HomeMy Public PortalAbout5409 BALDWIN AVE_Plumbing__ 76A667 APPIL[CATION FOR PLUMBING ■ ERMIT
DBS 17 12
OF BUMI)ING AND SAFETY
Depar ent of County Engmeer
County of Los Angeles BUILD 1 N G ,{ !J/� ' //w
WM J FOX COUNTY ENGINEER ADDRESS ✓ /`;// /y, rJiy�rD W�iV
CASSATT D GRIFFIN SUP T OF BUILDING Cy
LOCALITY �{i 0-1 /
FOR APPLICANT TO FILL IN NEAREST
yyLL _ I CROSS ST
OWNER DISTRICT NO GROUP ZZOOryryNE��', READY FOR INSPECTION
MAIL 15
_ADDRESS S ��� /I/Q /OG.F.D +'�` J� IINDURIAL
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CITY �L+o�t '�`m1 TEL NO AT7 304. WASTE APPROVAL
PLUMBER .�✓awc /, 1:7-%6 INSPECTION RECORD
v 1
ADDRESS
CITY TEL NO
LICENSE NO 93
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) $ - ! �d
BATHTUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO @ O 80 Oo APPROVALS
DATE INSPESTOR S SIGNATURE
GAS SYSTEM OUTLETS @ 1 00
f UNDER SLAB WORK
WATER HEATER @ 1 00
� ROUGH PLUMBING q
PERMIT $ I 1 00 GAS PIPING �/ r
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT IHAVE READ THIS APPLICATION HOT WATER HEATER A _
AD STATE THAT
THE ABOVE IS
C S CDE TO COMPLY
THALL COUNTYORD NAN C ESANDSTATE LAWS REGULATING PLUMBING FIXTURES I�t1I
PLUMBING GAS TEST B' �9t7 �/t A,
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED Dn
DESCRIBED RESIDENTIAL PROPERTY
\ SIGNATURE
OF PERM TTEE ��"�✓ + +� / � FINAL V /
ILLIAM J FOX COUNTY ENGINEER VALIDATION
_i�1 4 9 1 S LIAR 14� 3 1100
BY
I
_ DEPUTY
O 'a'�,�
- COUNTY OF LOS ANGELES TEMPLE CITY # 0508PfRM3
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS M 8 80010600 0
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
LEGAL ID FEES PAID DDR S n
ON FILE 5 N AVS
p" FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802625
ASSESSOR INFORMATION MBER NEAREST CROSS STREET OLIVE
8588 019 017 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 597 GRID 84 LOCALITY TEMPLE CITY
51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20
TENANT TOTAL FEES 43 95 ISSUED ON PROCESSED BY PLAN B XPIRE ON
01/06/00 UT 07/04/00
OWNER TEL NO FINAL DATE FINAL CODE
PAYNE jiggN/Q//,Hgk-D (626) 945 7930
5409 BALDWIN AV Z iQ
TEMP 917802625 DESCRIPTION OF WORK
EXTEND GAS LINE FOR NEW HEATING SYSTEM
APPLICANT TEL N
A C H PLUMB/HEAT/AIR COND (626) 821 2285
511 S FIRST'AVE SPECIAL CONDITIONS
ARCADIA CA
-LIES c
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
A C H PLUMBING HEATING AND A, C (626) 821 2285
511 S FIRST AVE #250 LIC NO UNDER SLAB WORK
ARCADIA CA 91007 705435 C20
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT ENGINEER TEL 0
ROUGH PLUMBING
LIC NO
1111111 UA-S—PIPING
�— GAS VENT
GJ o LKr0"- WORKS
OR S HOT WATER HEATER
MBING FIXTURES
0 a 3>� �fRpd LAWN SPRINKLERS
O ` AS TEST
UTILITY COMPANY OTIFIED
CWV
GRAY WATER SYSTEM
* ADDITIONAL DATA ON FILE
REPORT ID DPR263 ROUTE TO BS0508