HomeMy Public PortalAbout5406 GOLDEN WEST AVE_Plumbing__ i
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE( BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS Gollen 'Vent
LOCALITY rr^r .v
WATER CLOSET
NEAREST
BATH TUB CROSS ST.
OWNER
' SHOWER �.��"' �t`,t'i ;-aVc�v� 4d l"X •
LAVATORY MAIL
ADDRESS
SINK CITY TEL.NO.
DISHWASHER CONTRACTOR
! b r ,: Co.
CLOTHES WASHER ADDRESS ,
SWIMMING POOL RECEPTOR
CITY TEL.NOr C1
LAWN SPRINKLER SYSTEM - ----`-
STATE LIC.
WATER HEATER
LICENSE NO. -,' v � e CLASS ro
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE
OUTLETS OVER UNDER SLAB WORK �
5 PER SYSTEM ROUGH PLUMBING O
GAS PIPING V
W
GAS VENT J
U.
HOT WATER HEATER y
PLUMBING FIXTURES
GAS TEST 0
Plan check fee UTILITY CO.NOTIFIED a
PLUMBING PERMIT ISSUING FEE$ W
r
TOTAL FEE FINAL
Plan check applicant
PLAN CHECK VALIDATION
Name
Address
City Tel.No.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS ` 'q
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE
LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY.
SIGNATURE
OF PERMITTEE
DISTRICT NO. PROCESSED BY
UST
RIAL
LSTE APPROVAL
1.. COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
�- DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0202260019
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
s PHONE: (626) 285-0488 EXT:
LEGAL D: FEES PAID BUILDING ADDRESS:
TR: 35012 LT: 17 5406 GOLDEN WEST AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803218
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: OLIVE
8588-020-038 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY
47 WATER HEATER(S) 1.00 WTH 16.20
TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED Y: PLAN BY: EXPIRES ON:
02/26/02 JK 08/25/02
OWNER: TEL. NO: FINAL DATEFINAL BY / CODE:
KIM JGOWSOON (626) 287 4415 ,� /
5406 GOLDEN
ENN WEST AV /' !!! ---
TEMP 917803218 DESCRIPTION 0 ORK
RELOCATE WATER HEATER TO GARAGE
APPLICANT: TEL. NO:
CLARK' AND GEORGE'S PLUMBING (626) 273-2107-
9233 RIO DELL ST SPECIAL CONDITIONS:
ROSEMEAD
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
CLARK'S AND GEORGE'S PLUMBING (626) 573-2107-
9233 RIO DELL LIC. NO UNDER SLAB WORK
ROSEMEAD CA 91770 748881 C36
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TEL. NO:
- I ROUGH PLUMBING
LIC. NO: f
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
UTILITY COMPANY NOTIFIED
CWV
RAY WATER SYSTEM
C—x) P—c--z-r a.�l
REPORT ID: DPR263 ROUTE TO: BS0508.