HomeMy Public PortalAbout9121 BLACKLEY ST_Plumbing__ D.B.S.-17 25M SETS 11-46 APPLICATION FOR PERMIT
ARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES �L� �'N�
WM. J. FOX. CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO.
ROUGH FIXTURES COMPLETE _
HEATER CESSPOOL 1_1
SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
AS MISCELLANEOUS
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
E NAME ADDRESS
W
07 ADDRESS LOCALITY
f
NEAREST
.J CITY TEL.No. CROSS ST.
a
COUNTY
CERT.No. EXPIRES 0: NAME
W
LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL
ADDRESS
NORTH O
CITY TEL.NO.
IAM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
Iq 1
Y
3 i OWNER
CORRECTIONS
SOUTH
J
DESCRIPTION OF WORK z
BATH TUB FURNACE L7
IY
SHOWER DISHWASHER O
LAVATORY REFRIGERATOR
i
KITCHEN SINK WATER SOFTENER
r
FLOOR SINK SAND TRAP
SLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN
DATE INSPECTOR'S NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I
METER GAS SODA FOUNTAIN
OUTL 6A9 PIPING
GAS VENT I I
CESSPOOL I i
TOTAL NUMBER OF FIXTURES - SEPTIC TANK
CESSPOOL SEPTIC TANK SEWER I i
s - UTILITY CO.NOTIFIED
TOTAL FEE
FINAL
`E-8178) -9/79
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING Y-A 9121 E. Blackley
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET LOCALITY Temple ty
NEAREST
BATH TUB CROSS ST
SHOWER OWNER C. W. Zachary
LAVATORY MAIL
ADDRESS 9121 E. Blackley
SINK CITY Temple City TEL NO 286-6378
DISHWASHER CONTRACTOR
Bryant Heat. & Air Coal
CLOTHES WASHER ADDRESS 1350 E. Las Tunas Drive
SWIMMING POOL RECEPTOR
CITY San Gabriel TEL NO 286-1141
LAWN SPRINKLER SYSTEM
STATE
WATER HEATER LICENSE NO 221751 CIL SS C20
DISTRICT NO GROUP E RO ESSE BY O
], GAS SYSTEM OUTLETS 3 00 L V
OUTLETS OVER
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL V
w
a
INSPECTION RECORD C/) I
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE 7 50
Plan check applicant
Name APPROVALS DATE INSPECTOR 5 SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
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 THA I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED LOS ANGELES COUNTY AND STATE OF GAS TEST i
CALIFORNIA OR THAT I HE LEGAL OWNER A INTEND TO
RESIDE IN THE ABOVE DE C BED RESIDENTIAL P UTILITY CO NOTIFIED
SIGNATU RE
OF PERMITTEE f FINAL
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M 0 CASH
'3 2C--jUL 7 5 a 7.5 0 ,�Z
17 26 5 -45 APPLICATION FOR PERMIT
EPA TIVIENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES �� �' � '
Wm J FOX. CHIEF ENGINEER
`1, NATURE OF INSTALLATION DISTRICT NO GROUP ZONE PERMIT NO
i /�
ROUEN FIXTURES H
COMPLETE _5 � � J � CJ 7HEATER CESSPOOLSEPTIC TANKEIV B READY FOR /� 6
DATE SSUED
_ FIRST INSPECTION d - /
GAS MISCELLANEOUS �"'�s
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY 9,1
JOB n, V
C NAME ADDRESS
W �
m ADDRESS LOCALITY
f
D NEAREST
A
CITY TEL NO CROSS ST
COUNTY �� !
CERT No EXPIRES m NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL2 MAIL
f-
�j
3 ADDRES ✓ '� rot
NORTH
CITY
1AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
PLUMBER
I AM THE LEGAL OwUE 16F THE PROPERTY DESCRIOQLD
ABOVE
OWNER
CORRECTIONS
h 2 3
SOUTH _ d
DESCRIPTION OF WORK r y 9
ATH TUB FURNACE a
HOWER DISHWASHER C
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK RAND TRAP '
I
LOP SINK FLOOR DRAIN
kTOTALFEE
ASH TRAY URINAL APPROVALS
ATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME
ATER HEATER DENTAL LAVATORY ROUGH PLUMBING I I
ETER GAS aODA FOUNTAIN GAS PIPING I �1
OUTL
GAS VENT
TAL NUMBER OF FIXTURES 2
.6'd CESSPOOL
SEPTIC TANK
SSPOOL SEPTIC TANK SEWER
3 UTILITY CO NOTIFIED
2,7-7m
.` ®�
PINAL
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0201230008
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE- (626) 285-0488 EXT:
BUILDINGFEES PAID
ON FILE 9121 BLACKLEY ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803015
ASSESSORNEAREST CROSS STREET: ENCINITA
5388-011-032 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H5 LOCALITY: TEMPLE CITY
07 BATHTUBS/SHOWERS 2 00 FIX 32.40
TENANT: 11 CLOTHESWASHER(S) 1 00 FIX 16.20 ISSUED 0 PROCESSED A P .
21 HOSE BIBB(S) 1.00 FIX 16.20 01/23/02 JK 07/22/02
25 LAVATORIES/SINKS 2.00 FIX 32.40
OWNER: TEL NO: 45 WATER CLOSET/URINAL 2.00 FIX 32.40 FI AL DATE FINAL BY: CODE:
LAU; STANLEY (626) 309-1162- 47 WATER HEATER(S) 1.00 NTH 16.20 -2-
9121
9121 BLACKLEY ST 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 "
TEMP 917803015 - TOTAL FEES 189 75 DESCRIPTION WORK
PLUMBING FOR ADDITION
APPLICANT: TEL. NO
SAME AS OWNER
Y SPECIAL CONDITIONS:
CONTRACTOR: EL. NO f- APPROVALS DATE NSPECTOR SIGNATURE
SAME AS OWNER - i"^ � '� _ '
LIC. NO �`a - `' SLAB WORK
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECTE - L. NO:
ROUGH PLUMBING
LIC. NOJ
i GAS PIPING
GAS VENT
LHOT VATER H
PT_V, 1 PLUMBING FIXTURES
SPRINKLERS
r '1 iGAS
TEST
UTILITY COMPANY OTIFIED
CWV
GRAY WATER SYSTEM
REPORT_ ID: DPR263 ROUTE T0: BS0508, f