HomeMy Public PortalAbout5323 ENCINITA AVE_Plumbing__ CE 817(REV 6/76)` j -
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET LOCALITY
d
NEAREST
BATHTUB CROSS ST
SHOWER OWNER
LAVATORY MAIL
ADDRESS
1 133 Louise Ave-
SINK CITY TEL NO
DISHWASHER CONTRACTOR Owen Bros.. Plumbing,Inc.,'
CLOTHES WASHER _ ADDRESS
4265 N. Baldwin Ave.
SWIMMING POOL RECEPTOR
CITY - El Monte TEL NO 443-0078
LAWN SPRINKLER SYSTEM JATE LIC
WATER HEATER LICENSE NO 231 741 CLASS C36-20
GAS SYSTEM OUTLETS /� APPROVALS DATE PEc s sw ATURE
OUTLETS OVER (/ UNDERSLA WO'--' —
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING PRA
0
GAS VENT
HOT WATER HEATER0
7 7 l
PLUMBING FIXTURES —41q-4 �
GAS TEST j6 Zj:1.
Plan Check fee UTILITY CO NOTIFIED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL
Plan check applicant
PLAN CHECK VALIDATION n
Name
ox
0• (y1
Na -a y�� �
Address
CityTel No 8 2LL
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS,AP PLICATION AND STATE - G 1.A ,
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES `
AND STATE LAWS REGULATING PLUMBING - PERMIT VALIDATION
#'o O O O O 5
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE .. L r� O - 5200
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL " • _
PROPERTY 1 - 52,003
G.p q
SIGNATURE 1 Z, 1 7-7 9
OF PERMITTEE
DISTRICT�10� � PR ESSED�� f
INDUSTRIAL
WASTE APPROVAL
COUNTY OF^LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT `
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS - PL 0508 0801080002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
(LEGAL ID I FEES PAID - BUILDING ADDRESS _ -
IBK 43 PG 93 PC 2 I 1 5323 ENCINITA AV 1
I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803115 I
(ASSESSOR INFORMATION NUMBER- i I II NEAREST CROSS STREET- I
15388-008-030 101 PERMIT ISSUANCE FEE 27 75 I THOMAS PAGE 596 ,GRID J4 LOCALITY" TEMPLE CITY, Cl
1 107 BATHTUBS/SHOWERS 1 00 FIX 16 20 I I
ITENANT 125 LAVATORIES/SINKS 2 00 FIX 32 40 (ISSUED ON PROCESSED BY PLAN BY ,- EXPIRES ON: I
1 145 WATER CLOSET/URINAL 1 00 FIX 16 20 101/08/08 SR 07/06/08 1
1 1 TOTAL FEES 92"55 1 1
(OWNER TEL NO I IFINAL DAT`E� FINA Y. CODE. I
ISWANSON RICHARD M,SUSAN J (626) 202-6127- 1 1 1
15323 ENCINITA AV I I 1
ITEMP 917803115 I ID SCRIPTION OF WORK I
IPLUMBING FOR BATHROOM REMODEL I
(APPLICANT TEL NO - I
ISAME AS OWNER
I ISPECIAL CONDITIONS
I I I I
I I I I
I I I I
ICONTRACTOR TEL NO 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
ISAME AS OWNER - 1 I 1
LIC. NO 1 (UNDER SLAB WORK I 1
I I I I I I
1 I IWATER SERVICE I I
1 I ]PLASTIC YIN METAL YIN 1 1 1
]ARCHITECT OR ENGINEER TEL NO.
1 1 ]ROUGH PLUMBING 1
I - LIC NO
' IGAS PIPING I I r
I I I I I I
1 1 IGAS VENT I I I
I I I
1 1 IHOT WATER HEATER 1 I I
I I I I I I
I I 1PLUMBING FIXTURES I I I
I I I I I I
1 1 ]LAWN SPRINKLERS 1 1 1
IGAS TEST I I I
I 1 1 1
1 I ]UTILITY COMPANY NOTIFIEDI I I
I I 1 11 1
I 1CWV I I I
C1 11
1 1 IGRAY WATER SYSTEM I I 1
1 0, 1 1
Ad
I I I I I I
I I I I I I
I I I I I I
I I I I I I
1 IREPORT ID DPR263 ROUTE TO. BS0508 I I 1 1
I I I I I I