HomeMy Public PortalAbout4933 ARDEN DR_Plumbing__ 76AS67C (CE-81713) -9/75
APPLICATION FOR PLUMBING PERMIT
0- PJQ� C(�i�
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING147 3'
NUMBER FIXTURE OR ITEM @ FEE ADDRESS v
WATER CLOSET Il LOCALITY
BATH TUB C1 NEAREST
CROSS ST. �
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY TE L. IV41
!�
DISHWASHER
CONTRACTOR
CLOTHES WASHER �?1
ADDRESS l®
SWIMMING POOL RECEPTOR n/l
LAWN SPRINKLER SYSTEM CITY TEL. NO. /V'�
STATELIC
WATER HEATER LICENSE NO01 CLASS/Q_lJ��
DISTRICT NO. GROUPESSED BY
GAS SYSTEM OUTLETS r� V
OUTLETS OVER U!a
5 PER SYSTEM INDUSTRIAL V
WASTE APPROVAL 1y
Cl-
INSPECTION
INSPECTION RECORD GO
Plan check fee
PLUMBING PERMIT ISSUING FEE $ D
TOTAL FEE i� Q
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel. No. GAS PIPING
d
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLYp
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFYPLUMBING FIXTURES
THAT I AM PROPERLY REGISTERED AND/OR d
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 RESIDEN�T�I✓ALL\PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK.' M.O. CASH
5 7 3 DEG 2 5 D 7.5 U A:;,
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0506200014
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 11148 LT: 13 BL: A UN: .002 4933 ARDEN DR
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917804048
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LOWER AZUSA
8585-015-042 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY, C
07 BATHTUBS/SHOWERS 3.00 FIX 48.60
TENANT: 13 DISHWASHER(S) 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
19 FLOOR SINK(S) 1.00 FIX 16.20 06/20/05 JK 12/17/05
25 LAVATORIES/SINKS 2.00 FIX 32.40
OWNER: TEL. NO: 45 WATER CLOSET/URINAL 2.00 FIX 32.40 FINAL DATE FINAL BY: CODE:
CHIANG, LOIS (626) 453-3577- 47 WATER HEATER(S) 1.00 WTH 16.20
4933 ARDEN DR 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20
TEMP 917804048 TOTAL FEES 205.95 DESCRIPTION OF WORK
PLUMBING FOR BATHROOM AND KITCHEN
APPLICANT: TEL. NO:
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO UNDER SLAB WORK
0
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TEL. NO:
HAN, FREEMAN (626) 796-5899- ROUGH PLUMBING
9051 VALLEY BLVD. #104 LIC. NO:
ROSEMEAD, CA 91770 C21976 GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
UTILITY COMPANY NOTIFIED
CWV
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508