HomeMy Public PortalAbout6027 BALDWIN AVE_Plumbing__ 76A667 -CE#817 10-62
APPLICATION FOR PLUMBING PE MIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION MOWNER
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT OF BUILDING
Temple City
FOR APPLICANT TO FILL IN Rolling & Woodruff
�
NUMBER FIXTURE OR ITEM EACH FEE rst Baptist Church
11 WATER CLOSET $1.25 1 7 MAIL
BATH TUB 1.25 ADDRESS Temple City
CITY TEL. NO.
SHOWER 1.25 7 5
8 LAVATORY 1.25 10 00 CONTRACTC(8r O f f i t t & D u n n e l l P 1 b g. , C .
6 SINK 1.25 7 50 ADDRESS 170 N. Hawthorne Blvd.
DISHWASHER 1.25 ITY Hawthorne TEL. N0772-2768
LAUNDRY TUB 1.25 ONTRACTOR'S 165581 STATE
EGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PROCESSED BY
WATER HEATER 1.50 !J i�j •3 )(
GAS SYSTEM 6 OUTLETS 1.50 1NDUSTRIAL
OUTLETS OVER 5 PER SYSTEM 30 301WASTE APPROVA CORD
INSPECTION
1 Fire H. Cabinet 1. 25 1
3 Urinals 1 .25 3 75 �
1 Service Sink 1. 2 1 25 H
2 DrinkingFount. 1. 2 2 . 50 z
1 Floor Drain 1. 2 1. 25 r _
2 Floor Sinks 1.2 2 50 I, ;
/ t
APPROVALS . DATE INSPECTOR'S SIGNATURE!
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
t
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: HOT WATER HEATERS (I
PLUMBING.
a ii h ,
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OPLUMBING FIXTURES ;
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF y
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE \
OF PERM ITTE
FINAL
LIDATION ROBERT A.'WOOD
CK.
M.0. CASH SUPERVISING MECHANICAL ENG'R
Lrwo 3 8 0 8 SEP 1 6 5 D 6 0.5 5" a
7
DBS-1APPLICATION FOR PLUMBING PERMIT
D 4
B5 3IVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles
WM.J. FOX, COUNTY ENGINEER BUILDING
ADDRESS
CASSATT D. GRIFFIN, SUP'T OF BUILDING ...__.
LOCALITY.-
FOR APPLICANT TO FILL IN -NEAREST
/ CROSS ST.
OWNERF i, r
! ;` � � + �� DISTRICT NO. GROUP /ZONE READY FOR INSPECTION I
MAILAA .
_ADDRESS f "Y / `;...`t! YE-r"`'�.6T (j /..•
' INDUSTRIAL
C-1 TY, - TEL. NO. WASTEAPPROVAL
PLUMBER
• INSPECTION RECORD
t
ADDRESS
CITY .' f TEL.NO.
LICENSE NO. ,ry
/
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET)
BATH TUB
SHOWER -- --
LAVATORY (WASH BASIN) .-a - - - - -
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL-NO_ APPROVALS
DATE INSPECTORS SIGNATURE
GAS SYSTEM OUTLETS 1.00 -
_ J� WATER HEATER - 00 1.00 UNDER SLAB WORK
PERMIT 1 00
ROUGH PLUMBING
g �
/ GAS PIPING
TOTAL FEE 1,l 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 ---"- '--
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF UTILITY CO.NOTIFIED
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE ./`•�<_z.�-.c�L.�
OF PERMITTEE FINAL '
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION R. A. WOOD, CHIEF PLBG. INSPECTOR
D.S.S.17 25M SETS 12.44 '°'' 7 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES PLUMBINGWM.J. FOX.CHIEF ENGINEER,
NATURE OF INSTALLATION DISTRICT NO; GROUP ZONE PERMIT NO.
