HomeMy Public PortalAbout8853 GARIBALDI AVE_Plumbing__ 76A 6A ytv817--2-66
APPLICATION FOR PLUMBI G PR
CQUNTY OF LOS ANGELEO
DE,Pr,ARTMENT OF COUNTY ENGINEER
GUILDING AND SAFE'T`Y DIV181bN IMMING o
JOHN A. LAMME, COUNTY ENGINEER ADDLEN 853 0
COLEMAN W. JENKINS. BuF•7. of BUILbING LOCALITY
POR APPLICANT TQ FILL IN
CROM/T.
NUMbRR fl RE OR fT[M 4LACH FEE
O WRn
' WAN'$ CLOSET
'_ IATH TUB O AD1II1}J/
F— SHOWER. Im I ISO Cm TEL NO.
LAVATORY I= b coxTriACTOR �
sm AaaREss �S
DtaHWA Im cm 77 h} TEL NO. 3firATE -r�0 N�
LAUXI)RT M Im LLICENSE NO. )-J j - 7 CLA$3 C'�ap
CLOTMW WAAEatH b19TRICT NO. G Pot
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WATER HEATER 1.50
GAS STM-EM SOUTLETs 130 � MUSTRIAL WAXTE OVAL
OUTLET/ OVER 5 PER RTUrEU .70 nean=bk RECO 8
0
00Z
APPROVALQ DATE IH CrOR'9 SIGPIATURK
PERMrr f 2 00 UNDER SLAB WORK -gyp
ROUGH PLUMBING
TOTAL REEjz GAS PIPING
I Hclor ACIQNOWL[DQX THAT I HAVS R9AD 14+19 APPLICATION GAS VENT
AND J•TATI< THAT [THR ABOY79 coRJMC-f AND AGS TO COMPLY
WITH ALL COUNTY ORDIMAHQ9 AND /TATS LAW@ RKSULATINO HOT WATER HEATER
rLUM91NG.
I HE64Y CCRYIFY THAT I AM rROr9RLY NQ019r[RSD AND/OR PLUMBING FIXTURES
LICINSZD Al REQUIRm 9Y LO/ A)4CMLC9 COUNTY AND 9TAT9 OF GAS TEST
CALIFORNIA bR THAT 1 AN TRZ L;&AL dVfNSR OF,ANO INTEND TO
Ri91DN[ IN, qm RIKAIDONTIAL rROR9RTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PER
TIMAL
VALIDATION JACK R. ALLEN
c M.o. CA914 SUPERVISING MECHANICAL ENG'R.
X02 5-4 34 JM1.0 5 D 1 8.2 °5^'
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"APPLICATION FOR PLUMBING PERMIT
BVI �Nb swrferr D N
FOR A P PIKANT TO FILL IN 1 PRINT OR TYPO BU I LDI N G
NUMBER HXTURE OR ITEM FEE ADDRESS
WATER CLOSET 1,OC rTY r
NEAREST
BATH TUB CROSS ST.
SHOWER OWNER
LAVATORY MAI L
ADDRESS
SINK CITY TEL NO.
DISHWASHER ��
QOTHES WASHER
> ADDRESS
SWIMMJN6 POOL RECEPTOR
CITY TEL NO.
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER LICENSE NO. .�- CLASS
GAS SYSTEM OUTLETS DISTRICT NO. GROUP E
p��TS pyg� D�i
5 P82 SYSTEM W�E S
WAL 0
INS PECTIOiA of
O
Plan check fee
PLUMBING PERMIT ISSUING FEE S
TpTAI FEE
PI Nan check app
APMVALS DATE- INSPECTOR-113M"TURE
Name
UNDER SLAB WORJK
Addrm ROUGH PLUMBING
CBy Tel.No. GAS PIPING
r IK
HEREBY ACKNOWLEDGE THAT I HAVE READ THISALNCATHGN AMD STATE OW VENT
THAT THE ADOVE IS COIIRECT AND AGR"TO COMPLY WMi ALL COUNTY Of#DINANCES
AND SYAT£LAWS REGULATING PLUMBING. HOT WATER HEAT ER
I HOIEBY CEHPROPERLYY THAT I AM PROPERLY REGLSTCIIRD AND/OR LW-VMED AS PLUMBING F07QRES
FMQUI MD BY LOS ANGELES COUNTY AND STATE OR CJU PORNIA OR THAT I AM-TI-M. W TEST 7
LEGAL OWNER OF,AND DrrE11D TO RESIDE DI THE ADOVE DE$00HI D RESIDENnAL
"wwt TY. Un PTY CO.NOTIFIED
8 b NATU RL49r—
OF PER �R- FINAL
PLAN GH I M o. cws+N PERMIT VALIDATION
.,:ICY HOLDER: z3,- 1 3 LE>�V 17 5 6 1G.5 0 ,&%
P=OLICY NUMBER. IV 3 6 t57 _
I 6p va=>
I
f
COLAM OF LOQ ANGELES TEMPLE CITY # 0508 I PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0106200017
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-04x8 EXT:
LEGAL ID: FEEMID BUILDIh
BK: 9 PG: 95 PC: 2 8853 GARIBALDI AVASSESSOR INFOWTION NUMBER: L
FEE DESCRIPTION: QUANTITY: UOM: AN�N"T: TEMP CA 917801516
NEAREST CROSS STREET: VISTA 9T
5384-002-034 01 PERMIT ISSUANCE FEE 27_75 THOMAS PAGE: 596 GRID: H2 LOCALITY: .TEMP45 CITY
1
47 WATER HEATER(S) 1.00 YTH 16.20 I
TOTAL FEES 43.95 ON:
06/20/01 JK 12/17/01
OWNER: TEL. MD: FINAL DATE FINAL BY: CODE:
WESTFCGA1RIBALDI AV
SW3Y G JR,
- } ���
TEMP 917801516 . YORK
WATER HEATER CHANGE OUT
APPLICANT: TEL. NO:
ACTION CONTRACTOR (310) 515-1311-
17111 s.BRoADwAYSPECIAL
GARDENA CA 90248 CONDITIONS:
T
s �SyGELES Cc()ACTION CONTACTORS, INC. (310) 515-1311- APPROVALS DATE INSPECTOR SIGILATURE
CONTRACTOR: TEL. NO: ��
17111 BROADWAY LIC. NO ♦ \ UNDER-
GARDENA, CA 90248 HICARCHITECT OR ENGINEER: TEL. NO:
/ \ PLASTIC YIN METAL Y/N
-
LIC. I t�I ROUGH PLUMBING
GAS PIPING
GAS YENT
l� I
�rtm='UIBUC VV �< HOT QkTER HEAT 1�R,�
� Z p/ L tiam
J Q / GAS TEST
❑ bUTILI'TV COMPANY NOTIFIED
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GRAY WTER
* ADDITIONAL DATA ON FILE
REPORT ID: DPR263 ROUTE TO: BSD508
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