HomeMy Public PortalAbout9532 BLACKLEY ST_Plumbing__ 78°1 f1' APPLICATION FOR PLUMBING PERMIT
DBs•`I�'DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS 7
CASSATT D. GRIFFIN, SUP'T OF BUILDING �"•
LOCALITY /
FOR APPLICW TO FILL IN NEAREST
CROSS ST
OWNER DISTRICT N GROUPMAIL I Z ,I "DY FOR INSPECTION
ADDRESS 1
v
INDUSTRIAL - -
CITY TEL. WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS �- I
CITY //d F TE L. NO
LICENSE NO. G4�_ ?_
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1 00 O
BATH TUB- @ $1.00
SHOWER @ $1.00
-LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ $1 00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1 00
CLOTHES WASHER @ $1 00
WATER HEATER @ $100
GAS SYSTEM @ $100
APPROVALS
• DATE INSPECTORS SIGNATURE
UNDER SLAB WORK
PROUGH PLUMBING
PERMIT $ 1 00
GAS PIPING
TOTAL FEE 14 00
GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE'ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER 1
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
CALIFORNIA OR THAT I AM THE L GAL O�F-THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL ERTY
SIGNATURE
OF PERMITTEE FINAL
JOHN A. LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR
A5
,'C0 5 07 5n APR 13 3 6.0 0
i
• - COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1208270011
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE x(626) 285-0488 •EXT -
ILEGAL ID 1 FEES PAID I BUILDING ADDRESS I
ITR 14572 LT 63 1 9532 BLACKLEY ST
I IFEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917803142
(ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET
18590-007-028 ,101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY CAI
1 113 DISHWASHER(S) 1.00 FIX 16 20 I
ITENANT _ 125 LAVATORIES/SINKS +1 00 FIX 16.20 (ISSUED ON PROCESSED BY PLAN BY I
151 LOW PRS GAS 5 OUTLET 1.00 SYS 16 20 108/27/12 SR I
TOTAL,FEES 76 40 1
(OWNER TEL NO. I (FINAL DATE 7ALBY CODE 1
IDYNES DENNIS, H,YVONNE M (626) 286-2811- 1
19532 BLACKLEY ST V
ITEMP 917803142 1 IDESCRIPTION OF WORD I
INEW DISHWASHER, SINK, AND GAS PIPING FOR KITCHEN REMODEL I
I 1
1APPLICANT TEL NO I I
IKITCHEN MEDIC (909) 578-6745-
1672 16TH STREET I SPECIAL CONDITIONS
(UPLAND, CA
ICONTRACTOR TEL NO
APPROVALS DATE INSPECTOR SIGNATURE
IKITCHEN MEDIC (909) 578-6745- I 1
1672 16TH STREET LIC NO 1UNDER SLAB WORK
UPLAND, CA 826849 1I I I
1 IWATER SERVICE I I I
IPLASTIC YIN METAL YIN 1
1ARCHITECT OR ENGINEER TEL NO I I I I I
IROUGH PLUMBING ply
LIC NO IGAS PIPING
I I I• �
GAS VENT 1
1 + I IHOT WATER HEATER - I
IPLUMBING FIXTURES I
I - I
ILAWN SPRINKLERS I I
IGAS TEST I
(UTILITY COMPANY NOTIFIEDI I I
IcwV I
• i IGRAY WATER SYSTEM I
1 I I I I I
I I I I I I
I I I I
IREPORT ID DPR263 ROUTE TO BS0508
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