HomeMy Public PortalAbout4930 ARDEN DR_Plumbing__ 76A667Cf(CE-817B) -9 75
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
ADDRESS 4930 ARDEN DR.
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET LOCALITY CITY .
NEAREST
BATH TUB CROSS ST. ��
SHOWER OWNER YAMA,SAKI JOSE
LAVATORY MAIL
ADDRESS SAMF
SINK CITY TEM�'i CITY TEL. NO. 444_0197
DISHWASHER CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR 2034 N PECK RD
LAWN SPRINKLER SYSTEM CITY S. EL MNM . TEL. NO. 579-7982
STATE I
WATER HEATER LICENSE NO. 265094 CLASS C--20. O
DISTRICT NO. GROUP ZONE ROC D BY v
1 GAS SYSTEM 1 OUTLETS 3 00
OUTLETS OVER )-
5PER SYSTEM INDUSTRIAL LU
WASTE APPROVAL N
INSPECTION RECORD ?
Plan check fee
PLUMBING PERMIT ISSUING.FEE $ 4. 50
TOTAL FEE 7 90
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel. No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT C V
AND STATE THAT THE ABOVEIS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES`
LICENSED AS REOUI RED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED SIDEN PR ERTY. UTILITY CO. NOTIFIED �
S1 G N A T U RE
OF PERMITTEE INAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATI N CK. y
190��AR 16 5 �' ` • .
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 4930 Virden .])rive
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY Temple City
FOR APPLICANT TO FILL IN NEAREST Wer Azusa
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
2 OWNER Mr. Bade
WATER CLOSET $1.25 2 O
MAIL
11 BATH TUB 1.25 1 2 ADDRESS
SHOWER 1.25 CITY TEL. NO.
2 LAVATORY 1.25 O CONTRACTOR Owen Bros Plumbing
1 SINK 1.25 1 25 ADDRESS 4265 N. Baldwin I
DISHWASHER 1.25 CITY El Monte TEL. NO. 443-0078
LAUNDRY TUB 1.25
CONTRACTOR'S 231"(7STATE
REGISTRATION NO. 41 COUNTY El
1 CLOTHES WASHER 1.25 1 2 DISTRICT NO. GRoua ZONE P CESSED BY
WATER HEATER 1.50
GAS SYSTEM 5 OUTLETS I'S0 1 50 INDUSTRIAL -O
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U
U
W
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ Z 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE 15 00 GAS PIPING U
1 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
PLUMBING. HOT WATER HEATER n D }a
.lf+ '�T
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES "
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST
RESIDE IN,THE AB DE IBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE C
OF PERMITTEE FINAL
LIDATION ROBERT A. WOOD
CK. M.O. CASH SUPERVISING MECHANICAL ENG'R
a1 77 0-10- MAY 18 5 0 1 5,vE