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HomeMy Public PortalAbout10938 WILDFLOWER RD_Plumbing__ F61 C6678'BB58 APPLICATION FOR P-L.IJIVIBING PERMIT le BUILDING AND SAFETY DMSION Department of County Engineer County of Los Angeles BUILDING JOHN A.LAMBIE,COUNTY ENGINEER ADDRESS CASSATT 0.GRIFFIN,,SUPT OF BUILDING LOCALITY FOR AUECANT O FILL IN NEAREST CROSS 87. OWNER DISTRICT NO. GROUP ZONE I READY FOR INSPECTION MAIL �w ADDRESS CITY TEL.NO. INDUSTRIALWASTE APPROVAL PLUMBER Valley Plumbing Co. INSPECTION RECORD eetWoo Y. - ADDRESS Glendora 5-1292 CITY TEL.NO. LICENSE NO. NUMBER TYPE OF FIXTURE OR ITEM 'FEE WATER CLOSET (TOILET) @ $1.00 $ BATH TUB @ $1.00 SHOWER @ $1.00 LAVATORY (WASHBASIN) @ $1.00 KITCHEN SINK @ $1.00 i DISHWASHER @ $1.00 LAUNDRY TUB.OR TRAY @ $1.00 CLOTHES WASHER @ $1.00 WATER HEATER @ $1.00 GAS SYSTEM @ .$1.00 APPROVALS DATE INSPECTORS SIGNATURE , UNDER SLAB WORK j/, L ' �/Il'. �✓ PERMIT $ 1 ,00 ROUGH PLUMBING r GAS PIPING TOTAL FEE ® d GAS VENT I HEREBY ACKNOWLEDGE THAT I HAVE READ THI APPLICATION HOT WATER HEATER i AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING. PLUMBING FIXTURES I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST O ' LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 A THE L AL OWNER OF THE BOVE UTILITY CO.NOTIFIED DESCRIBED RESIDENTIAL PERTY SIGNATURE ss OF PERMITT INAL ROBERT A.WOOD, JOHN A.LAMBIE. OUNTY ENGINEER AIMATION SUPERVISING MECHANICAL ENG'R CH. N.O. CASH C 3 5 0 7C;- DCT 1 S 3 10.00 d WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUTAI ING PERMIT iii I herr k affirm that I have a certificate of consent to self 76A667A insure;or a certifico'te of Workers'Compensation Insurance, CE 817(REV. 10/81) ?!or a'ce`rllfyetd copy ihereoff(Sec.9800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Police N Z93CK�any Mno 'Certified copy is hereby furnished. ADDRESS 3 �1.! 1 FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ❑' Certified copy is filed with the county building inspec• NUMBER FIXTURE OR ITEM Q FEE tion department. • �I ^'f � ll LOCALITY � � �1� Date d -a� -S Appli4` ,Iltan ,,;-�J WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATH TUB CROSS ST: COMPENSATION INSURANCE SHOWER OWNER �Q �- (This section need not be completed if the work involved by MAIL the permit is for'one hundred dollars($100)or less.) LAVATORY i ADDRESS 1 certify that in the performance of the work for which this permit is issued, I shall not-employ any person in any manner SINK CITY TEL. NO. so as to become subject to the Workers'Compensation Laws. DISHWASHER CONTRACTOR �' �V;� � � o Date Applicant CLOTHES WASHER ADDRESS NOTICE TO APPLICANT: Ify after making this.Certificate of (0-Oi -Q. 40 IA9— Exemption, you. should become subject to the Workers' SWIMMING POOL RECEPTOR CITYTEL..NO. Compensation provisions of the Labor Code, you must forth- ©� �( fO3�-153c' with comply with such provisions or this permit shall be LAWN SPRINKLER SYSTEM STATELIC: deemed revoked. WATER HEATER LICENSE NO. CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO. ROCESSED BY I hereby affirm that I am licensed under provisions of Chapter 9 -GAS SYSTEM OUTLETS (commencing with Section 7000.) of Division 3 of the Business OUTLETS OVER St�� and Professions Code,and my�license is in full force and effect. 5 PER SYSTEM IL DATE VAL ATION IL License Number 1 �y +' Lic. Class �� of FIN Contracto4nut�plme�L ` DateQ S� BY O � 16Q8A u ❑ I am exempt under Sec. # o o a'o 0 5 y B.BP.C. .for this reasonPlan check fee I o 0 3 Q 5 p Date: ' PLUMBING PERMIT ISSUING FEE$ 5 0'o 0 3 0,50 5 • Signature TOTAL FEE 'O 228-85 SINGLE FAMILY Plan check applicant HOME OWNER-BUILDER DECLARATION Name I hereby affirm that I am exempt from the Contractor's License Address 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 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 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-mention property for,inspection purposes. mss. