HomeMy Public PortalAbout4911 GOLDEN WEST AVE_Plumbing__ 76A667-f 817 12/59 � � M'a crG` 1 �
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER L
BUILDING AND SAFETY QIVISION BUILDING 9�/
JOHN A. LAMBIE. COUNTY NGINEER ADDRESS /
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEARESTT. 2�
NUMBER FIXTURE OR ITEM CROSS
OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS ....A J
CI � t TEL. NO
SHOWER
LAVATORY CONTRACTOR�V l
SINK ADDRESS �X? '
DISHWASHER CITY t TEL. NO �
CONTRACTOR'S TE ❑
LAUNDRY TUB REGISTRATION NO. TY ❑
CLOTHES WASHER DISTRICTNO. I G OUP I ZON14D BY
WATER HEATER lia V25
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
a
U
a
O
E-
P.P.
In
z
0 $1.00 PER ITEM
OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE
-H PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
I GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 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
LDESCRIBED
CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
S REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
E 'ITTELoy�- FINAL
®P VALIDATION ROBERT A. WOOD.
cK. Y.0. cpsH SUPERVISING MECHANICAL ENG'R
7BA6APPLICATION FOR PLUMBING PERMIT 1
:)BS-17 to-ss
DIVISION OF BUILDING AND SAFETY
Department of County Engineer /
County of Los Angeles
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
CASSATT D. GRIFFIN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL INI NEAREST
CROSS ST. �}
OWNER ' .A-'Q 7, 1' DISTBJ.CT NO. GROUP Z N READY FDR
''..INS CTIQN
MAIL
ADDRESSAl
RIAL
CITY ?}Z &,I&/ TEL. NO.,'G / ����'? WASTEAPPROVAL
PLUMBER rnR INSPECTION RECORD
ADDRESS ��t��1
CITY TEL. NO. {'.� %tom c.--c;) , km ``( 4.1 gam[ '4 RIR
LICENSE NO. L. tiG �r�.��f '-.l :w. , l'tI,tf�
NUMBER TYPE OF FIXTURE OR ITEM FEE
-_-.
WATER CLOSET (TOILET) @ $1.00 $ _
BATH TUB @ $1.00
' x
SHOWER @ $1.00
LAVATORY (WASH BASIN) - T
KITCHEN SINK @ $1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
DjkTE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING tall
,O[! GAS PIPING
TOTAL FEE
GAS VENT I
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
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
I HEREBY 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. �_..,
za..
SIGNATURE ` fl„
OF PERMITTEE FINAL W7
JOHN A. LAMBIE. COUNTY ENGINEER VALIDATI ROBERT A. WOOD, CHIEF PLBG. INSPECTOR
CK. Y.
t ' 1 6 0 5IV'; "2 6 3 2.00 .9
D. ■. 17 �•)r Z7
FOR.I'E
k PT f, I MP1
' I)EPARTMF.NT OF BUILDING AN',) Obi
.,_. . -•—�
LL
WM.
J. FOX CHiCf ENGINEER {. =ia t /L C .• . C. +. ^�*
NATURE OF INSTALLATION ?;; D1sTRICT_rj0. `I GRIP I �O,E 4 PERMIT N.
100.
I � SLUM V 1N,7 •I•••.f.• fIXTUR[! -i,
ROUGtI � � �
READY fOlt G_ _. C L'( I �UAII tttsva0
_ i6Kx3L'+ =y IQCPTIC TANK r� „
L.A f MISCELLANCOVe
APPLICANT I~'II,L; IN- HEAVII,Y OUTLINED'PORI►t)N ONLY
'_.'. r ;e %�. w /1 •/Y Y. �� y L�C.
of
COUN • .� LL —N C A R C f T 1
,J CITY Q
TE ' No/j} CROSS 1T. I
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Rea. NO. .. [XPIRft ' . . i • r rNAMC • IAt y ..
