HomeMy Public PortalAbout4816 CAMELLIA AVE_Plumbing__ 13
76A667 (CE-817)-8-71 T /��-� �f
APPLICATIOI4FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDESSING ?/, f G/g,
ADDR �j
LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST /d
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CROSS ST. ULo E� ZUS
NUMBER FIXTURE OR ITEM @ FEE P /G
OWNER _
WATER CLOSET 1.75
MAIL
BATH TUB 1 .75 ADDRESS
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SHOWER 1 .75 CITY /C�ff���, L!/T TEL. NO.GIjs=
LAVATORY 1.75 CONTRACTOR
SINK 1.75 ADDRESS /D f
DISHWASHER 1.75 CITY TEL. NO.
Elul G E Ci `/�/ -70 f70
CLOTHES WASHER 1'75 STATELIC
LICENSE NO. ���`� CLASS (O / •�J
SWIMMING POOL RECEPTOR 1.75
DISTRICT NU. GRO P ZONE PR ES BY
LAWN SPRINKLER SYSTEM 1.75 c O A�
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WATER HEATER 1.75 NDUSTRIAL
WASTE APPROVAL IL
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GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD
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OUTLETS OVER
5 PER SYSTEM - .30 Z
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Plan check fee See reverse.
PLUMBING PERMIT ISSUING FEE S 3 00
TOTAL FEE 'S
APPROVALS DATE INS PECTO R'B SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT
HEREBY ACKNOWLEDGETHAT HAVE PEND THIS APPLICATION HOT WATER HEATER
AND STATE THAT THEEABOVE IS CORRECT AND AGREETO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLV MBINc. GAS TEST
I HEREBY CERTIFY THAT I NMPROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOSANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF: AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED REy/SI•DENTIAL OPERTY. FINAL
SIGNATURE �A /� .'
OF PERMITTEE
PERMIT VALIDATION cB. M.o. CASH
PLAN CHECK VALIDATION CR.. M.D. CASH
LAll,ju0 ^°? N ,�uL31 5 D 4.75
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 - PLUMBING_ PERMIT- '
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9809160023
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGA ID: - FEES PAID BUILDING ADDRESS:
TR: 14467 LT: 54 481'6-CAMEL'L'IA AV�3
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ". TEMP-CA-917804240
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LOWER AZUSA
8589-016-004 ,01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY
47 WATER HEATER(S) 1.00 WTH 16.20
TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
09/16/98 UT 09/16/99
OWNER: TEL. N0: FINW DA
EI6 L 8Y: CODE:
POLO 4814 CAMELLIA AV ANITA TR ANITA POLO TRUST - (u p i
TEMP 917804240 DESCRIPTI 1 OF WORK
MOVE WATER HEATER TO AGE FROM INSIDE HOUSE
APPLICANT: TEL. N :
BASHFORD ENTERPRISES (626) 443-4833-
12155 PINEVILLE ST. I SPECIAL C NDITIONS:
EL MONTE
P�IGELES CO
CONTRACTOR: TEL. NO: �5 U�T APPROVALS DATE INSPECTOR SIGNATURE
BASHFORD ENTERPRISES (818) 443-4833- V y
12155 PINEVILLE ST LIC. NO UNDER. SLAB WORK
EL MONTE, CA 91732 3191128
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TEL. N0:
ROUGH PLUMBING
LIC. N0: f1 +(n1I C� /�1 (] �111�1/1�11 G S PIPING
lPUQLLC VJ V OU KS GAS 1rE�
SCS HOT WATER HEATER
PLUMBING FIXTURES
B
LAWN SP INKLERS
D !:
GAS TEST
UTILITY C014PANY NOTIFIED
CWV
Service Tha
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508