HomeMy Public PortalAbout5940 AGNES AVE_Plumbing_5/7/1965_ 76A667 (CE-817) - 5/73 --7/�- �/V(
'i l
APPLICATION F R PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING ,i
ADDRESS v •i /',God �F'`J s�
HARVEY T. BRANDT, COUNTY ENGINEER . LOCALITY ��—
FOR APPLICANT TO FILL IN (PRINT O TYPE) NEAREST
P
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET 1.7 OWNER,
MAIL ,,.- - -�. .c..(.•.
BATH TUB 1.75 ADDRESS 7 ""i
SHOWER1,75 CITYa TEL.`NO.
CI
LAVATORY J 1. 15 CONTRACTOR
SINK 1.15 ADDRESS
DISHWASHER 1. 5 CITY TEL. NO.
CLOTHES WASHER 1J5 STATE LIC
LICENSE NO. CLASS'
SWIMMING POOL RECEPTOR 1.T5
DIS�ICT NO. -GROUP NE FRO ESSED BY
LAWN SPRINKLER SYSTEM 1. 5
WATER HEATER 1. 5
INDUSTRIAL }
WASTE_APPROVAL a.
GAS SYSTEM OUTLETS, 1. 5 _ INSPECTION RECORD V
OUTLETS OVER
5 PER SYSTEM 30 �� 7_4'& v / Se e, ®.S0.496 e 0
A,�01,gl' C A 0 A
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE 16 6DD
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING v? 5V 1-2
City Tel. NO. GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I 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
PLUMBING. GAS TEST p
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED '
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER-O-F, AND IIN�(TTEE/�} 'TO /
f Af
RESIDE IN THE ABOVE DESCRIBED RESIDENTI ..PR PERTY.' c (fes'
FINAL 7�
SIGNATU RE
OF P E R M I
TTE •ice �' ��'` r''^�' 7
PERMIT VALIDATION `CK. .0. CASH
PLAN CHECK VALIDATI N M.O. CASH
� U 4 I`1t1! y J u �
1 .
76A667 (CE 817) 4/72
J
APPLICATION FOR PLUMBING PERMIT t,
t COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO BUILDING
ADDRESS Q
HARVEY T BRANDT COUNTY ENGINEER
Agnes
LOCALITY Temple Cit
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM @ FEE
1 WATER CLOSET 1 75 L OWNER
Allan ShInn
MAIL
BATH TUB 1 75 ADDRESS 5940 Aanes
1 SHOWER 1 75 v CITY TEL NO —
LAVATORY 1 75 CONTRACTOR John Mosley
1 SINK 1 75 C O ADDRESS
DISHWASHER 1 75 CITY Arcadia TEL NO 444-6839
CLOTHES WASHER 1 75 STATE LIC
LICENSE NO CLASS C
SWIMMING POOL RECEPTOR 1 75
LAWN SPRINKLER SYSTEM 1 75 DISTRICT N GROUP ZOiE PROCE <Y
TWATER HEATER 1 75 INDUSTRIAL
WASTE APPROVAL 0
GAS SYSTEM OUTLETS 1 75 V
INSPECTION RECORD
OUTLETS OVER L>:
5 PER SYSTEM 30 d ,r UAW-,- Gift 0/t-
CD
v
a
z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE 16
APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check applicant UNDER SLAB WORK
n
Name ROUGH PLUMBING A0-4 ff-72
Address GAS PIPING
City Tel No GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I 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
PLUMBING GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LO ANGELES COUNTY ND STATE OF
CALIFORNIA OR THAT I M TH LEGAL OW R ND I TEND TO
RESIDE IN THE ABOVE D CRIB D ESIDE P ERTY FINAL
SIGNATURE
OF PERMITTEE
PERMIT VALIDATION CK M 0 CASH
PLAN CHECK V LID TION CK M 0 SH
.m" 5 5 5 D 1 6 5 0 ®mac,
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1207170016
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
(LEGAL ID: I FEES PAID I BUILDING ADDRESS: 1
ITR: 6561 LT: 47 UN: .002 1 5940 AGNES AV 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( TEMP CA 917802217 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LAS TUNAS 1
18587-031-018 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, Cl
I 147 WATER HEATER(S) 1.00 WTH 16.20 I
1TENANT: 192 NO PERMIT OWNER-BLDR 166.40 DOL 166.40 (ISSUED ON: PROCESSED BY: PLAN BY: 1
TOTAL FEES 210.40 107/17/12 SR 1
I
OWNER: TEL. N0: 1FINAL DATE FINAL BY: CODE:
FEI THOMAS;WENDY (626) 577-2135- 1 � /
15940 AGNES AVE. I ! 1/ OK G
1TEMPLE CITY CA 91780 DE`SCRIPTICN OF WORK
I 1REPLACE WATER HEATER
I
1APPLICANT: TEL. NO:
ISAME AS OWNER - I I
I 1SPECIAL CONDITIONS:
ICONTRACTOR: TEL. NO: 1 1APPROVALS DATE INSPECTOR SIGNATURE 1
1SAME AS OWNER - 1 I I
I LIC. NO 1 (UNDER SLAB WORK
I I I
I 1WATER SERVICE I
IPLASTIC Y/N METAL Y/N
1ARCHITECT OR ENGINEER: TEL. NO:
- I 1ROUGH PLUMBING
1 LIC. NO: I
IGAS PIPING I
I I I
_I IGAS VENT I I
I I I
I I IHOT WATER HEATER I I I
I I I
I I 1PLUMBING FIXTURES I
I I I
LAWN SPRINKLERS I
I I I
I 1GAS TESTI
I I i
I 1UTILITY COMPANY NOTIFIEDI I I
I I ICWV I I I
IGRAY WATER SYSTEM
I I I
I I I I I I
I I I I I I
I I I I I I
I 1REPORT ID: DPR263 ROUTE TO: BSO508 I I