HomeMy Public PortalAbout5506 BALDWIN AVE_Plumbing__ (2) 76A667 (CE-817)-4/72
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET 1,75 OWNER
AMAIL
DDRESS fir— /%/
CITY BATH TUB 1.75 V9
CITY TEL. NO. /
SHOWER 1.75 '� 7
LAVATORY 1,75 CONTRACTOR
SINK 1,75 ADDRESS
DISHWASHER 1.75 CITY ` �� TEL. NO e_qjo
CLOTHES WASHER 1.75 STATE �)/1rcl 4 C/ CLASS LIC
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SWIMMING POOL RECEPTOR 1,75 LICENSE N0.
DISTRICT NO. GROUP NE OCESS D BY
LAWN SPRINKLER SYSTEM 1,75 /��� 6�
v t 6
WATER HEATER 1.75 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD V
OUTLETS OVER
5 PER SYSTEM .30 CD
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE (, 7�"
APPROVALS DATE INSPECTOR'S SI,NATURE
Plan check applicant 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
PLUMBING. GAS 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 DESCRIBED RESIDENTIAL PROPERTY. FINAL
SI GNATU RE
OF PERMITTEE '`
PERMIT VALIDATION CK. M.0. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1104200016
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: 1
ITR: 16957 LT: 4 I I 5506 BALDWIN AV 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917802627 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1
18586-022-004 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, Cl
1 113 DISHWASHER(S) 1.00 FIX 116.30 I 1
(TENANT: 125 LAVATORIES/SINKS 3.00 FIX 48.80 (ISSUED ON: PROCESSED BY: PLAN BY: I
1 145 WATER CLOSET/URINAL 2.00 FIX 32.50 104/20/11 SR I
TOTAL FEES 125.40 I 1
(OWNER: TEL. NO: I IFINAL DATE FINAL BY: CODE: I
(BUTLER, JOHN - I I 1
19596 APRICOT AVE. I I 1
1ALTA LOMA CA 91737 I IDESCRIPTION OF WORK I
I I IPLUMBING FOR KITCHEN REMODEL, REPLACE 2 LAVATORIES AND 2 I
I I IWATER CLOSETS I
(APPLICANT: TEL. NO: 1 I
IRIVERA CONSTRUCTION (626) 444-8466- I I
112107 E. MC GIRK AVE I ISPECIAL CONDITIONS: 1
IEL MONTE, CA 91732 I I
I I I I
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1
IRIVERA CONSTRUCTION (626) 444-8466- 1 1 1
112107 E. MCGIRK AVE. LIC. NO (UNDER. SLAB WORK I I I
IEL MONTE, CA 91732 361071BHIC 1 1-1 1
1 IWATER SERVICE
I IPLASTIC Y/N METAL Y/N I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 I I 1
I - IROUGH PLUMBING
1 LIC. NO: I II I
j IGAS PIPING
EXPIRE1 GAS VENT 1 1 1
I
I I 1
IHOT WATER HEATER I I I
13 (PLUMBING FIXTURES I I I
1LAWN SPRINKLERS
I I I
I IGAS TEST I I I
I I I
1 1UTILITY COMPANY NOTIFIED( I 1
1CWV I
I 1GRAY WATER SYSTEM
I I I
I I I I I I
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I I I I I I
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I 1REPORT ID: DPR263 ROUTE TO: BS0508 I I I
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