Gu COMPENSATION INSURANCE SHOWER OWNER Ko he 2 (This section need not be completed If the work involved by MAIL the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS >� I certify that in the performance of the work for which this per- SINK CITYTEL. NO. mit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR ��yv Date Applicant CLOTHES WASHER ADDRESS L NOTICE TO APPLICANT: If, after making this Certificate of Ex- SWIMMING POOL RECEPTOR y emption,you should become subject to the Workers'Compen- CITY TEL.NO. Q O LJ' sation provisions of the Labor Code,you must forthwith comp- ly with such provisions or this permit shall be deemed revok- STATEr� - LIC. ed. WATER HEATER //_ �° LICENSE NO. (G� /,� CLASS LICENSED CONTRACTORS DECLARATION / �i DISTRICT NO. PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER lid Y and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL VALIDATION fect. / i�p HOSE BIB DATE ' �7 7 �� y License Number /a I�.S Lic. Class � �' n Q FINAL - U Contractor. S �� u7hT Date BY Q ❑ C I am exempt under Sec. V B.&P.C. for this reason 7 Plan check fee ® a Date: PLUMBING PERMIT ISSUING FEE$ C Signature G TOTAL FEE SINGLE FAMILY HOME OWNER-BUILDER DECLARATION Plan check applicant 5 I hereby affirm that I am exempt from the Contractor's License Names Law for the following reason (Section 7031.5, Business and ACCTe4 Professions Code): Address 3303 43°40 ❑ 1, as owner of the property, will do the work and the City Tel. No. 1 ITEMS structure is not intended or offered for sale(Section 7044, TOTAL , _ ' Business and Professions Code). CONSTRUCTION LENDING AGENCY CHECK 43.40 1 hereby affirm that there is a construction lending agency for CHANCE ,00 the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lenders Name 0000-0001 1/23/96 4371 1 ASI 9".42 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 represent tives of this County to enter upon the above-ment' ne ro ty for' ection purposes. /` SEE REVERSE FOR EXPLANATORY LANGUAGE ,gignarrure of Permitte Date I 1� r APPLICATION FOR PLUMBING PERMIT .1 7BB.I7,fO.SS J TMSION OF BUILDING AND SAFETY Deportment of County Engineer County of Los Angeles BUILDING JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS ' CASSATT D,GRIFFIN,SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN I NEAREST CROSS ST. L=-I O OWNER NIP, DISTRICT NO. I GROUE ZONE READY FOR INSPECTION MAIL WASTE APPROVAL PLUMBER /70Rd a�r.Gi.arJG INSPECTION RECORD ADDRESS lCto 0 C9 CITY jjTEL.NO 9. ��' LICENSE NO. 44 16-62 NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) @ $1.00 $ BATH TUB @ .$1.00 SHOWER @ $1.00 LAVATORY (WASH BASIN) @ $1.00 KITCHEN SINK @ $1.00 DISHWASHER @ $1..00 LAUNDRY TUB OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 GAS SYS'[EM @ $1.00 APPROVALS DATE INSPECTORS SIGNATURE UNDER SLAB WORK PERMIT $ 1 '00 ROUGH PLUMBING GAS PIPING TOTAL FEE QQ GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ-THIS APPLICATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES 1 HEREBY CERTIFY THAT. 1 AM PROPERLY REGISTERED.AND/OR GAS TEST -N -vk g(e LICENSED AS REOUIR D BY LO ANGELES CO NTY AND STATE OF CALIFORNIA OR THA I A HE LEGAL 0 ER OF HE ABOVE UTILITY CO.NOTIFIED 4 -4 „P/� DESCRIBED RESIDENT P TY.. 4 q SIGNATUREb2f OF PERMITTEE FINAL \t OHN A.LAMBIE. OUNTY ENGINEER VALIDATION ROBERT A.WOOD.CHIEF PLBG. INSPECTOR CK. M.O. CASH i 8 9 S u° JAN 1-.6 3 :11.0 0