ROUGH FIXTURES COMPLETE
HEATER CESSPOOL I-I SEPTIC TANK IYED Y `READ FOR DATE ISSUED
.r FIRST IN
fA MISCELLANEOUS
f 1
�� /A�PP-LIICANT FILL INb HEAVILY OUTLINED-PORTION
� ONLY
AME !1a Q. fF -7 GX'�/ DDRESS ✓ A V' f � .�rDDRESS ��Q r�.Q/!-A LOCALITY J /r aC... / y 3 NEAREST TY it BEL.No. CROBBsT. +�OUNTYERT.NO. EXPIRES ®tl R7 Q�'I NAME I
LOCATION OF SEPTIC TANK, OR CESSPOOL 9 MAIL.
ADDRESS S
NORTH 0 .
CITY TEL.No.
1 AM THE LEGAL POSSESSOR GF THE ABOVK-LOS
ANGELES COUNTY CERTIFICATM-OF [A-LIF ION.
e C - PLUMBER
CAN THE LEGAL OWNER OF THE;PROPERTY DESCRIBED
ABOVE. �t
wpuffi'
CORREMONS
SOUTH �. .
DESCRIPTION OF WORK
ATH TUB FURNACE
HOWER ^ISHWABHER - ^A
LAVATORY REFRIGERATOR
KITCHEN BINK WATER.BOFTENER
R:BINK SAND TRAP
Q'^P BINK r'OOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET FOUNTAIN' DATE I1IbPBCTOR'6.MAMR '
WATER NEATER DENTAL LAVATORY ROUGH PLUMBING
ETEAB DA FOUNTAIN
OUTL ®AB PiPIN6 I I
GAS VENT i
CESSPOOL
ETOTAL NUMBER OF FIXTURES SEPTIC TANK
POO� BEPTIC TANK SEWER
S UTILITY CO.NOTIFIED
TOTAL.FEE
FINAL
,D,t3.ial7;23M s6 alm.44. APPLICATION FOR PFJtXri
DEPARTMENT•SOF BUILDING AND SAFETY
COUNTY OF LOS. ANGELES : -PLUMBI.N I
Wm.-J. FOX,,CHIEF ENGINEER
NATURE-OF INSTALLATION DISTRICT NO.-- GROUP -ZONE jury PE'RyJMrIlT•NO.
ROUGH R FIXTURES COMPLETE
I—I SEPTIC TANK IVSD Y READY FOR DAT�gB I�SrSUED
HEATER, CESSPOOL
.�/^.■dam'n FIRST INSPECTION
' 6Atg .MISCELLANEOUSE�HERB
.
APPLICANT FILL,IN HEAVILY OUTLINEID.PORTIO/N�ONLYJOB
/► )�r ,/ �f/'
C' . -NAME C• �0�11 '/ / ADDRESSJ''�
or
g ADDRESS �(�'(� syF � ae�n`�/4e LOCALITY / 1Y�/.'/ --J.w� .�. �+ fes.
OJ. CITY * �EL.NO.em=_ " CROSS ST. �AY 7 —ow 1"t
COUNTY . - . ]� /+ fie+
CERT.NO. I EXPIRE 4 NAME // TV
LOCATION OF SEPTIC TANS, OR CESSPOOL z MAIL••
_ 3 ADDRESS / za5t
NORTH O
"CITY - TEL.NO.
I AM THE -LEGAL POSSESSOR OF. THE ABOVE LOS
ANGELES COUNTY CERT�IFIEOF gUAL-IRICATION.
- 4 �• PLYMB -
I AM THE LEGAL OWNER OF THE•PROPERTDESCRIBED
ABOVE.•
CORRECTIONS. .
SOUTH
DESCRIPTION OF WORT
MATH TUB FURNACE
SHOWER DISHWASHER
AVATORY REFRIGERATOR .
ITCHEN SINK 'WATER SOFTENER.
FLOOR SINK SAND TRAP .