IAC:1'I'IO�t 01' SI;('I'iC•TA.tiK,
NORTH , . O OR CF.��I'OOL ';'"A16.0M.:
ADORES$
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f UI:SCRIPTION
=AT" Tvr _ .F '•� .'•.-� 1 --.. , .... .. � ..J .•;
--____f110•N[R __..DIfHNABoC?•-eyl'� ' �: �. . 1 A 1'1'1,_11 �' _ f ` -.� !:' .J• j�•I� rr
LAVATORY'.,'( , .- [FR';.C•JAT�R ;xTiC f) _ DAT[ I,'* MA1o't I V
KITCH[FI SINK _WA,TCR f'FT C'1Cn
�FLOCR LINK SANO,TRAI" CAR P'••'143 { ^,� I 'A
• ----_:_Cr t;NK __r_COR ORAtN � cAq vCNT `'R'V1•
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TR.1vP.'NAL i-� rnnLA.WlIE[i CLrf.L ..r1,/:.;N ICUNTAkl'4 I 1. Tl
r:T[ft ^-GA9 b.;CA F:.)l 1.!AIN UTILITY�O. NOThFI D r -� +1 �►'r�" }[ '
Irr 4A
�•' `�' t AM TH[ LIOAL OWNER OF TTi[ AN Lvi ANGCLcl `
COUNTY R[G16TRAT10N MBLR . s
TOTAL NUMQ[R Of FIXTUR[/.._._...,
e StrTIC TANK y _.Y 1� .► KVr1Kn - .,
,1 c[Gs►004 -��,-� t PAN n[ AL OWN ZR IZXTY C[FcRIIN[D i
A ItOV9
TOTAL !EE .• _•
,fir ,} .• � .v,�,•.G:}t?� � ' r141;'�(y {t
o:'..' ;y :.M 1., ,. I�_. ,. IN;:APPLICATION
iiFZPA"RTM�N'i` OF BLTILDINt' `AND SAF` T�'': �'�~; �
COUNTY OF L( ANGELES:
.. ` C I[R [NOIN[[R '
- 1VA`rrDISTRICT NO. G�R?rUP ZONE .:P ,fmrr a_URE INSTALLAjj
rLUMBINa RI?S1'Uf:Ls • COMFL[T[ � :Ft[ADY FOR A[C[IV[D /Y-: � /,T<'ILW�D * ',
S!Ci ThC TANK
HEAT" flRi"f INfr[CT10H t ? _
HEATG!<iaPOd" r
'
G•+.: '1' ��¢� _ r ". 1
OAS
> APPLI,CANT FILLJN. IHEAMY 'OUTLINED PORTION ONLY
f f .iolr
m'
'ADDRESS
CITY L CRo" ST;'
COUJ4 1 1,
ID.Cr RES
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RM. No. = .
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—MAIL _ -
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DESCRIPTION
UOF-'.WORK .
1.
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ATH TUB
Y� rr,•_: :APPROVAL& * "' -
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: VATORY, Ia A f r'.. •f' `'i Yl'fi'7.'*a '' ''. DAt[r. _ .r r?r.ncor[crom a!I h
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TOTAL'Nu�}is KR Wil+ Ir.I
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COUNTY OF LOS ANGELES TEMPLE CITY 0 0508 PLLMING PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9807060022
'BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: FEES PAID B-UILDING ADDRESS:
TR: 5342 LT: 9 4911 GOLDEN WEST AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803938
ASSESSOR BER: NEAREST CROSS STREET: LOWER AZUSA
8589-019-003 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A5 LOCALI TEMPLE CITY
07 BATHTUBS/SHOWERS 1.00 FIX 16.20
TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: E)tPIRES ON:
07/06/98 UT /06/99
OWNER: TEL. NO: FINAL DATE FINAL B CODE:
LIM DAVID (626) 442-7161-
4911 GOLDEN WEST AVE UlAg
TEMP 917803150 DESCRIPTION OF WORK' v
PLUMBING FOR NEW BATH TUB
APPLICANT: TEL. NO:
SAME AS OWNER -
PECIAL CONDITIONS:
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER - -
LIC. NOUNDER SLAB WORK
WATER SERVICE
ARCHITECT OR ENGINEER: TEL. NO: ll. - PLASTIC Y/N METAL Y/N
ROUGH PLLMING
LIC. N0:5' � ,--- - - - ' � i � � .��lll lil, `F fL3�
- i -
GAS VENT
HOT WATER
PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
UTILITY COMPANY NOTIFIED
CwV
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508