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date _ q,W WORKERS'COMPENSATION DECLARATION i APPLICATION FOR PLUMBING PERMIT I ,aereby�pffirm that I have a certificate of consent to self ; 20-0026 DPW 6/87 rte:ure or a certificate of Workers'Compensation Insurance, •76A667A or a certified copy thereof(Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES L DEPT. OF PUBLIC WORKS Policy Nort�nCompany Certified copy is hereby furnished. FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified copy Is filed with the county building inspec- NUMBER FIXTURE OR ITEM @ ' FEE tion de artment. I /pp LOCALITY SGC Date _Applicant yaw. WATER CLOSET NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' BATHTUB CROSS ST. COMPENSATION INSURANCESHOWER OWNERnge! 0J I►yt (This section need not be completed If the work Involved by _ the permit is for one hundred dollars(5100)or less.) S LAVATORY MAIL �,�6 ADDRESS : Vv L'.�J —Zac I certify that',In the performance of the work for which this ; j permit is issued, I shall not employ any person in any manner / SINK d- CITY Gc TEL. NO �G so as to become subject to the Workers'Compensation Laws. � DISHWASHER,• 4/44 k5jT. CONTRALTO Date Applicant CLOTHES WASHER v ADDRES NOTICE TO APPLICANT: If, after making,this Certificate of ' Exemption, you should become subject -to the Workers' SWIMMING POOL RECEPTOR Compensation provisions of the Labor Code,you must forth- , LAWN SPRINKLER SYSTEM CIT TEL.NO. with comply' with_ such provisions or this permit shall be STATE LIC. deemed revoked. WATER HEATER LICENSE NO. LZ CLASS.P LICENSED CONTRACTORS DECLARATION „ DISTRICT NO. PROCESSED B I hereby affirm-that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS � (commencing with Section 7000)of Division 3-of the Business OUTLETS OVER' and PFofessions Code,and my license is in full force and effect. 5 PER SYSTEM. FINAL - VALIDATION DATE License Number Lic. Class1f!k__/ �b�r z O a ry FINAL Contractor Date. u ! BY ❑ I am exempt under B.&P.C. for this reason Plan.check fee s Date: i PLUMBING PERMIT ISSUINCeFEE$ I i4 c 1--r,.-.f• � SignatureI t r I ' TOTAL FEE �' wG h•i'i i�== Plan check applicant („l.-I" ,1!E' ti,:{ SINGLE FAMILY HOME OWNER-BUILDER'DECLARATION Name I hereby affirm that I am exempt from the Contractor's License '! ;'ESI :_;_i�=:; 'r Address .•r; Law for,the following reason (Section 7031.5, Business and I :,.:1, y; �; Professions Code): City Tel..No. " I,`as owner of the property; will'do.the work and the i 'strudture 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 Lender's Address + I 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' roperty r inspection.purposes: '$EE REVERSE FOR EXPLANATORY LANGUAGE i aiure o itt Date I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0103160015 BUILDING ANSI SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 If PHONE: (626) 285-0488 EXT: LEGALFEES PA BUILDING ADDRESS: TR: 23949 LT: 9 10938 WILDFLOWER RD FEE DESCRIPTION: QUANTITY: UGM: AMOUNT: TEMP CA 917803511 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: WELLAND 8573-034-009 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY 07 BATHTUBS/SHOWERS 1.00 FIX 16.20 TENANT: 25 LAVATORIES/SINKS 1.00 FIX 16.20 ISSUED 0PROCESSED B A BY: EXPIRES ON: 45 WATER CLOSET/URINAL 1.00 FIX 16.20 03/16/01 JK 09/12/01 TOTAL FEES 76.35 OWNER: TEL. NO: FINAL DATE I CODE: THOMAS JAMES W JR;JOYCE K - xp1 1J 10938 WILDFLOWER RD TEMP 917803511 6R�f��ION OR REMODEL EXISTING BATHROOM APPLICANT: L. NO: TOM OLEARY (626) 287-0927- 5823 AGNES SPECIAL CONDITIONS: TEMPLE CITY, CA - CONTRACTOR: TEL. N0: •�;%'. _ '.' ;�� APPROVALS DATE INSPECTOR SIGNATURE TOM OILEARY CONSTRUCTION (626) 287-0927- . , `•,,�, 5823 AGNES AVENUE LIC. NO o f ,: `� ':.+� DER SLAB WORK TEMPLE CITY, CA 91780 489354 B-1 ✓/. ` yi WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. 0: I LIC. N0: ROUGH PLUMBING /17 _ - - U� + = GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES AWN SPRINKLERS GAS TEST UTILITYCOMPANY NOTIFIED CwV GA -WATER SYSTEM- REPORT ID: DPR263 ROUTE TO: BS0508