HomeMy Public PortalAbout10651 FREER ST_Plumbing__` 76A667-CE817-8-58
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, County., Engineer ADDRESS D (c - r c t"t"
CASSATT D. GRIFFIN, Sup t of Building T << `
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. tx
NUMBER FIXTURE OR ITEM
OWNER cn, rt '
WATER CLOSET MAILi
BATH TUB ADDRESS /(}(f rc e r
SHOWER CITY '��yr� �` TEL. NO. G I --4 -3),
Z�
LAVATORY CONTRACTOR w
SINK ADDRESS
DISHWASHER CITY TEL. NO.
CONTRACTOR'S STATE El
LAUNDRY TUB REGISTRATION NO. NTY ❑
CLOTHES WASHER DISTR�T NO. GROUP ON PR CE ED BY
WATER HEATER t{q�Q
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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APPROVALS
T] @ $1.00 PER ITEM '/
OR FIXTURE $ L� DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2100 ROUGH PLUMBING Z J b-j"7 'Y'
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE FINAL
OF PERMITTEE
q 00-0—
ROBERT A.WOOD.
®F VALIDATION UPERVISING MECHANICAL ENG'R
6.00
�fe �
o... 11 25M SET. I.-a3 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY �����'��
' � COUNTY OF LOS ANGELES
Wm. J. FOX. CHIEF ENGINEER
NATURE OF INSTALLATION DISTRICT NO. GROUP ZONE PERMIT NO.
ROUGH FIXTURES COMPLETE _
HEATER CESSPOOL 11
SEPTIC TANK RECEIVED BY READY FOR DATE ISSUED
_ FIRST INSPECTION
GAS- MISCELLANEOUS
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
x NAME ADDRESS
W
D ADDRESS LOCALITY
g
7
NEAREST
'J CITY TEL.No. CROSS ST.
IL
COUNTY
CERT.NO. EXPIRES K NAME
W
LOCATION OF SEPTIC TANK, OR CESSPOOL z MAIL
3 ADDRESS
NORTH O
CITY TEL.No.
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
i PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
fII�11 ABOVE.
W D
3 OWNER
CORRECTIONS
II
SOUTH
J
DESCRIPTION OF WORK a
_z
BATH TUB FURNACE 5
Q'
SHOWER DISHWASHER Q
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
' FLOOR SINK SAND TRAP
SLOP SINK FLOOR DRAIN
r WASH TRAY URINAL
� APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME
/ WATER HEATER DENTAL LAVATORY ROUGH PLUMBING
METER GAS AODA FOUNTAIN GAS PIPING
OUTL
GAS VENT
�. CESSPOOL I i
TOTAL NUMBER OF FIXTURES SEPTIC TANK
CESSPOOI SEPTIC TANK SEWER I '
s
UTILITY CO.NOTIFIED
TOTAL FEE
FINAL
J
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0901060018
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE- (626) 285-0488 EXT
LEGAL ID: . I FEES PAID I BUILDING ADDRESS:'
IBK: 23 PG: 57 PC: 2 1 I 10651 FREER ST I
I IFEE DESCRIPTION. QUANTITY: DOM. AMOUNT. 1- TEMP CA 917803428 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
18585-031-032 - 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE 597 GRID: C4 LOCALITY: TEMPLE CITY, Cl
1 147 WATER HEATER(S) 1.00 WTH 16 20 I I
(TENANT: I TOTAL FEES 43.95 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1
101/06/09 SR 07/05/09
1OWNER: TEL NO: 1 (FINAL DAJE FIN Y: CODE:
ILOPEZ MABINI S;DULCE M - _ i s
110651 FREER ST I I —� Z-�I. 1
(TEMP 917803428 1D SCRIPTS N OF WORK I
_ - (REMOVE/REPLACE GAS WATER HEATER I
I I I
(APPLICANT: TEL. NO:
(HOME DEPOT (800) 454-8955- i
112601 132 ND. AVE NE I (SPECIAL CONDITIONS: 1
IKIRKLAND, WA 98034 I 1 1
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE I
(HOME DEPOT (800) 454-8995- 1 1 1
112601 132ND AVE NE LIC. NO 1UNDER SLAB WORK I I I
1KIRKLAND WA 98034 602331 I 1 I I
I (WATER SERVICE
1 1 IPLASTIC YIN METAL YIN I I I
(ARCHITECT OR ENGINEER: TEL. NO: I i I I I
i I IROUGH PLUMBING 1
LIC. NO: I I II I I
1 I IGAS PIPING
I I I
I I IGAS VENT I I I
IHOT WATER HEATER I I I
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1 I (PLUMBING FIXTURES 11 1 1
I I I I I I
1 ILAWN-SPRINKLERS I 1 I
I I I I I I
I 1 IGAS TEST I I I
I 1 1 1
1 I (UTILITY COMPANY NOTIFIEDI I I
I 1 11 1
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(GRAY WATER SYSTEM
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1 (REPORT ID: DPR263 ROUTE TO. BS0508
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