HomeMy Public PortalAbout5617 GOLDEN WEST AVE_Plumbing__ 76A667-C EV81 7 10-67
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APPLICATION FOR PLUMeING PERT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDI s 5617 No.Golden West
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY Temple City
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
LasCROSS ST. as Tunas & Woodruff
NUMBER FIXTURE OR ITEM EACH FEE
OWNER Andrew Berk .
WATER CLOSET 1.50 MAIL
BATH TUB 1.50
ADDRESS same as above
SHOWER 1.50 CITY Temple City TEL. NO.
LAVATORY 1.50 CONTRACTOR Pacific Installers
SINK 1.50 ADDRESS lO 20 E.Grand Ave
DISHWASHER 1.50 CITY T e>riple .City TEL. NO- 442-7070
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO. 211898 CLASS
SWIMMING POOL RECEPTOR 1.50
DISTRICT NO. Gi�'Qi7P ZONE PRO SS BY
LAWN SPRINKLER SYSTEM 2.00 �% O
V
WATER HEATER 1.50 10 INDUSTRIALWASTE APPROVAL C=
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD U
OUTLETS OVER .30 a
5 PER SYSTEM
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 9 2 00
TOTAL FEE 3 �5o
APPROVALS DATE INSPECTOR'S 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
PLUMBING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF /I
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO �'r' �}
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL
SIGNATURE "/� f1..A/I JACK R. ALLEN, SUPERVISING MECHANICAL ENG'R.
OF PERMITTEE - - ...
PERMIT VALIDATIO cK. M.O. cAs-
PLAN CHECK VALIDATION CK. M.0. CASH
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" COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1204130015
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: 1 FEES PAID I BUILDING ADDRESS:
ITR: 11131 LT: 4 I 1 5617 GOLDEN WEST AV 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917802521 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: 1
18588-011-004 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY CAI
1 - 107 BATHTUBS/SHOWERS 2.00 FIX 32.40 1 1
(TENANT: I TOTAL FEES 60.20 (ISSUED ON: PROCESSED BY: PLAN BY: 1
I 104/13/12 SR 1
I I I I
IOWNER: TEL. N0: I IFI E FINAL CODE:
ISHEENH GURDAS S;USHA I
15606 GOLDEN WEST AV 1
ITEMP 917802520 I IDESCRIPTION OF WORK T1
I I IBATHROOM REMODEL BATHTUB REPLACEMENT 1
I I I
(APPLICANT; TEL. NO: I I
ISHEENH, BIKRAM (626) 285-5944-
15617 GOLDEN WEST 1 ISPECIAL CONDITIONS: 1
ITEMPLE CITY CA 91780 I I
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1
IAPNA CONSTRUCTION (626) 786-6912- I - 1
15617 GOLDEN WEST LIC. NO 1 (UNDER SLAB WORK I
ITEMPLE CITY CA 91780 966821 1 I
I IWATER SERVICE 1
I I IPLASTIC YIN METAL YIN I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 I I I
IROUGH PLUMBING 1 1
1 LIC. NO: 1 I I I
IGAS PIPING I
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I IHOT WATER HEATER I I
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I 1PLUMBING FIXTURES I I I
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I IGAS TEST
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i (UTILITY COMPANY NOTIFIEDI I I
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IGRAY WATER SYSTEM I
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I IREPORT ID: DPR263 ROUTE TO: BS0508 I I 1
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