LOP SINK FLOOR DRAIN
�j WASH"TRAY URINAL APPROVALS
WATER CLOSET I^RINKING FOUNTAIN DATE IMBP6CTOR'B NAM[
WATER HEATER ^ENT AL LAVATORY ' 2'3
T`
ROUGH PLUMBING [1•.
r
ETER� aA8 SODA FOUNTAIN' GAS.PIPIN6 I'
OUTL
J GAS VENT
/' CESSPOOL _
TOTAL NUMBER OR FIXTURES G/C� SEPTIC TANK '
CESSPOOL SEPTIC TANK SEWER I.
UTILITY CO.NOTIFIED I' I `/
TOTAL FEE �,." 1 �,� •
1 FINALI -
n.e. i9F ssM aers is-as APPLICATION FOR PERMfr
DEPARTMENT OF BUILDING AND SAFETY' ® �
COUNTY OF .LOS ANGELES �Ldlr����� '
WN.J.FOX.CHIEF ENGINEER
NATURE O .INSTALLA ON DISTRICT GROUP O E PERMIT NO.
ROUGH FIXTURES COMPLETE AV
HEATER CESSPOOL SEPTIC TANK R RIVED BY READY FOR D T6 SSU
- FIRST INSPECTION
AS• MISCELLANE U
Psommommom
ICANNT FILL IN HEAVILY OUTLINED PORTION' ` ,�ONLY
E NAME Jort. E!1 L'/�iT� � JOB G1 �f �L:�
��ff ADDRESS
ADDRESS A P/d� 6....a.... LOCALITY
'J (�"'NEAREST
d CITY /! �t T �0. nJ•/ d O CROSS ST. `
COUNTY / ��}} / �* y ^ :
CERT.No: ( !P !. E7 PIRES (,a�-.1�' � __NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL aMAIL
3 ADDRESS
NORTH O CITY . .....
` 1 AM THE L,Bf�AL POSSE SO'R pF THE_ABOVE
ANGELES COUNTY CERTIFI $O gUAL1;ICAfON.
ei.uMesR
1AM THE LEGAL OWNER OF THE PROPERTY'DRSCRIBED
W ABOVE.
Y
3 OWNER
CORRECTIONS
SOUTH
_ J.
- DESCRIPTION of WORK Z.
ATH'TUB FURNACE 0
Ir
ROWER DISHWASHER 13
WAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR:SINK SAND TRAP
LWA
P SINK FLOOR DRAIN
H TRAY URINAL APPROVALS
ER CLOSET DRINKING FOUNTAIN.i DATE. INSPECTOR'S NAME
ER HEATER -zmTAL LAVATORY ROUGH'PLUMBING I
ER. nAS QODA FOUNTAIN GAS PIPING I I
OUT
GAS VENT
CESSPOOL
AL NUMBER OFFIXTURES -SEPTIC TANK
SPOOL SEPTIC TANK SEWERUTILITY CO:NOTIFIEDE FINAL (f
- o.a.s.-lb'SSM SETS 11-48 APPLICATION.FOR PERMIT '
" DEPARTMENT,pF BUILDING.AND SAFETY
COOF LOS ANGELES PLUMBING
FOX.CHIEF ENGINEER
NATURE OF
p' ISTRI NO. GROUP ZONE PERMIT NO.L .
'ROUGH
FIXTURES COMPLETE
HEATER CESSPOOL I�SEPTIC TANK R Id BY READY FOR DATE 1980.
/ r� FIRST MIBPECTION V7
AS 18CELLANEOU /r J 4� �/
APPLICANT FILL IN HEAVILV OUTLINED PORION ONLY
NAME.
fliG✓�� S�C� ' Q'� Lf4GL+LJt�L�'
'- �� +✓�.--: ADDRESS
18
MADDRESS �I ; 51 �, LOCALITY 1�Lli 1 ' rr
ONEARKET. .
d' CITY TEL.No. ' CROSS ST. Qom! r(,I M iCD.t%C�
COUNTY r !
