HomeMy Public PortalAbout4928 GOLDEN WEST AVE_Plumbing__ nwwYA res $17m) -WV
-'y APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAPETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM FEE ADDRESS
WATER CLCLSET LOCALJTY
BATH TUB NEAREST p �
CROSS ST.
SHOWER AWNER
LAVATORY AA' DLRESS 100-
SINK [TTY 7WTEL.NO.
DLSH`WASH ER CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR JO
QTY t�leTEL NO.
LAWN SPRINKLER SYSTEM
STATE Lr—
WATER HEATER LICENSE NO. 7 CLASS d1-3
GAS SYSTEM OUTLETS T O U ZONE D BY
0 3
5� INDUSTRIAL - 8
WASTE APPRQVAL cc
INSPECTION RECORD
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FR
Plan check applicant
Name APPROVALS DATE IINSICCTO"3MMATURK
UNDER SLAB WORK
Address RDUGH PLUMBING
City Tel.W. GAS PIPING
I HEREBY ACOtOWU DU THAT I HAVE (RAD THtI APPLICAT00"AND STATE GAS VENT
TIHAT THC ADM M CORRIECT AND AG REI TO COY PLY WrrH ALL COU MT'ORD GiAIICIE
AND STATE LAws RIaULATTwa PLUrsaRa HOT WATER HEATER
I HERCDY CEATlY THAT I PRo"JtLY Mg LK'ZPM7,.D AS PLUMBING FIXTURES
RI.CUTAID eY LAS C AM STAT[OF THAT I AY THI C�TEST
LSGM.OWKER OP. RTIR RLSm[I C AiOVE D Im RE=EwrIAL
PROPIRTY. UT I LTTY CO.NOTI F I ED iv
e Ia NATU R E r
Of PERMr T! FINAL
PLAN CH ALIDATION CPLY o. cAIH PE3IANT D
V ATION NIC Y o. CAM
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COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer PLUMBING
DIVISION OF BUILDING & SAFETY
WILLIAM J. FOX. County Engineer
i ZONE R9111T NEI.
FOR APPLICANT TOO�FILL IN DI R D. UP
PLUMBER _ /yam" ! RECEIVED BY READY FOR 1
DATE ISSUED
FIRST INSPECTION I_
ADORES If
E✓ BUILDING /
CITY _ TEL. NO. / ^,_ ADDRESS r
COUNTY r`G LOCALITY__
LICENSE NO. EXPIRES I C.' ✓ /-
NEAREST
PERMIT FEES CROSS ST.-
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET(TOILET) a 0.50 ADDRESS
BATH TUB 0 0.50
CITY _TEL NO.
SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ 13.513 U AND STATE LAWS REGULATING PLUMBING.
p^ 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 (f�t ANGELES COUNTY LICENSE, OR 1 AM TAE LEGAL OWNER
OF THE RESIDENTIAL RPERTY DE ISED ABOVE.
GAS SYSTEM__ OUTLETS @ 0.50 / I
WATER HEATER @ 0.50 J SIONP TRI MR�fEFA L
SLOP SINK @ D.so INSPECTION RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN @ 0.50
-.DISHWASHER @ 0.50 - -
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50 Q
Z
HOUSE SEWER @ 0.50
MISCELLANEOUS
Q'
T 1T' O
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING -
- f -
GAS VENT
CESSPOOL - 1.00 CESSPOOL
SEPTIC TANKS SEPTIC TANK
DRAIN ( ) PIT ( ) QI 1.00 SEWER _
PERMIT .
1.00 GAS TEST
UTILITY CO.NOTIFIED
TOTAL FEE 40
FINAL 41
76A667 DBS$17 10/52
76A667 (CE-817) - 5/73
APPLICATION FOR PLUMBING PERMIT
• COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING 28
ADDRESS Golden Weqt
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
Temple City,
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST. J�
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET 11.75 366 OWNER M/M Jack Price
MAIL
BATH TUB 1.75 ADDRESS 4928 Golden Wes
/ SHOWER 1,75 CITY Temple City TEL. NO. 287_9397
LAVATORY 75 CONTRACTOR
SINK .75 ADDRESS 4265 N. Baldwin Ave.
DISHWASHER •75 CITY Fl- Mantp TEL. NO. 44 j—QQ7A
CLOTHES WASHER 75 STATE qq LIC I�
LICENSE NO. 23��14� CLASS \i 3620
SWIMMING POOL RECEPTOR 1175
DISTRICT NO. GROUP E P CE D BY
LAWN SPRINKLER SYSTEM 1 75 r Z
WATER HEATER 1175 �r INDUSTRIAL
WASTE APPROVAL a
GAS SYSTEM OUTLETS 1. 5 INSPECTION RECORD V
OUTLETS OVER D
5 PER SYSTEM
- O
F—
U
W
a
Cn
Z
Plan check fee See Reverse C
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE h2S 0
APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING a �e'✓�f.
Address GAS PIPING
City Tel. No.
GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST r
PLUMBINGL
CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
S REQUIRED BY LOS ANGELES COUNTY AND STATE OF
OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
E ABOVE CRI ED RESIDENTIAL PROPERTY. FINAL
E
MITTEE 9--
PERMIT VALIDATION MO. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
3 c5 SFR G `� Uj 6.J