HomeMy Public PortalAbout5716 GOLDEN WEST AVE_Plumbing__ D.B.S.17 25M SETS 7-47 APPLICATION FOR PERBUT
DEPARTMENT OF BUILDING AND SAFETY ��
COUNTY OF LOS ANGELES
Wm. J. FOX. CHIEF ENGINEER
NATURE O INSTALLATION DISTRICT NO. GROUPI ZONE PERMIT NO.
ROUGH FIXTURES COMPLETE � l
HEATER __CESSPOOL -I SEPTIC TANK RECEIVED BY READY FOR DATK ISSUED
AS MISCELLANEOUS
FIRST INSPECTION // _=y--
*� (A�PPLLICANT FILL IN HEAVILY OUTLINED/PORTION ONLY
TTINGHAM CO. JOB
K NAME 111•'1 y l��TO ADDRESS 4 O
m ADDRESS 123 No. Cloverly Ave. LOCALITY
A.
CITY TFMPLE CITY,ICALIF. Mr. `
COUNTY
CERT.No. EXPIRES m NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL = MAIL
NORTH
3 ADDRESS
O
CITY TEL.No.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COU TY CERT IIC UALIFIC TT�IO.NN..
ItUUMBER
e
THE WLEGAL ONER OF THE PROPERTY DESCRIBED
OWNER
CORRECTIONS
SOUTH
J
DESCRIPTION OF WORK a
z_-
BATH TUB FURNACE L7
Q'
SHOWER DISHWASHER Q
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
SLOP SINK FLOOR DRAIN
WASH TRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'!NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING
METER GAS SODA FOUNTAIN GAS PIPING
OUTL
GAS VENT I I
CESSPOOL 1,/,y-� -ve
TOTAL NUMBER OF FIXTURES SEPTIC TANK
-CESSPOOI SEPTIC TANK ���• SEWER
S UTILITY CO.NOTIFIED
TOTAL FEE r
76A667 -(' J,B17 2-62
l
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER !7 �-�� ��J
BUILDING AND SAFETY DIVISION ADDREBUILDISS�r C? Gt.�L� Vlit
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A JENSEN, SUPT OF BUILDING
LOCALITY /_pwJ12� t�
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE +J'
OWNER ,ICJU�//l'/T�V
WATER CLOSET $1.25 MAIL
BATH TUB 1.25 ADDRESS
7 CITY �_._ TEL. NQ -
SHOWER IA/ 1.25 71
LAVATORY 1.25 CONTRACTOR �� lhI�Q�I J
SINE 1.25 ADDRESS_1'2 P ? fir' W S g 6 7 V Bi
DISHWASHER 1.25 CITY .fS f TEL. NOble��,7�
CONTRACTOR'S ` STATE ❑
LAUNDRY TUB 1.25 REGISTRATION NO. fG ZGCC 2- %GSMCOUNTY ❑
CLOTHES WASHER 1.25 DISTRI N GROUP ZONE �q�IESSED BY
WATER HEATER 1.50
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD d
O
V
GC
O
1-
V
N
Z
APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT
UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FE GAS PIPING7�lj-�'v " y
I HEREBY ACKNOWLEDGE THAT I HAVE RE TH LICATION GAS VENTI�
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS G LATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY TH 1 M P RLY REG TER AND/OR 'PLUMBING FIXTURES
LICENSED AS REQUIRE B O E 5 COON A STATE OF !GAS TEST
CALIFORNIA OR THATHE OWNER A INTEND TO
RESIDE IN,THE ABOi RIB ENTIAL OP RTY - UTILITY CO NOTIFIED -
SIGNATURE
OF PERMITT FINAL
(-V' VALIDATION ROBERT�A WOOD
CCK./ M o CASH SUPERVISING MECHANICAL ENG'R
L& 8 2 2 _7 DEC�. 5 D 4.5 0
• CQUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1312090022
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT.
ILEGAL ID 1 FEES PAID BUILDING ADDRESS
ITR 6561 LT 458 I 5716 GOLDEN WEST AV
I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802503
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET LAS TUNAS
18587-028-021 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE. 597 GRID A3 LOCALITY TEMPLE CITY CAI
107 BATHTUBS/SHOWERS 1 00 FIX 16 20
ITENANT 125 LAVATORIES/SINKS 1 00 FIX 16 20 (ISSUED ON PROCESSED BY- PLAN BY 1
145 WATER CLOSET/URINAL, 1 00 FIX 16 20 112/09/13 SR
164 WATER PIPNG <= 1 1/2 1 00 LIN 16 20 1
(OWNER TEL NO. 192 NO PERMIT OWNER-BLDR 344 00 DOL 344 00 1F NAL DATE FINAL BY CODE
ILAN, MING-CHEN (626) 309-0727- I TOTAL FEES 436 60 177
15716 GOLDEN WEST AV
(TEMP 917802503 I I DESCRIijriON OF WORK
I IREPIPE PLUMBING FIXTURES BATHTUB/SHOWER, LAVATORIE, WATER
ICLOSET AND WATER MAIN
(APPLICANT TEL NO 1 I I
ISAME AS OWNER -
I, I ISPECIAL CONDITIONS.
I I I
ICONTRACTOR TEL NO I 1APPROVALS DATE INSPECTOR SIGNATURE 1
1SAME AS OWNER - I
LIC NO i 1UNDER SLAB WORK
I I IWATER SERVICE 1 1
I i 1PLASTIC YIN METAL YIN 1 1 I
IARCHITECT OR ENGINEER TEL NO 1 I
I - I IROUGi4 PLUMBING
LIC NO
IGAS PIPING
1 I IGAS VENT
I I
1 I IHOT WATER HEATER
IPLUMBING FIXTURES
1 (LAWN SPRINKLERS
1 IGAS TEST
I (UTILITY COMPANY NOTIFIEDI
I I ICWV 1 i
I GRAY WATER SYSTEM I
i
i II i 11 I I I
I I I I I I
I I I I I I
(REPORT ID DPR263 ROUTE TO BSO508
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