HomeMy Public PortalAbout6018 AGNES AVE_Plumbing__ 76Ao67 (CE 817) 8 71 c✓��
-.4'�` ,APPLICATION FOR PLUMBING PERIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM p FEE
WATER CLOSET 1 75 OWNER
MAIL
BATH TUB 1 75 ADDRESS
SHOWER 1 75 CITY TEL NO
LAVATORY 1 75 CONTRACTOR zk r,
SINK 1 75 ADDRESS D
DISHWASHER 1 75 CITY TEL NO
CLOTHES WASHER 1 75 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1 75
S ICT N r OSJP Z ESS B Y
LAWN SPRINKLER SYSTEM 1 75f�f
WATER HEATER 1 75 INDUSTRIAL
WASTE APPROVAL 96
GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD V
OUTLETS OVER 30
5 PER SYSTEM z
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Plan check fee See reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE 7
Plan check applicant APPROVALS DATE INSPECTORS SIGNATURE
UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel NO 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 PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS AS TEST
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 I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBE REBID NTIAL PROP v p� FINAL
SIGNATURE Y
OF PERMITTEE 'V
i
PERMIT VALIDATION CK M o CASH
PLAN CHECK VA L ATION CK M o ASH
LjiLo A 79,—,j APR 14 15 D 4 7 5- a
76A607-CE817 10 60
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS O1 Y
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY `
FOR APPLICANT TO FELL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET
L
BATH TUB ADDRES
CITY TEL NO
SHOWER
CONTRACTO
LAVATORY
SING
ADDRESS '
DISHWASHER CITY <
CONTRACTOR'S STATE ❑
LAUNDRY TUB REGWRATION NO Q COUNTY ❑
CLOTHES WASHER DISTRICT NO GROUP ZONE PROCESS B
WATER HEATER I O
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL }
INSPECTION RECORD °-
I
0
N
z
PER ITEM /
FIXTURE $ APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNE�OFBOVE y�
DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE i �lAiO'W F
OF PERMITTE
FINAL
�ALIDATIO� ROBERT / WOOM O cns SUPERVISING MECHANICAL ENG R
UA 7.0 1 5 3 1Z,- JM12 5� D 3.5 0n
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1308140038
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ITR 6561 LT 50 UN 002 6018 AGNES AV
I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917801707
ASSESSOR INFORMATION NUMBER INEAREST CROSS STREET
15385 028 016 101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID A2 LOCALITY TEMPLE CITY CAI
I 107 BATHTUBS/SHOWERS 2 00 FIX 32 40
ITENANT Ill CLUTHESWASHER(S) 1 00 FIX 16 20 (ISSUED ON PROCESSED BY PLAN BY
113 DISHWASHER(S) 1 00 FIX 16 20 108/14/13 SR I
_121 HOSE BIBB(S) 2 00 FIX 32 40 1 I
(OWNER TEL NO 125 LAVATORIES/SINKS 4 00 FIX 64 80 IFINAL DATEFIN BY CODE I
ICHAN SAM (626) 665 3557 145 WATER CLOSET/URINAL 3 00 FIX 48 60 1 I
16018 AGNES AV 147 WATER HEATER(S) 1 00 WTH 16 20 1 I"J�
(TEMP 917801707 151 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20 1D�F - YrTIO OF WORK I
I I TOTAL FEES 270 80 IPLUMBING FOR KITCHEN BATHROOM PODWER AND REMODEL BATHROOM
I I IGAS LINE AND WATER HEATER I
(APPLICANT TEL NO I
IMIU HONG (626) 675 6692 1
I
11809 S MONTEREY ST IISPECIAL CONDITIONS
JALRAMBRA A 91801
I I
I
ICONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE
IMIU CONSTRUCTION INC (626) 675 6692
11809 S MONTEREY ST LIC NO (UNDER SLAB WORK
ALHAMBRA CA 91801 938325 1
IWAIER SERVICE IY
I I IPLPSTIC Y/N METAL Y/N
(ARCHITECT OR ENGINEER TEL NO I
IWU HAROLD P (626) 288 0708 IROUGH PLUMBING
11168 SAN GAPRIEL BLVD LIC NO I
ISUITE N 938325 IGAS PIPING
IROSEMEAD CA 91770 I
I_ I
GAS VENT 1
I
I II I
I IHOT WATER HEATER I I I
I I_
(PLUMBING FIXTURES
ILAWN SPRINKLERS
IGAS TEST I I I
(UTILITY COMPANY NOTIFIEDI I
ICWV I I
GRAY WATER SYSTEM I I I
Cti y-I -) 3
I I I I I I
I
I* ADDITIONAL DATA ON FILE I I I I
I I I I I I
IREPORT ID DPR263 ROUTE TO BS0508 I I I I
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