HomeMy Public PortalAbout9819 WENDON ST_Plumbing__ 76 A 667- dE 617 7�i9c�• /_ (%�
APPLICATION FOR PLUMBI •G •PERMIT
COUNTY & LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION fD
ILDIN
JOHN A. LAMBIE, COUNTY ENGINEER DRESSCOLEMAN W. JENKINS. SUPT. OF BUILDING CALITY01,pL
FOR APPLICANT TO FILL IN(PR NT OR TYPE) AREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
�,-` OWNER 5��.✓
WATER CLOSET 1.50 w
AD
BATH TUB 1.50
�Q DRESS Q/ Q
SHOWER 1.50 CI ✓ TEL.NO, O 30
LAVATORY 1.50 CONTRACTOR
SINK •1.50 69 ADDRESS
DISHWASHER 1.50 CITY TEL.NO.
CLOTHES WASHER 1.50S2STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50 DIfR�J2Ic 0. GROUP NE R ESSED BY
LAWN SPRINKLER SYSTEM 2.00 � 7i1,
WATER HEATER 1.50 y INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM '2�0155TLETS 1.50J INSPECTIO RECORD
OUTLETS OVER
5 PER SYSTEM .30 Ir 7171 (5;r.43f
Iu
En
z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEES 2 00
TOTAL FEE APPROVALS ATE IN PEGTOR'S 1 ATURE
Plan check applicant UNDER SLAB WORK
Name I/? 1.. r� J ROUGH PLUMBING
Address �/�f�J�V GAS PIPING
y ,%e �o Tel. No. d � GAS VENT
Cit HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES' AND STATE LAWS REGULATING GAS TEST 'Q
PLUMBING. _
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO _
BESIDE IN,THE ABOVE DESCRI ED REBID .IA�ROF Y. FINAL
SIGNATURE • '� JACK R. ALLEN, SUPER ISING CHANICAL ENG'R.
OF PERMITTEE +
PERMIT VALIDAI CK. M.O. CASH
PLAN CHECK.VALIDATION CK. M.O. CASH tv
. ic��.:5 .9 7 �'�� �,i�L21 5 a' '1 4.0 0" ��
/J ale
78A887-CE0817 10-67 CiV , Of Temple' City
' A�PF?LICATION FOR PLUMBING PERMIT .
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION B
UILDING r
JOHN A. LAMBIE, COUNTY ENGINEER 9 VlrendOn
COLEMAN W. JENKINS. SuP-T. OF BUILDING CALITY Temple Cit
Y.
FOR APPLICANT TO FILL IN PR NT OR TYPE) REST
. OSS ST. Goldenwest
NUMBER FIXTURE OR ITEM EACH FEE
P Larson OWNER
WATER CLOSET 1.50 l 50
BATH TUB 1.50 AADDDRESS 9819 Wendon
I SHOWER 1.50 1.1 50 CITY Temple CitY TEL.NO.
LAVATORY 1.50 3 00 CONTRACTOR IT & D Plumbing CO.
SINK 1.50 ADDRESS 414 So. San Gabriel B1Vd
DISHWASHER 1.50. rIN
abriel TEL.NO. 2870579
1 CLOTHES WASHER 1.50. l STATE LIC
AT
243896 CLASS 36
SWIMMING POOL RECEPTOR 1.50NO. GRO P' ZONE PRESSED BY
LAWN SPRINKLER SYSTEM 2.00 '� Y� _ E
WATER HEATER 1.50 VAL
CD
GAS SYSTEM OUTLETS 1.50INSPECTION RECORD t
OUTLETS OVER 30 y
5 PER SYSTEM
_ Z
Plan check fee 25%of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE 9 50 APPROVALS 'DA7E (IN)
PEGTOR' ATURE .
Plan check applicant UNDER SLAB WORK Q O
Name ROUGH PLUMBING
Address GAS PIPING
'GAS VENT
City. TeL No.
HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
1 HEREBY CERTIFY THAT I AM P PER REGISTERED AND/OR UTILITY CO.NOTIFIED
• LICENSED AS REQUIRED BY LOS A ELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1.AM THE L AL HER OF,AND' INTEND.TO -
RESIDE IN.THE ABOVE DESCRIBE ES TIAL PROPERTY. FINAL
SIGTT
NATURE JACK R. ALLEN, SUPERVISING MECHANICAL E
OF PERMI
PEB,MIT VALIDATION CK. M.O. ASH{
PLAN CITE AL,IDATION CK. M.O. CASH
4
�
^ 6.6 7 3r SEP 10 5 D 9..5 0 . ._
WORKERS'COMPENSATION DECLARATION 76A667A
I hereby affirm 'that I have a- certificate of consent to jelf Ce a+7(z-66j APPLICATION FOR PLUMBING PERMIT .
insure,'er a certificate of Workers'Compensation Insurance,or
awe tiffs copy ther of(mac.3800 b.C.)
1 y� COUNTY OF LOS ANGELES
TIC, BUILDING AND SAFETY
Po icy No. C.
E] Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (PRINT OR TYPE) TAD
ILDIN �^
DRESS �,Certified copy is filed witll the county bu' g inspection NUMBER FIXTURE OR ITEM ® FEEdepa tme"t. `�.--,r �� � WATER CLOSET CALITDate '� Applican —fes f✓r! ARESTC RTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB OSS ST,
COMPENSATION INSURANCE SHOWER OWNER
s
LAVATORY MAI L
(This section need not be completed if the work involved ADDRESS /L�- a
by,. the permit is for one hundred dollars ($100) or less.) SINK CITYTEL.N� U
I certify that in the performance of the work for which this DISHWASHER cc
permit is issued, I shall not employ any perso in any manner CONTRACTOR
so aWbo ubject tot Workers'C m e ation Laws. CLOTHES WASHERADDRESSatApplican `' ' LUSWIMMING POOL RECEPTOR CITY TEL.N NOLICANT: If, after making this Certificate of
Exemption, you should become subject. to the Workers' LAWN SPRINKLER SYSTEM STA E +�/ LIC. �+� . z
Compensation provisions of the Labor Code, you must forth- WATER HEATER LICENSE NO.Y CLASS
with comply with such provisions or this permit shall be
deemed revoked. GAS SYSTEM OUTLETS DISTRICrT�NO' P OCESSED B
LICENSED CONTRACTORS DECLARATION OUTLETS OVER �.UO
I hereby affirm that I am licensed under provisions of Chapter 5 PER SYSTEM
9 (commencing with Section 7000)of Division 3 of the Busi- FINAL ??
ness and Professions Code, and my license is in full force and DATE VALIDATION�_Gr3
effect. 100,'
r FINAL
License Number Lic.Class ef y BY �► �'
Contract ) Date E
El I am exempt from the licensing requirements as I am a Plan check fee
licensed architect or a registered professional engineer PLUMBING PERMIT ISSUING FEE$
acting in my professional capacity (Section 7051, Bus- 6
iness and Professions Code). TOTAL FEE Ae SO
Lic.or Reg.No. Date Plan check applicant
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm that I am exempt from the Contractor's Address C • 3'3 1.5 A
License Law for the following reason (Section 7031.5, Busi- Gity Tel.No _
# ° ° ° 0 ° 5
ness and Professions Code): ,
I, as owner of the property, am exclusively contracting
with licensed contractors to construct the project 2.° 1 6.5 0
°
(Section 7044,Business and Professions Code). o o'0 1 6506.
CONSTRUCTION LENDING AGENCY 3, 1 8.-8 2.
1 hereby affirm that there is a construction lending agency
for the performance of the work for which this permit is
issued(Sec.30.97,Civ.C.).
Lender's Name
Lender's Address
I certify that ve read this application and state that the
abo6 ' form tion correct:I agree to comply with all County SEE REVERSE FOR EXPLANATORY LANGUAGE
ordinan a d t to laws regulating Plumbing, and here y
a th ze r en atives of this County to ent r upo he
ab on d /rop�erty four inspection purpos
/�-'L^moi•• 1� r� -
Si store ittee Dat
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0911050014
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
1TR: 11386 IT: 2 BL: A UN: .002 9819 WENDON ST
1 ]FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801727
ASSESSOR INFORMATION NUMBER: ' ] NEAREST CROSS STREET:
15385-022-014 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, Cl
1 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 ] 1
]TENANT: 1 TOTAL FEES 43.95 ]ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: ]
1 111/05/09 SR 11/05/10
I
]OWNER: TEL. NO: ]FI TE FI. BY: CODE:
]WANG, TAMIE (626) 286-8669- 1 t
19819 E. WENDON AVE. ] ] A ]
]TEMPLE CITY CA 91780 1 ]DESCRIPTION OF WORK ]
1 1 ]REPLACE 1 GAS PIPE FROM GAS METER TO HOUSE 1
]APPLICANT: TEL. NO: 1 1 1
1KAO (626) 347-3434- 1 1 1
12128 S. 7TH AVE. 1 ]SPECIAL CONDITIONS:
1ARCADIA, CA 91006 ] 1
]CONTRACTOR: TEL. NO: ] ]APPROVALS DATE INSPECTOR SIGNATURE 1
]BRIAN Y KAO (626) 347-3434- 1 1 1
12128 S. 7TH AVENUE LIC. NO ] UNDER SLAB WORK 1 1 1
1ARCADLA, CA 91006 897876 C36 ] 1 1
1 WATER SERVICE 1 1
]PLASTIC YIN METAL YIN 1 ] ]
ARCHITECT OR ENGINEER: TEL. NO: - i ]ROUGH PLUMBING ] 1 1
1 LIC. NO: 1 1 1
1 ] GAS PIPING!^ ](
1 1 ]GAS VENT V` ]1 1
] ] ]HOT WATER HEATER ] ] 1
1 ] 1PLUMBING FIXTURES 1 1 ]
1 ] (LAWN SPRINKLERS 1 1 1
1 I 1 GAS 'TEST 1 1 1
1 1 ]UTILITY COMPANY NOTIFIEDI ] ]
I ] ICWV I I I
1 1 ]GRAY WATER SYSTEM 1 ] 1
I I I I ]
I I 1 I ] I
I I ] 1 ] ]
I I ] I ] I
1 ]REPORT ID: DPR263 ROUTE TO: BS0508 1 ] 1 ]
] .1