HomeMy Public PortalAbout4852 GOLDEN WEST AVE_Plumbing__ I 76664117O"0117-A)- 11/76
r "'-APPLICATION FO PLUMBING PERMIT
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COUNTY OF LOS ANOE11-118
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
Ir POR APPLIC-kNT TO FILL IN(PRINT QR TYPE) BUILDING �-
NUMBER FIXTURE OR IT-EM a FEE ADORES
WATER CLOSET LOCALITY
BATH TUB NEAREST
' CROSS SI. �
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK QTY EL.NO.
DGHWASHER CONTRACTOR -
CLQTH ES WASHER
. ADDRESS
SWIMMING POOL RECEPTQR CITY Ae7c TEL NO. P!/
LAWN SPRINKLER SYSTEM
STATE LIC
WATER HEATER UCENM NO. / J CLASS
GpA�ST�$EY�STpEyMg� OUTLETS 58 R Z ED BY
lz
3 PER SYSTEM �V
INDUSTRIAL (CfJ �
WASTE APPROVAL
INSPECTION{RECORD
N� ,dad` �`o IoIYI7-r-P-6 o
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Ian check applicant
APPROVALS DATE INSPECTOR'S MKATURR
Namp
UNDER SLAB WORK
Address ROUGH PLUMBING
Chy Tel.No. GAS PIPING
IHMBY AClOIOV"DGI THAT I HAVE RIAD THt5 ArrLND ICATION ASTATE GAS VENT
THAT THI ABOVE 1:5 CORRECT AND AGREE TO LOWLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. FIQT WATER HEATER
I HEREBY PMrPrY THAT I Ail ERO"FILY REGISTERED AND/Oft UCENSED AS PLUMBING FIXTURES
REQURED BY LOS APS15JLS COUNTY AND STAT(OF CALFORNLA OR THAT I Ail THE (S TEST
LYGAL OWNER OF,AND fNTElO TO RESrDE IN THG ABOVE DEDCF45ED REBIDMTAL
PROPERTY. ' LmLTTYCo.NCTnR
r
SIGNATURE
OF PBRMfTrEe FINAL
PLAN CHECK ATJ *�; CIL y o. casr PERMIT VALIDATION c>< o. Pas++
063cMIIR 14 5 0 0.00e
74667.-QYE17.S
kPPLICATION FOR PLUMBING PERMIT
COUNTY OF LOSG
NT
DEPARTMENT OF COUENGINEM
BUILDING_ VM SAFETY DIVISION eD > G o?
JOHN A. BIE. COUNTY ENGIN[[R
COLEMAN W,JKNKINS. SUr'T. Or BUILPLNG LdId urrT
FOR APPLICA14 TO FILL IN $wr OR TYPE)[
ET.
KUTABtR FIXTURE OR ITEM CASH 1+[Q
ovn=
WATER CLOBET 1.5-0
KAM
BATH TUB 1.5Q impam
SHOWER 1'$o TEL 110
LAVATORY 1.50 CONMAC"
BINK 1.50 ADDEW
DIBHWABHER 130 Cr" T=XO,
CLOTI-IEB MASHER 1.50 STAT[ LtC
LFCENA[ NO. CLASS
SW LGAINQ POOL RECEPTOR 1.50 DISM CTrry30. aROUIi [ t• [fl [Y
LAWN BPRVgrLA9 SYSTEM 7.00 �'Q x �/
ATIIR HEATRk 1.50 OVAL
GAS -EM OUTLETS 1.50 Dfal�i30>i�Olm
OUTT
LEBOVER 90
5 AER SYSTEM
Plan check fee 25%of above. See Teverae.
PLUMBING PERMIT ISSUING FEE .= 00
TOTAL FEE
APTROVA�.B DAT9 IHsfECTOR•A 810NATURE
Plan cheek applicant UNDUR SLAB WORK
Name ROUGH PLUMBING i
Addres& GAB PIPIryG
City, TeL No. GAa VENT
HOT WATER HEATER
I H>DOY ACKNOWL«+S+ THAT_I HAVE IRAD tHl• APPL.ICATIO"
ANP *TATE THAT THE ASOVC 7E COMM& AND Aa REE TO CQNrL.Y PLUMBING.FIXTURED
WITH Al.L,'COUNTY 0011DINANCM6 AND gTATK LAWIr J*fULATIN•
pUmimNs. GAS TEST
I OER
HXAY CERTIFY THAT I r PFAM ERRE
tY *ISTG® AND/ow UTILITY 00.NOTIPIED
L.ICLNOWAA ItpUIRJm A d=l" COUNTY AND /TATE QF
/CAU FORM IA O# THAT L LEaAL R TO
ItsloE IN.THE FINAL
SIGNATURE JACK R.ALLEN, 9 R srCK
ANICAL IZ Q'R.
9F FERMI -PERMn VALIDA ONM . CASH.
PLAN CHECK VALIDA'T'ION C-K. M.O. CALH
li -- COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1002250024
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 ETT:
LEIAL ID: FEES PAID BUTWING ADDRESS:
ON F= 4852 GOLDEN 1I= AV
FSE DESCRIPTION: QUANPTT'Y: DOM: AMOUNT: TEMP CA 917803935
ASSESSOR 1]511-�RMATION NUMBER: NEAREST CROS9 STREET: LOWER AZUSA
8589-020-020 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 LAID: A5 LOCALITY: TEMPLE CITY, C
07 BATHTUBS/SHOWERS 1.00 FII 16.20
TENANT: 25 LAVATORIRS/SINES 2.00 FII 32.40 ISSUED ON: PROCESSED BY: PLAN BY: EZPTRR4 ON:
45 NATER CLOSET/UR-TNAL 1.00 FII 16.20 02/25/10 SR 02/25/11
47 NATER HEATER(S) 1.00 vm 16.20
OWNER: TEL. NQ: 51 LOW PRS GAS 5 OUTLSiT 1.00 SYS 16.20 FZbEkL DATE FINAL BY: CODE:
PRICE, WILLIAM A (626) 808-8857-' `- TOTA.L FEFS 124.95 //
.n)) KL; v "'(J(��''
4836 GOLDEN WEST AV IAIC
TEMP 917803935 DESCRIPTION OF WORK
PLUMBING FOR xrrrrIEN, BATHROOOM REMODEL ON GUEST HOUSE
APPLICANT: TEL. NO:
SAME A9 07NR -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SAME A9 OWNER -
LIC. NO UNDER 91AB FORE
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINRER: TSL. NO:
ROUGH PLUMBING
LIC. NO:
GAS PIPING
GAS VENT
HOT WATER HRA=R
PLUMBING FIXTURES
LAWN SPESIN]CLERS
GAS TEST
UTILITY CG1dPANY NlOgrIFITD
CNV
GRAY MATTER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508