HomeMy Public PortalAbout5211 GOLDEN WEST AVE_Plumbing__ 76A687 17 5-49® APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE �R�MIT NO.
9- /7 / PP//
PLUMBER VALLEY 1 p RECEIVED BY READY FOR DATE ISSUED
__ _ S;1�1'Jt4-1 � FIRST INSPECTION
ADDRESS OOQ t'QCT %/Al I Fy 1211111
BUILDING
h 9 7�'�
CITY •n`� F� TEL. NO. 2-271c) ADDRESS
COUNTY LOCALITY V/
LICENSE NO. 91 EXPIRES 6-30-
rGtl.� s
NEAREST
PERMIT FEES CROSS ST. /m.
NUMBER TYPE OF FIXTURE OR ITEM FEE OW ER rriC�•�L0. �ff�L' '" ��
I MAIL
WATER CLOSET (TOILET) Q 0.50 $ ADDRESS
�) BATH TUB @ 0.50 CITY TEL. NO.
SHOWER @ O s0 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) Q 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK @ O 50 STATE LAWS REGULATING PLUMBING. 1.
I CERTIFY THAT I POSSESS THE ABOVlk VALID LOS
LAUNDRY TUB OR TRAY @ O s0 ANGELES COUNTY LICENSE, OR--I AM THE'LEGAL OWNER
OF THE RESIDENTIAL PROPERTY,DES'CRIE)ED ABOVE.
GAS SYSTEM-3—OUTLETS @ 0.50 SIGNATURE OF
WATER HEATER @ 0.50 PERMITTE��'^'��'s`''>,"7r
SLOPSINK @ o so INSPECTION-RECOliD�
FLOOR SINK @ 0.50
FLOOR DRAIN Q 0.50
DISHWASHER Q O 50
DRINKING FOUNTAIN @ O 50
URINAL @ O s0 ..1
HOUSESEWER Q O 50 Z
MISCELLANEOUS
I`
� I O
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING I/�/����C ~?7r
GAS VENT -14 /1/
CESSPOOL Q 1 00 I CESSPOOL
SEPTIC TANK: SEPTIC TANK n
JY
DRAIN ( ) PIT ( ) Q 1 00 SEWER
PERMIT . 1 00 GAS TEST
( I /f/
/�/ UTILITY CO. NOTIFIED r ./ It .q'� !✓
TOTAL FEE $ / FINAL �I P, F`r
` DEPARTMENT OF COUNTY ENGINEER L BIto -;L 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDfNG
A,
WILLIAM J. FOX, COUNTY ENGINEER- ADDRESS ' 6-4 /-404-Al WAd '
FOR APPLICANT TO FILL IN LOCALITY
NEAREST
BUILDING f CROSS ST-
ADDRESS
� DISTRICT NO. GROUP ZONLF PERMIT NO.
LOCALITYNEAREST
ROSS ST. r c- RECEIVED BY Ready for Inspection DATE ISSUED
OWNER
to
— rs
�
MAIL 1 DUSTRIAL
ADDRESS WASTE APPROVAL
INSPECTION RECORD
CITY TEL.N0.
PLUMBER VALLEY BOULEVARD PLUMBING CO.
ADDRESS 8300 EAST VALLEY BLVD:
CITY ROSEMEAD TEL.,NO. AT. 2-2719 • ,
.y p+/J❑STATE
./
LICENSE NO. c /O v /1 J
PERMIT FEES a
_z
NUM�EP. TYPE OF FIXTURE OR ITEM FEE 0
WATER CLOSET(TOILET) @ 080 $' O
BATH TUB @ 080
YD o
SHOWER @ 0.80
LAVATORY(WASH BASIN) @ 0.80
KITCHEN SINK@ 0.80
LAUNDRY TUB OR TRAY @ 0.80
SLOP SINK @ 0 80
FLOORSINK @ 080
FLOOR DRAIN @ 0.80
t DISHWASHER _ Cd 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 030
GAS SYSTEM---- ......--OUTLETS @ 1.00
WATER HEATER @ 1 00
MISCELLANEOUS
APPROVALS
'DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK \
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE GAS PIPING r
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING: 'It PLUMBING FIXTURESa`ice - -
I HEREBY CERTIFY_THAT I AM PROPERLY REGISTERED ee..
AND/OR LICENSED, S REQUIRED BY LOS ANGELES COUNTY GAS TEST 3 ZSI� .' rsCv+-
AND STATE OF C 0RNIA ORT AT i AM THE LEGAL
ER OF THE ABOV ESCRIBED SID IAL.PROPERTY. UTILITY CO.NOTIFIED ?_
SIGNATUR
,OF PERMITTE .......... ......... ............... ....................................
FINAL
_ 76A667 DBS 17 1/58
v
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0708100015
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
ILEGAL ID I FEES PAID I BUILDING ADDRESS. I
ITR: 15683 IT 4 I I 5211 GOLDEN WEST AV
I IFEE DESCRIPTION QUANTITY. UOM: AMOUNT: ( TEMP CA 917803247 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET I
18589-010-004 101 PERMIT ISSUANCE FEE 27 75 I THOMAS PAGE: 597 GRID A4 LOCALITY TEMPLE CITY, Cl
1 151 LOW PRS GAS 5 OUTLET 1.00 SYS 16 20 1 1
(TENANT: I TOTAL FEES 43 95 (ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 1
I I 108/10/07 SR 02/06/08 I
1OWNER TEL. NO 1 1r DAT"' Y CODE 1
IBARAKAT, FOUAD (626) 286-3212-
15211 GOLDEN WEST AV
1TEMP 917803247 CR PP
ION OF WORK
1GAS LINE FOR HVAC SYSTEM 1
I I I I
1APPLICANT• TEL. NO I
1SAME AS OWNER -
I I 1SPECIAL CONDITIONS 1
I I I I
ICONTRACTOR: TEL. NO 1 (APPROVALS DATE INSPECTOR SIGNATURE I
ISAME AS OWNER - 1 I I
1 LIC NO 1 (UNDER SLAB WORK I 1 I
IWATER SERVICE I I
1 I IPLASTIC Y/N METAL Y/N I I I
1ARCHITECT OR ENGINEER TEL NO I I I I I
IROUGH PLUMBING I I I
LIC NO
IGAS PIPING
I I I I I
GAS VENT
IHOT WATER HEATER I I I
IPLUM13ING FIXTURES I I I
ILAWN SPRINKLERS I I I
I I I I I I
1 I IGAS TEST 1 I I
I I (UTILITY COMPANY NOTIFIED( 1 I
I I ICwv I I I
I I I I I I
IGRAY WATER SYSTEM I I
I I I I I I
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I 1REPORT ID. DPR263 ROUTE TO BS0508 I 1 I I
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