HomeMy Public PortalAbout5430 BALDWIN AVE_Plumbing__ (2) 76A667 (CE 817) 5/73 ,, v
APPLICATION FOR) PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO BUILDING
ADDRESS J 0
HARVEY T BRANDT, COUNTY ENGINEER , LOCALITY
FOR APPLICANT TO FILL IN (PRINT OF TYPE) NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM FEE
WATER CLOSET 1 5 OWNER
MAIL 4
BATH TUB 1 5 `ADDRESS
SHOWER 1 L5 CITY TEL NO
s
LAVATORY 1 F5 CONTRACTOR �y jv
SINK 1 5 ADDRESSDISHWASHER 1 5 CITY TEL NOel
CLOTHES WASHER 1 5 STATE LIC- CLASS
LAWN SPRINKLER SYSTEM 1 5 If SWIMMING POOL RECEPTOR 1 5 LICENSE NO`CT Ng GROUPNE P CESSED B
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WATER HEATER 1 5 INDUSTRIAL
WASTE APPROVAL }.
GAS SYSTEM OUTLETS 1 5 �� INSPECTION RECORD U
OUTLETS OVER 30
5 PER SYSTEM
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CL
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE Sj I&O
APPROVALS DATE INSPECTOR S SI(NATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING , fid
City s 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 GAS TEST / 1
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LO ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM TH LEGA WNER F AND INTEND TO
RESIDE IN THE ABOVE DESCRIB RES ENTIAL RTY FINAL ,
SIGNATU RE
OF PERMITTEE
PERMIT VALIDATION /� CK� M O cns
PLAN CHECK VALI AT ON CK M 0 CASH `I�.A g
3 4 8rnFR Z5 5 D 5 0 0 dib
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1007140007
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE 5430 BALDWIN AV
IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802624
ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET OLIVE
18586-023 016 101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID B4 LOCALITY TEMPLE CITY Cl
1 125 LAVATORIES/SINKS 2 00 FIX 32 50 1
(TENANT 45 WATER CLOSET/URINAL 1 00 FIX 16 30 JISSUED ON PROCESSED BY PLAN BY 1
1 92 NO PERMIT OWNER BLDR 257 00 DOL 257 00 107/14/10 SR 1
I TOTAL FEES 333 60
OWNER TEL NO I F DATE FINAL BY CODE
IWIN SANDA (626) 321 2572 1I
15430 BALDWIN AV 1 1 b • I\
TEMP 917802624 I (DESCRIPTION OF WORK
I (REPLACE KITCHEN SINK BATHROOM LAVATORIE AND WATER CLOSET
APPLICANT TEL NO I I
ISAME AS OWNER 1 1
I 1 (SPECIAL CONDITIONS
I
I I I I
1CONTRACTOR TEL NO 1 1APPROVALS DATE INSPECTOR SIGNATURE 1
ISAME AS OWNER I
I LIC NO (UNDER SLAB WORK
I I I
I I (WATER SERVICE I
I 1 IPLASTIC Y/N METAL Y/N 1 1 1
1ARCHITECT OR ENGINEER TEL NO I I I I
1 1 IROUGH PLUMBING 1 I 1
1 LIC NO
I IGAS PIPING I I 1
I I I
IGAS VENT 1 I
I I I
IHOT WATER HEATER I I
I I I
I I 1PLU111BING FIXTURES I I
I I I
1 1 (LAWN SPRINKLERS I I 1
I I I
I 1 IGAS TEST 1 I
I I I
(UTILITY COMPANY NOTIFIEDI I
I I I� I I
I I IGRAY WATER SYSTEM
I I I
I I I I I I
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1 IREPORT ID DPR263 ROUTE TO BS0508 I I I
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