CERT.N2; L ' `"f EXPIRES :NW. `J .�(/L/�✓ Gtr l.Qf� ..CtVi41.•w� •Rr�i�
LOCATION 00 SEPTIC TANS, OR CESSPOOL, z MAIL
NORTH G ADDRESS
CITY TEL.No.
1'AM THE LEGAL POS EBSOR OF THE ABOVE .L09
ANGELES COUNTY CERTIF OF ALIFI ATION.
•rwita tae
ABOVE THE LEGAL OWNER OF THE PROPERTY DESCRIBED
OWNER
CORRECTIONS.
'. SOUTH
J
DESCRIPTION OF.WORK a
Z
HATH TUB FURNACE
HOWER ISHWASHER. 'p.
.—LAVATORY _ REFRIGERATOR
KITCHEN SINK - WATER SOFTENER:
FLOOR SINK SANDTRAP
LOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME .
WATER HEATER + DE-N.TAL,LAVATORY ROUGH PLUMBING I
METER AAS SODA FOUNTAIN GAS PIPING I
I
�
GAS VENT �
CESSPOOL-
TOTAL
ESSPOOLTOTAL NUMBER OF FIXTURES SEPTIC TANK
�CESSPOOEPTICTANK 'vy SEWER
UTILITY-CO.NOTIFIED
TOTAL FEEy
FINAL i %
.17 25M OLTH.IC-47
DEPARTMZNT OF BUILDING AND SAFETY APPLICATION FOES PST
COUNTY OF LOB ANGELES PLUMBINGWM.J. FOX.CHIEF ENGINEER
o.
A O STA TIO t: DISTRI O. GROUP ZONE
�/P -7ROUGH FIXTURES COMPLETE /`�" 7 .�- `4
HEATER CESSPOOL' 1-1 SEPTICTANK L RECEIVED BYREADYrFOR DATE ISSUED
IR
PST INSPECTION
AS MIimm
SC L 11210011
AN US t'F
APPLICANT FILL IN HE Y OUTLINED PORTI _ ONLY
NAME ;QLIz 'ad '�il-IY� JOB
B y S LL6 ADDRESS.Id
B A_DDRE88' wp �j�11E$wn-. a »id�Q�1A"!�
B LOCALITY
J NEAREST
tL CITY TEL.No. CROSS ST.
COUNTY
CERT.NO. J•�/ EXPIRESQ•' -
NAM E
LOCATION OF SEPTIC TANK OR CESSPOOL Z MAIL
3'
NORTH ADDRESS '
0
CITY TEL.NO.
1 AM THE L AL PO88 THE OVE LOS
ANGELES COUNTY CBRTIF R ALIFIC ON::'
' rcuwseR
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
OWNER
CORRECTIONS,
SOUTH
DESCRIPTION OF WORK r t z
.BATH TUB FURNACE
litter c7es.t ifivdi bs,_�
_ HOW= 01SHWASl119R- _ %!' �j 13
'.• j . . VATORY, REFRIGERATOR
-KITCHEN SINK WATEIj SOFTENER
FLOOR SINK SAND TRAP
SLOP BINK ______.FLOOR DRAIN
WA8N TRAY URINAL ® APPROVALS , f
—.WATER CLOSET DRINKING FOUNTAIN' DA ` INIPECTOR'e NAME
WATER H(E��ATER - DENTALLAVATORY ROUGH PLUMBING , I 1
-METER-2 SODA FOUNTAIN GAS.PIPING I �/ I
OUTL
y GAS VENT
CESSPOOL I
TOTAL NUMBER OF FIXTURES ,5�� SEPTIC TANK I
CE88POO SEPTIC TANK SEWER I
8
TOTAL FEE UTILITY,CO.NOTIFIED
W1 AL -�y
VORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT
j h v affirm that I have a certificate of consent to self 76A667A
din r dr a certificate of Workers' Compensation Insurance, CE 817(REV. 10/81)
or a certified copy thereof (Sec. 3800, Lob. C. COUNTY OF LOS ANGELES BUILDING AND SAFETY
�Policy,.NcsP86226OUpony Staib & Associfl3tes
Certified copy is hereby furnished.
+` FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ILAJI Certified copy is filed with the county building inspec- ADDRESS 6019 Baldwin
tion department. NUMBER FIXTURE OR ITEM @ FEE LOCALITY
8-25-86 Robert L. Munso WATER CLOSET
_ Temple City
Date Applicant NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' Bari-Elle �nikl CROSS ST.
COMPENSATION INSURANCE SHOWER OWNER FirSt Baptist Church
(This section need not be completed if the work involved by MAIL
the permit is for one hundred dollars($100)or less.) LAVATORY ADDRESS 6019 Baldwin
I certify that in the performance of the work for which this
permit is issued, I shall not employ any person in any manner SINK ! CITY Temple City TEL. NO.
so as to become subject to the Workers Compensation Laws. DISHWASHER
CONTRACTOR Robert L. Munson, Inc.
Date Applicant i� CLOTHES WASHER ADDRESS r7
NOTICE TO APPLICANT: If, SWIMMING POOL RECEPTOR ft�aking this Certificate of 307-A-A `S'• Vermont Ave.
Exemption, you shout-d-15ecome subject to the Workers' CITY Glendora TEL. NO. 6 41
LAWN SPRINKLER SYSTEM
Compensation provisions of the Labor Code, you must forth- 9 3-9
with comply with such provisions or this permit shall be STATE O LIC.
deemed r .`ked. WATER HEATER LICENSE NO. 8 6 CLASS crj 6
LICENSED CONTRACTORS DECLARATION / DISTRICT NO. PR CESSED6 BY
I hereby affirm that I am licensed under provisions of Chapter 9 GAS SYSTEM OUTLETS �� U
(commencing with Section 7000) of Division 3 of the Business OUTLETS OVER
and Professions Code,and my license is in full force and effect. 5 PER SYSTEM FINAL 1 VALIDATION
Z S
License Nu be Lic. ClassDATE awl_ 0
Fl
Contract r - • Date
L
2 U.
lY
❑ I am exempt Eder Sec.
U
B.BP.C. for this reason W
Plan check fee ► p.,
Date: PLUMBING PERMIT SUING $ Z
Signature
OT F
Plan check.qpplicankjl i
SINGLE FAMILY
HOME OWNER-BUILDER DECLARATION Name
I hereby affirm that-I am exempt from the Contractor's License Address _- (�_t� 53 0,3 A
Law for the following reason (Section 7031.5, Business and _ — Q
Professions Code): City e� Tel. No. ' 6�"� `� # • • • • • 5
❑ I, as owner of the property, will do the work and the ) • • 8250
structure is not intended or offered for sale (Section
7044, Business and Professions Code). • • • 8250c5i
CONSTRUCTION LENDING AGENCY $ 2 6-8 6
I hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued
(Sec. 3097, Civ. C.).
