HomeMy Public PortalAbout5612 GOLDEN WEST AVE_Plumbing__ 7G A 667i-',-,CE 817 8/68j—
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APPLICATION FOR PLUMBING ;WRMIT��
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING r
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS J� L
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST. +
NUMBER FIXTURE OR ITEM EACH FEE ) a
OWNER
-WATER CLOSET 1.50
MAIL
BATH TUB 1.50 ADDRE$$
SHOWER 1.50 CI TEL. NOZ
LAVATORY 1.50 CONTRAC R `
SINK 1 50 ADDRESS
DISHWASHER 1 50 CITY TEL. NO.
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO ` CLASS ZAP
SWIMMING POOL RECEPTOR 1 50
DISTRICT NO. GROUP ZONE PrR6 ESSED BY �
LAWN SPRINKLER SYSTEM 2.00 � �j U
WATER HEATER 1.50 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1 50 j �J INSPECTION RECORD W
OUTLETS OVER Q.-
5
_5 PER SYSTEM 30 Z
Plan check fee 25% of above. See reverse
PLUMBING PERMIT ISSUING FEF" S 00
TOTAL FEE S
APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel No HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST i.Z�♦ �.�
PLUMBING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE �CRIBEDRESIDENTIAL PROPERTY FINAL
SIGNATURE JACK R. ALLEN, SUPERVISING ECHANICAL ENG'R
OF PERMITTEE—;
PERMIT VALIDATION c"K M O CASH
PLAN CHECK VALIDATION CK M O CASH
a
2 1 2` AUG26 6 -5 D 4�./ 5-
76'A 6-67=CE 817 4-68 `
APPLICATION FOR PLUMBIN PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
ADDRESS 5612 Golden West
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS. SUPT OF BUILDING LOCALITY CALITY
Temple City
NE
FOR APPLICANT TO FILL IN PR NT OR TYPE) CROSS Sr. Broadway
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET 1.50 Bade ConstructionCo.,
MAIL
BATH TUB 1 50gF
& ADDRESS
SHOWER 1.50 CITY Arcadia TEL. NO.
LAVATORY 1 so coNi'RAcrox Owen Bros. Plumbing,
SINK 1.50 ADDRESS 4265 No. Baldwin Ave.
DISHWASHER 1 50 CITY El Monte TEL" NO. 44A-0078
CLOTHES WASHER 1.50 lirSTATE LIC C�36
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1.50
DISTRICT NOZONE P OCES D BY
.LAWN SPRINKLER SYSTEM 2 00 a Tp
I
14,
WATER HEATER 1.50 INDUSTRIAL 'I � ,
WASTE APPROVAL
GAS SYSTEM OUT-LETS 1.50 INSPECTIO RECORD y�0e
OUTLETS OVER .30
'-I 5 PER SYSTEM iltl9 NNN2222
N
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE
APPROVALS DAT INS TOR'S S N URE
Plan'check applicant UNDER SLAB WORK (t
Name ROUGH PLUMBING
Address GAS PIPING
GASVENT
City Tel. No HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1.HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST G
PLUMBING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE ESCR BED RESIDENTIAL PROPERTY FINAL
SIGNATURE
JACK R. ALLEN, SUPERVISING CHANICAL ENG'R
OF PERMITTEE
PERMIT VALIDATION cK M o CASH
PLAN CHECK VALIDATION CK M o CASH
( F --9'7&7,,;_0.�. NAY 5 5 D 20.00-
d
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT f
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0306160033
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
FEES PAID BUILDING ADDRESS:
TR: 11131 LT: 15 BL: .001 5612 GOLDEN WEST AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802520
ASSESSORNEAREST CROSS STREET: LIVE OAK
8588-012-025 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY
47 WATER HEATER(S) 1.00 WTH 16.20
TOTAL FEES 43.95 .
06/16/03 JK 12/13/03
OWNER: TEL. NO: FINAL DCODE:
VAN ETTEN;DEBRA (626) 285-5996EX-
5612 GOLDEN WEST AV
TEMP 917802520 UFRERTM
REPLACE WATER HEATER
APPLICANT: . NO:
JAKE BALLARD (661) 259-0520-
24707 SAN FERNANDO SPECIAL CONDITIONS:
SANTA CLARITA 91321
CONTRACTOR:
L. NO: APPROVALSDATE SPECT SIGNATURE
AFFORDABLE WATER HEATER AND PLUMBIN (661) 259-0520-
24707 SAN FERNANDO ROAD LIC. NO UNDER SLAB WORK
SANTA CLARITA CA 91321 627368-C36
� WATER SERVICE
PLASTIC Y/N METAL Y/N
ENGINEER:ARCHITECT OR O: ROUGH PLUMBING
LIC. NO: ,
GAS PIPING
GAS VENT
LAWN SPRINKLERS
S TEST
UTILITY COMPANY NOTIFIED
cWV
GRAY WATER
REPORT ID: DPR263 ROUTE TO: BS0508