HomeMy Public PortalAbout5136 DOREEN AVE_Plumbing__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0010300022
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL FEES PAID BUILDING ADDRESS:
TR: 11290 LT: 5 BL: D UN: .002 5136 DOREEN AV
- FEE DESCRIPTION: QUANTITY: LOM: AMOUNT: TEMP CA 917803438
ASSESSOR INFORMATION NUMB R: NEAREST CROSS STREET: KEY WEST
8585-022-026 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY
47 WATER HEATER(S) 1.00 WTH 16.20
TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN B XPIR 5 ON:
10/30/00 UT 04/29/01
OWNER: TEL. NO: FINAL DATE F BY: CODE:
BOLINGER BEVERLY J TRUSTEE (626) 444-5851-
5136 DOREEN AV -�•W
TEMP 917803438 D�CRIP IO F WORK
WATER HEATER CHANGE OUT
APPLICANT: . NO:
ACTION CONTRACTORS (310) 515-1311-
17111 S. BROADWAY SPECIAL CONDITIONS:
GARDENA, CA
PNGELES CO
CONTRACTOR: TEL. NO: �S ���, APPROVALS DATE INSPECTOR SIGNATURE
ACTION CONTACTORS, INC. (310) 515-1311-
17111 BROADWAY LIC. NO UNDER SLAB WORK
GARDENA, CA 90248 HIC
/ WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TE :
ROUGH PLUMBING
LIC. N0: / 111111
L GAS PIPING
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PLUMBING FIXTURES
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A ❑ ®-� ®5 UTILITY COMPANY-NOTTIFIED
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Ser ice
GRAY WATER SYSTEM
* ADDITIONAL DATA ON FILE
REPORT ID: DPR263 ROUTE TO: BS0508
76A667.CE08I7 4-67 I (/ / ///'•(� 1
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APPLICATION FOR PLUMBING PERMIif u
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
_ JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS J !D
COLEMAN W. JEN KINS. SUPT. of BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. L
NUMBER FIXTURE OR ITEM EACH . FEE
OWNER
WATER CLOSET 9h35 QD MAIL
I BATH TUB }pg Q ADDRESS
CITY TEL. NO.
I SHOWER I �Q m
3 CONTRACTOR
LAVATORY .M5
SINK A-25 O ADDRESS
DISHWASHER 1.25 CITY /'nVSATE �I ?� �-T E� TEL. NO.�/ 3-U Idp
O
LIC
LAUNDRY TUB 1.25 LICENSE NO. O'�� I -' I / I CLASS C - 31g
CLOTHES WASHER -Los- _ D4ISTRIC�T'IN,O{�// GR P ZONE PRO C Ex BY
WATER HEATER 1.50 5"O �/ ♦ (/ `I /
T
GAS SYSTEM 5OUTLETS 1.50 5o INDUSTRIALCD
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .70 INSPECTION RECORDCD
Qa
Delo c = 6 70-7
1 S k 4
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W = L
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APP OVALS DATE INSPECTORS SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING p✓/ �Y
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 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 i
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF.AND INTEND TO
RESIDE IN,THE AB E DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL C
ALI0. JACK R. ALLEN
M. ,
M.D, CASH SUPERVISING MECHANICAL ENG-R.
35682 W13 5 D 1 9.7 5 a
16N661C ICE-811BI -9/15 el —7—,cL
APPLICATION FOR LUMBING PERMIT
BUILDING AND SAFETY DIVISION /
FOR APPLICANT TO FILL IN (PRINT DR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS ! J I
WATER CLOSET LOCALITY r�
BATH TUB NEAREST �n
CROSS ST. IC_ Ajd
SHOWER OWNER d` I �� e.
LAVATORY MAIL
ADDRESS
SINK CITY TEL. NO. -
DISHWASHER CONTRACTQACIFIC INSTALLERS
CLOTHES WASHER ADDRESS 10920 E. GRAND
SWIMMING POOL RECEPTOR
CITY TE T
LAWN SPRINKLER SYSTEM
STATE ^ ] 416
WATER HEATER LICENSE NO. rte[-/ CL o
DISTRICT NO. GROUP NE PR CESS BV U
GAS SYSTEM OUTLETS i Nr
OUTLETS OVER o -/
5 PER SYSTEM INDUSTRIAL w
WASTE APPROVAL
INSPECTION RECORD ?
Plan check fee
PLUMBING PERMIT ISSUING FEE $ _fin
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIONATURi
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 THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REOU I RED 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 DESC81BHED R I-DENNT/III*1- PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK,'�.. M.O. CASH
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