Lender's Name
Lender's Address
I certify that I have read this application and state that the ,
abov Anf motion is correct. I agree to comply with all County
ordinances State la regul * g Plumbing, and hereby
uthorize re rese tativ sof t 'f ounty to enter upon the
bov -men ne ro y fo n pection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Sign ture of Permute Date
l
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1306030007
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: I
ITR: 6561 LT: 7 BL: .001 UN: .002 I I 6019 BALDWIN AV I
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 TEMP CA 917802240 - I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: WOODRUFF
18587-032-001 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 ' GRID: A2 LOCALITY: TEMPLE CITY, Cl
1 125 LAVATORIES/SINKS' 5.00 FIX 81.00 I I
(TENANT: 145 WATER CLOSET/URINAL 7.00 FIX 113.40 (ISSUED ON: PROCESSED BY: PLAN BY: I
1 160 DWV REPAIR OR ALTER 1.00 SYS 16.20 106/03/13 SR I
1 I TOTAL FEES 238.40 1 1
1OWNER: TEL. NO: I 7AL DATE, FI AL B CODE:
IFIRST BAPTIST CH OF TEMPLE CITY (626) 286-3125- I I I
16019 BALDWIN AV I
ITEMP 917801709 1 ID CRIPTION OF WORK
15 LAVATORIES, 7 WATER CLOSE S AND DRAINAGE/VENT
(APPLICANT: TEL. NO: 1 1 I
IKITLERMAN, JOHN (626) 301-9546- I _
1823 S MAGNOLIA AVE i ISPECIAL CONDITIONS: I
IMONROVIA CA 91016
(CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I
IFINISHLINE CONSTRUCTION (626) 301-9546- I 1 / I
1823 S MAGNOLIA AVENUE LIC. NO I (UNDER SLAB WORK I I
IMONROVIA CA 91016 884981 1 1 I
I I IWATER SERVICE
PLASTIC YIN METAL YIN 1 I
(ARCHITECT OR ENGINEER: TEL. NO: I I I I
I - I IROUGH PLUMBING I
I LIC. N0:
I IGAS PIPING
I
IGAS VENT I I I
I I I
I I IHOT WATER HEATER I I I
I I I
IPLUMBING FIXTURES
I I I
ILAWN SPRINKLERS I 1 1
I I I
1 I I GP_S TEST
I I I
I (UTILITY COMPANY NOTIFIED( I I
I I 1CTATV I I I
IGRAY WATER SYSTEM
I I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I ii
1 IREPORT ID: DPR263 ROUTE TO: BS0508
I I I I I I
• COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1404300004
BliILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: 1
ITR: 6561 LT: 7 BL: .001 UN: .002 I I 6019 BALDWIN AV I
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( TEMP CA 917802240 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: WOODRUFF 1
18587-032-001 101 PERMIT•ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY, Cl
1 125 LAVATORIES/SINKS 1.00 FIX 16.20 1 I
(TENANT: 160 DWV REPAIR OR ALTER 1.00 SYS 16.20 (ISSUED ON: PROCESSED BY: PLAN BY: I
1 163 WATER PIPING BR/FIX 2.00 FIX 13.60 104/30/14 SR I
I I TOTAL FEES 73.80 1 a1
(OWNER: TEL. NO: I IFINA DAT FB CODE: I
IFIRST BAPTIST CH OF TEMPLE CITY (626) 286-3125— 1 1 l 1
16019 BALDWIN AV 1 1 I
ITEMP 917801709 1 IDE C IPTI N OF WORK
I I ILAVATORIE, DRAINAGE/VENT AND REPIPE 2 PLUMBING FIXTURES HOT 1
I I I& COLD I
(APPLICANT: TEL. NO: I I I
IDAVILA, RAY A (626) 216-7547— I I
12402 N PAL JAY AVE ISPECIAL CONDITIONS: I
IROSEMEAD CA 91770 I 1 ,•I
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I
INU WAY BUILDERS (626) 216-7547— I 1 I
12402 N. PALJAY AVENUE LIC. NO 1 (UNDER SLAB WORK I I I
IROSEMEAD CA 91770 771401 * 1 1 1-1 I
I IWATER SERVICE
I IPLASTIC Y/N METAL Y/N I I
1ARCHITECT OR ENGINEER: TEL. NO: I I I
I — I IROUGH PLUMBING
1 LIC. NO:
GAS PIPING I
IGAS VENT
I I IHOT WATER HEATER
I I I
IPLUMBING FIXTURES I 1
I I I
1 I ILAWN SPRINKLERS I I I
I GAS TEST
I11 1
1 I JUTILITY COMPANY NOTIFIED( I 1
I 1CWV I I I
IGRAY WATER SYSTEM I 1
I I I I I I
I I I I I I
I I I I I I
I I I I I I
1 I* ADDITIONAL DATA ON FILE I I I
I I I I I I
I I I I I I
IREPORT ID: DPR263 ROUTE TO: BS0508 I I I
I I I I I I