HomeMy Public PortalAbout4936 FIESTA AVE_Plumbing__ DO 8,17 25M BETS 11-46 APPLICATION FOR PERMIT
VAPARTMENT OF BUILDING AND SA TY
COUNTY OF LOS ANGELES PLUMBING
,? WM J FOX CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT NO GROUP ZONE PERMIT N
ROUGH FIXTURES COMPLETE I s;— q V&
HEATER CESSPOOL SEPTIC TANK RECEIVED BY READY FOR ISSUEDI
FIRST INSPECTION —DATE
AS MISCELLANEOUS
APPLIC NT FILL IN HEAVILY OUTLINED PORN2N qNLY '/ D
NAME JOB
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ADDR S_�'/ LOCALITY
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CERT No EXPIRE A m NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL
NORTH O ADDRESS
CITY TEL No
I AM THE LEGAL PO F T E ROVE LOS
ANGELES COUNTY CERTIFI E QUAL! TION
PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
3 OWNER
CORRECTIONS
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SOUTH (4l 1, r �� J
DESCRIPTION OF WORK a
z_
BATH TUB FURNACE 0
ROWER DISHWASHER
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
SLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
/ WATER CLOSET DRINKING FOUNTAIN
DATE / INSPECTOR 8 NAME
WATER HEATER DENTALLAVATORY ROUGH PLUMBING I /����/ �I i5v a4 f
METEI�CiAB SODA FOUNTAIN
OUTL GAS PIPING
CTAS VENT I I
CESSPOOL I
TOTAL NUMBER OF FIXTURES SEPTIC TANK
CESSPOOl9—SEPTIC TANK SEWER
UTILITY CO NOTIFIED
TOTAL FEE
FINAL U
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APPLICATION FOR PLUMBING PERMIT {�
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BUILDING ND SAFETY DIV( N
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS v-e—
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST
ROWER 3 f OWNER
LAVATORY ✓ , MAIL 19f-3-4
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ADDRESS
SINK CITY TEL NqW
DISHWASHER CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR
AWN SPRINKLER SYSTEM CITY e�a&',V , TEL NO �!7✓[�3/J
STATE LIC _
WATER HEATER LICENSE NO CLASS �3 r
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DISTRICT NO GROUP ZONE ESSED BY
GAS SYSTEM OUTLETSIZ f
OUTLETS OVER
5 PER SYSTEM CD
INDUSTRIAL V
WASTE APPROVAL
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INSPECTION RECORD t�
Z
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE 5D
Plan check applicant
Name APPROVALS DATE INSPECTOR S SIGNATURE
UNDER kt3n WORK S'-Z 27 /
Address ROUGH PLUMBING e-27-27 e52��
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 1 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 RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATU RE
OF PERMITTEE FINAL S
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION M O CASH
9 T3 i'_APR 26 S O 1 6.5 0 ®ts
X
76A667A ICES 17B1 11/76
APPLICATION FOR PLUMBING PERMIT iiibbb
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS J`
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST
SHOWER OWNER �y
MAIL
LAVATORY ADDRESS
SINK CITY TEL NO
DISHWASHER CONTRACTOR ��
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR t +
CITY TEL NO
LAWN SPRINKLER SYSTEM STATE LIC /
WATER HEATER LICENSE NO CLASS
GAS SYSTEM OUTLETS
NO� GROUP N R SED BY
OUTLETS OVER
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL V
INSPECTION RECORD at
u�u
1�
N
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check applicant
APPROVALS DATE INSPECTOR S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel No GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST
LEGAL OWNER OF AND INTEND T RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY UTILITYCO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M 0 CASH
3K2 4 JA jr-9 7 5 0 ®�:-i
Os
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1303040028
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
ILEGAL ID FEES PAID BUILDING ADDRESS I
ITR 14647 LT 13 4936 FIESTA AV
I IFEE DESCRIPTION QUANTITY UOM AMOUNT I TEMP CA 917803816 1
(ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET
18590 018 004 101 PERMIT ISSUANCE FEE 27 80 I THOMAS PAGE 597 GRID A5 LOCALITY TEMPLE CITY Cl
107 BATHTUBS/SHOWERS 1 00 FIX 16 20 I
ITENANT 117 FLOOR DRAIN(S) 1 00 FIX 16 20 (ISSUED ON PROCESSED BY PLAN BY
1 125 LAVATORIES/SINKS 1 00 FIX 16 20 103/04/13 SR 1
I 145 WATER CLOSET/URINAL 1 00 FIX 16 20 1 I
(OWNER TEL NO I TOTAL FEES 92 60 IFI AL DATE FINAL CODE 1
IRODRIGUEZ MARIA (626) 614 5827 1 !f[
14936 FIESTA AV I I I
TEMP 917803816 I 109SCIZIPTION OF WORK
I 1SHOWER WATER CLOSET FLOOR DRAIN AND LAVATORIE
(APPLICANT TEL NO
IMIKOLASKO DANIEL R (626) 338 0055 1 1 I
15118 CALMVIEW AVE I ISPECIAL CONDITIONS 1
1BALDWIN PARK 91706 I I
ICONTRACTOR TEL NO 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
(DAN MIKOLASKO CONSTRUCTION INC (626) 338 0055 1 1-
15048 CALMVIEW AVE LIC NO I 1UNDER SLAB WORK
1BALDWIN PARK CA 91706 855601 I 1-
WATER
_WATER SERVICE I I
1 I 1PLASTIC YIN METAL YIN I 1
1ARCHITECT OR ENGINEER TEL NO I I I I I
IROUGH PLUMBING
LIC NO I
1 1 IGAS PIPING
1 i 1GAS TENT
I I I
1 I IHOT WATER HEATER I 1 -
I I I
1 IPLUMBING FIXTURES 1
I I I
1 1 ILAWN SPRINKLERS I 1
1 I IGAS TEST
I I I
I 1UTILITY COMPANY NOTIFIEDI I I
1 ICWV I I
1 i 1 IGRAY WATER SYSTEM I I 1
I I I
I I I I
I I I I I I
1 I I I I I
1 1 I I I I
1 1* ADDITIONAL DATA ON FILE
I I I
I I I I I I
1 (REPORT ID DPR263 ROUTE TO BS0508 I 1