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HomeMy Public PortalAbout9825 WENDON ST_Plumbing__ o COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0910130023 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: I ITR: 11386 IT: 2 BL: A UN: .003 1 9825 WENDON ST FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917801727 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: GOLDEN WEST 15385-022-015 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, Cl 1 107 BATHTUBS/SHOWERS 1.00 FIX 16.20 I I (TENANT: I TOTAL FEES 43.95 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I 110/13/09 SR 10/13/10 I (OWNER: TEL. NO: IFINAL DATE FINAL BY: CODE: THOMAS, EDWIN (626) 374-4998- I 1 _ 1 9825 WENDON ST I I I� I TEMP 917801727 1 IDESCRIPT ON OF WORK 1 I I INEW HOT MOP AND NEW DRAIN 1 (APPLICANT: TEL. NO: 1 I 1 (DAN MIKILASKO CONSTRUCTION (626) 716-2273- 1 15048 UNIT A CALMVIEW I ISPECIAL CONDITIONS: �BALDWIN PARK 91780 I I I I (CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE I IRAN MIKOLASKO CONSTRUCTION (626) 338-0055- 1 1 I 15048 A CALMVIEW AVE. LIC. NO I (UNDER SLAB WORK I I I IBALDWIN PARK, CA 91706 855601E I I I I 1 WATER SERVICE I I 1 I 1 PLASTIC YIN METAL YIN 1 1 I (ARCHITECT OR ENGINEER: TEL. NO: 1 I I I 1 - I ]ROUGH PLUMBING 1 1 1 LIC. NO: I I (GAS PIPING I 1 IGAS VENT 1 1 I 1 IHOT WATER HEATER 1 1 I 1 1 (PLUMBING FIXTURES I 1 1 1 ILAWN SPRINKLERS I 1 1 IGAS TEST I I I I I I I I 1 (UTILITY COMPANY NOTIFIED I I I I 1CWV I I I 1 1 (GRAY WATER SYSTEM 1 I I I I I I I I I I I I I I I I I I 1 IREPORT ID: DPR263 ROUTE TO: BS0508 1 1 I 1 I I I I I I • WORKER'S COMPENSATION DECLARATION 0os;A DPW APPLICATION- FOR PLUMBING PERMIT Thereby affirm that I have a certificate of consent to salt insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereot(Sec.3800 Lab.C.) Policy No. Compan y 5 t_eviya COUNTY OF LOS ANGELES DEPT.OF PUBLIC WORKS { DEPT.OF PUBLIC WORKS DIV. ' Certified copy is hereby furnished. BUILDING ` FOR APPLICANT TO FILL IN(PRINT OR TYPE ADDRESS 3n S` &W6 d Certified copy is filed with the county building inspection department. NUMBER FIXTURE OR ITEM ® FEE `1-L—Applicant LOCALITY Date A pplicantu •el`LVS 2, WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST. Lo COMPENSATION INSURANCE ASSESSOR / ,.�ri1 (This section need not be completed If the work Involved by the SHOWER / .' MAP BOOK �a PAGE Go - I PARCELD/� permit Is for one hundred dollars($100)or less.) LAVATORY OWNER I certify that in the performance of the work for which this permit MAIL is issued, I shall not employ any person in any manner so as to SINK �� ADDRESS 1 �© become subject to the Workers'Compensation Laws. DISWASHER CITY �� ! TEL.NO. " Date Applicant 6 CLOTHES WASHER CONTRACTOR S / NOTICE TO APPLICANT: If, after making this Certificate of 1 Exemption,you should become subject to the Workers'Compensation SWIMMING POOL RECEPTOR provisions of the Labor Code,you must forthwith comply with such ADDRESS i _F41V&1eC &b b Ok provisions or this permit shall be deemed revoked. LAWN SPRINKLER SYSTEM LICENSED CONTRACTORS DECLARATION CITY8 y� TEL.No. /,f�aa f� } I hereby affirm that I am licensed under provisions of Chapter 9 I WATER HEATERf0 S / 11STATE LIC. (commencing with Section 7000)of Division 3 of the Business and GAS SYSTEM OUTLETS LICENSE NO. 3 �' T CLASS 6 (C`r Professions Code,and my license is in full force and effect. OUTLETS OVER ' DISTRICT NO. PROCESSED BY Q 5 PER SYSTEM C License Number ) Lic.Class FINAL VALIDATION LL ,//�� � fUS `�� 6 � {, DATE Z C�_g 7 n, Contractor 4 12-C S i:4 S eDate 7 -9-Z u l a Cr ❑ I am exempt under Sec. FIN L ? B.&P.C.for this reason Date: Plan check fee Signature PLUMBING PERMIT ISSUING FEE$ TOTAL FEE EJ r x SINGLE FAMILY Pled check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractot's License Law for the following reason(Section 7031.5, Business and Professions Address *;; =;" Code): i,_,r. ❑ r Li Cityl 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 �';1;°• '.- ,i.IJ and Professions Code). " CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the _ =_i- (;itis s ? `.F!``.- performance of the work for which this permit is issued(Sec.3097, 7 a . Civ.C.) t-s' y in'L 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 pur ses. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date