HomeMy Public PortalAbout9331 DAINES DR_Plumbing__ 76A667 -CE#817 12-64 B 8646
City of Temple City
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 9331 ,bainnes Dr.
COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY Temple Cit
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. Rosemead
NUMBER FIXTURE OR ITEM EACH FEE
OWNER E. C o tan in
WATER CLOSET $1.25 MAIL
BATH TUB 1.25 ADDRESS Same
SHOWER 1.25 CITY TEL. NO.
LAVATORY 1.25 CONTRACTOR General Installation Co.
SINK 1.25 ADDRESS 6558 West Blvd.
DISHWASHER 1.25 CITY Los Angeles TEL. NO. PL 3-2541
CONTRACTOR'S C-36 151839 787cO
LAUNDRY TUB 1.25 REGISTRATION NO. STATE
CLOTHES WASHER 1.25 DISTORIgT GR P NE PROC SSED BY
WATER HEATER 1.50 /
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL 97
WASTE APPROVAL @y
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD
1
Softener 1 SO Ready for Inspection Now
a
Lu
r�
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE 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 THAT I AM PROPERLY REGISTERED AND/OR - PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RES7A�ROPE Y. UTILITY CO. NOTIFIED
SIGNATURE CJS
OF PERMITTEE FINAL ''AA
VALIDATION ROBE T A. WOO
CK.
M.0. CASH SUPERVISING MECHANICAL ENG'R
LfL� 4 9 3 5:�-00 S�EP23 5 D 3.50
J
T PLUMBING I
i., (DEPARTMENT OF COUNTY ENGINEER
-DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FDX, COUNTY ENGINEER
ADDRESS �.
FOR APPLI NT TO FILL INn LOCALITY
BUILDING y K/ NEAREST ST. (..�
ADDRESS d VVV
Com- DIST N0. GROUP ZON® 243 NO.
LOCALITY p� �• `��
NEAREST ��� a� � �1+.�.
CROSS ST. RECEIV B. Ready for Inspection DAT ISSUED
OWNER �! , -
MAIL INDUSTRIA`
ADDRESS WASTE APPROVAL
CITY TEL.
INSPECTION RECORD
N�OI_,J,�`
PLUMBER
ADDRESS 7e 7dCITYg" 4/ TEL.N0. _A1e*
0 STATE
LICENSE NO. RLCOUNTY
. PERM{IT FEES a
. z
`JUMPER TYPE OF FIXTURE OR ITEM FEE Ur
WATER CLOSET(TOILET) @ 0.80 $
BATH TUB @ 0.80 4 &F O
SHOWER @ 0.80
LAVATORY(WASH BASIN) @ 0-80
KITCHEN SINK @ 0.80
LAUNDRY TUB OR TRAY @ 0.80
SLOP SINK @ 0.80
FLOOR SINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80 ��gg
GAS SYSTEM:--�-_OUTLETS @ 1.00 X40
WATER HEATER @ 1.00 Qiy
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK _
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE �J>�® GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AMD/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST / ��,� ✓ �ib�
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN.
ER OF THE ABOVE DESC ED RES UE IAL PRGPERTY. UTILITY CO.NOTIFIED
SIGNATURE w / 1
OF PERMITTEE---------------
- - - FINAL d v
nrmvm
/\ 76A667 DBS 17 1/53
C 121REV.6/78) �'���Sq}•�'";-'� �/���
COUNTY OF LOS ANGELES BUILDING AN®'SAFETY .
OR APPLICANT TO FILL IN(PRINT OR TYPE) _ BUILDING 3 3ADDRESS / ,� /_
NUMBER FIXTURE OR ITEM @ ' FEE �3�$
LOCALITY
WATER CLOSET'
NEAREST �J
BATHTUB CROSS ST. i to to.
SHOWER -'OWNER
LAVATORY MAIL'
'ADDRESS
SINK CITY TEL.NO.
DISHWASHER CONTRACTO
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR /
CITY TEL.NO. 4l-7—AnoQ"
LAWN SPRINKLER SYSTEM
STATE LIC.
wAi E R 1 1 EI-0 ER/r� LICENSE NO CLASS
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING'
GAS PIPING
GAS VENT
L;
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST a
Plan Check fee UTILITY CO.NOTIFIED
PLUMBING PERMIT ISSUING FEE$ jJ`"� P
TOTAL FEE FINAL
Plan checkapplicont PLAN CHECK-VALIDATION '
U
Name ,
�O Q
Address
r
City Tel.No.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
r REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE -97 O. 1 FI
LEGAL OWNER'OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY.
D D O 0 0y
_y SIGNATURE
OF PERMITT 2 n C 1 6 0 0
DISTRICT NO. PRO &SED BY
INDUSTRIAL
WASTE APPROVAL