HomeMy Public PortalAbout4917 BALDWIN AVE_Plumbing__ 76A667C ICE 8178) 9/75 '
APPLICATION FOR PLUMBING PERMIT
BUILDYNG AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING A
NUMBER FIXTURE OR ITEM @ FEE `
ADDRESS &4 01 I ri . 1 Rue.
WATER CLOSET LOCALITYNEAREST
' Wl�
BATH TUB CROSS ST LowQ
SHOWER OWNER Q" I G u"6
LAVATORY MAIL
ADDRESS N q � IIJ e
'
SINK CIT TEL NO 57
1-
DISHWASHER CONTRACTO
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL NO
LAWN SPRINKLER SYSTEM
STATE LIC
WATER HEATER LICENSE NO CLASS a-
DISTRICT NOGR UP N!F
O ESSED BY V
GAS SYSTEM OUTLETS -. o
OUTLETS OVER �� v
5 PER SYSTEM INDUSTRIAL LLJ
WASTE APPROVAL
�^ INSPECTION RECORD
Plan check fee
PLUMBING PERMIT ISSUING FEE S
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR 5 SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING /7
City Tel No GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS 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 REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT THELEGALOW OF AND INTEN TO
RESIDE IN THE ABO E RIBENT AL ROPER Y UTILITY CO NOTIFIED T/ _
SIGNATURE �'r / `&I"
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION M 0 CASH
0 1 4-JAN 3 5 D 1 050A—
76AS67 t7 9 50 Ki APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J FOX CHIEF ENGINEER PLUMBING 1
FOR APPLICANT TO FILL INDISTRICT NO GROUP I ZONE PERMIT NO
PLUMBER Standard Plumbing Com an RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS4333
3 33 E. Florence Avenue
Aw
-t.--
BUILDING
CITY Bell., Calif. TEL NO Je• 1124 ADDRESS. 4917 Baldwin
COUNTY LOCALITY (Temple City
LICENSE NO 105-M EXPIRES
o
NEAREST Lawer Azusa Blvd.
CROSSST
PERMIT FEES /� .}
s O ett
NUMBER TYPE OF FIXTURE OR ITEM FEE G
OWNER E. Bi
MAIL
1 WATER CLOSET (TOILET) Q O 50 $ 50
ADDRESS
BATH TUB Q O 50 CITY TEL NO
SHOWER @ O SOI 50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
-
1 LAVATORY (WASH BASIN) @ O 50 50 VE S CORRECT AND
AGREEATOOCOMPLY N AND TWITH ALL ATE THAT TCOUNTHE Y ORDINANCES AND
KITCHEN SINK @ O 50 STATE LAWS REGULATING PLUMBING
CERTIFY
THAT
THE
/LEGALLOWNER
LOS
LAUNDRY TUB OR TRAY Q O 501 ANGELESCOUNTYLICENSE/ ORI IAM THEE
OF THE RES IDENT IALePPR'JOOPERTY/DESCIR`BEEDABOVE' �-
GAS SYSTEM OUTLETS @ O Sol SIGNPERMITTEF _.PX�-`�'"�t-' 477�.f
WATER HEATER Q O SO
SLOP SINK @ O 501 1 INSPECTION RECORD
FLOOR SINK @ O SOI L —
FLOOR DRAIN Q O 501 ' 7,
, r A
DISHWASHER @ O Sol �d r� H --/A:23*- r 1Z 1,3 1 Cl
F=ii DRINKING FOUNTAIN @ O 501
URINAL @ O 50
HOUSE SEWER @ O Sol I
MISCELLANEOUS I I 6
I
0
I I
I
APPROVALS
DATE INSPECTORS NAME
ROUGH PLUMBING V—pL— ! ,,,moi
-� GAS PIPING /O-/�',Sd /111412 [�
GAS VENT
CESSPOOL Q 1 00 i I CESSPOOL
ISEPTIC TANK SEPTIC TANK
I DRAIN ( ) PIT ( Q 1 00 SEWER
PERMIT 1 OO GAS TEST A'yl/
TOTAL FEE $ 2 50
4a L
UTILITY CO NOTIFIED
I I
FINAL
176 667 69 17 7 61 APPLICATION FOR PERMIT
I�� TMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES L S
WILLIAM J FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT_Nll GROUP PERMT NOO
PLUMB&R Standard Plumbing C ari REC IVSD BY READY FOR DATE ISSUED
FIRST INSPECTION
ADDRE99 4333 E. Florence Avenue GD�I D's
BUILDING 4917 Baldwin Avenue
CITY Bell, Calif. TEL No Je.1124 ADDRESS
COUNTYlOrJ"� LOCALITY Temple City
LICENSE NO VEXPIRES
NEAREST Loner Azusa Road
PERMIT m 1DLCROSS ST
�•i
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER Bissell
MAIL
WATER CLOSET(TOILET) a 050 IS ADDRESS
BATH TUB 0 O 50 CITY TEL No
SHOWER 0 050 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) @ 050 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ O 5O AND STATE LAWS REGULATING PLUMBING
I CERTIFY THAT 1 POSSESS THE AB.�OVE VALID„LO9
LAUNDRY TUB OR TRAY !� O 50 ANGELES COUNTY LICE AM T,uHE �OWNER
OF THE RESIDENTIAL DEH RIS D VE
13AS SYSTEM OUTLETS 0 50
810HATURE OF
WATER HEATER O 50 PERMITTEE.
SLOP BINK 050 INSPECTION RECORD
FLOOR SINK 01513
FLOOR DRAIN O 50
DIBHWASHER ® 050
DRINKING FOUNTAIN 080
URINAL O SO J
i Q
HOUSE SEWER O SO Z
MISCELLANEOUS E3
FZ
0
APPROVALS
i
DATE INSPECTOR 9 NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL 100 I CESSPOOL
SEPTIC TANKe SEPTIC TANK
DRAIN C ) PIT ) IN 1 00 SEWER
PERMIT I 1 Dp GAS TEST b70
TOTAL FEE 1 � 1
UTILITY CO NOTIFIED -
�
FINAL
r
COUNTY OF LOS ANGELES TEMPLE e,ITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0003210006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
i
LEGAL ID FEES PAID BUILDING ADDRESS
TR 9848 LT 20 4917 BALDWIN AV
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917804009
ASSESSOR INFORM ION NUMBER NEAREST CROSS STREET LOWER AZUSA
8589 025 020 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID B5 LOCALITY TEMPLE CITY
49 WATER TREATING EQUIP 1 00 SYS 16 20
TENANT TOTAL FEES 43 95 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
03/21/00 UT 09/17/00
OWNER TEL NO FINAL DATE FINAL BY ODE
LIN,HSIU TUAN (626) 442 6668 9
4917 BALDWIN AV
TEMP 917804009 CRTPTION OF WOR
NEW WATER SOFTNER
APPLICANT TEL N
SAME AS OWNER
SPECIAL CONDITIONS
S ���
CONTRACTOR TEL NO S R,N�E L E � APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC NO UNDER,SLAB WORK
�e WATER SERVICE
A PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER TEL NO
/ ROUGH,PLUMBING
LIC NO (L/ 1111111 GAS PIPING
r GAS VENT
� rUE UC VO UV S HOT Wa R HEATER
PLUMBING FIXTURES
D 0 Ff LAWN 5P IN L RS
O 0
GAS TEST
® ®yUTILITY COMPANY NOTIFIE
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REPORT ID DPR263 ROUTE TO BSO5O8