HomeMy Public PortalAbout6219 GOLDEN WEST AVE_Plumbing__ 76A667 (CE-817) - 5/73 -
• APPLICATIO FOR P MBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
_ BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO BUILDI7NSG
ADDRE
HARVEY T. BRANDT, COUNTY ENGINEER
-LOCALITY-
FOR
OCAL
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEARE '
CROSS • 16
NUMBER FIXTURE OR ITEM @ FEE
OWNER
WATER CLOSET 1.75 J
MAIL
BATH TUB 1,75 ADDRESS
SHOWER 1,75 CITY TEL NO...qO�-
LAVATORY 1.75 CONTRA
SINK 1.75 ADDRESS 4
v.
DISHWASHER 1.75 CITY TEL NO.
CLOTHES WASHER 1'75 STATE LCENSE'NO �—V�7 CILASS ` •'%5'--3
SWIMMING POOL' RECEPTOR 1.75
DI TRICT NO G U NEr FR)CESSEJ3 BY
LAWN SPRINKLER SYSTEM 1,75
WATER HEATER. 1.75 5 INDUSTRIAL (�
_WASTE APPROVAL,
GAS SYSTEM OUTLETS 1.75 d
INSPECTION RECORD U
OUTLETS OVER
SPER SYSTEM 30 p`.,���.7
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE x
APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel NO GAS VENT
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
PLUMBING GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED ��
LICENSED AS REOUI REO BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO A �I A f
RESIDE IN THE ABOVE ��7R ESI ATIAL PROPERTY FINAL / e�
SIGNATURE OF PERMITTE
PERMIT VALIDATION j7CM/.f/CASH
PLAN CHECK VALIDATION CK. M 0 CASH v
2 9.&CZMAR 29 5 D/� I ' 8.2 5 ,&w
7J
76A667-CE#817 5-51
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING /
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING ar
LOCALIrY
FOR APPLICANT TO FILL IN NEAREST
EARS T
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET
MAIL
BATH TUB ADDRESS
CITY TEL NO.
SHOWER
coNTancroa
LAVATORY
SINK ADDRESS S `
r
DISHWASHER CITY TEL. NO. T S
CONTRACTOR'S A
LAUNDRY TUB REGISTRATION NO. COUNTY
CLOTHES WASHER DISTRICT NOBLIB� ZONE P SED BY
.
WATER HEATER �Q O
GAS SYSTEM - - INDUSTRIAL
WASTE APPROVAL
- INSPECTION RECORD �
. O
v
W
a
Vf
$1.00 PER TEEM
OR FIXTURE $ ` �p O APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE O O ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I
HEREBY CERTIFY THAT I AM PROPERLY REGISTfiR13D AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE GAS TEST ( 'y _
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO NOTIFIED -;I ..`/,Y iIll
SIGNATURE 'VV _ r) �✓' f� -� Ila
OF PERMME ����((((////VVVV FINAL �A L1 7,
LIDATION ROBERT A.�WdOD
GK.
M.0. CASH SUPERVISING IMECHANICAL ENG'R
'76A667-CE8i7 12/59
14 APPLICATION OR PL SING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTYENGINEER BUILDING
BUILDING M�i�cFETY ENGINEOER FADES$ 6219 Golden Vilest
WILLIAM A JENSEN, SUPT OF BUILDINGLITY Temple City
FOR APPLICANT TO FILL•IN ESS TT. Vdendon Ave,
NUMBER FIXTURE OR ITEM
2 WATER CLOSET OWNER Mr, Ca oraso
MAM
1 BATx TUB ADD BEES 2727 Vanderhoff Dr.
1 BATH TU CITY Vilest Covina TEL. NO. ED- 20586
2 LAVATORY CONTRACTOR Owen Bros. Plumbing
1 SINS ADDRESS 525 N, Baldwin Ave.
DISHWASHER MY El Monte Tm NO. GI- 37644
CONTRACTOR'S STATE l3:
LAUNDRY TUB REGISTRATION NO. 197184 COUNTY ❑
1 CLOTHES WASHER DISTRICIO. GROUP I ZONE I APCESSEDB
Y
1 WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
- P a
0
- z
Casi.•. •. i� ,d O
E-
10
10 Q V.DD PER ITEM 10,00
OR FIXTURE $ I APPROVALS ;—DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBI17
12 OO GAS PIPING /
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
-
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
CEp
LINSED AS REQUIRED BY LOS ANGELES COUNTY-AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY UTILITY CO.NOTIFIE i»o
SIGNATUREJ
OF PERM[TTE FINAL I� I
®P VALIDATION R BERT/A./WOOD,
1 r 1 M.O. CASH UPERVISING MECHANICAL ENG'R
\� �s3461 M4 g 5 A - 12.00 .
• - `%=�T'✓��ii-,ter/
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PERM
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 991209019
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL D: FEES PAID %TE
ING A P.ESSs
ON FILE G W D,EN WESQMeAV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 78
ASSESS NFORM T N MBER: NEAREST CROSS STREET: LONGDEN
5385-021-025 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY
47 WATER HEATER(S) 1.00 WTH 16.20
TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
12/21/99 UT 06/18/00
OWNER: TEL. NO: FINAL DATE Y: CODE:
DON LEROY D JR;HITOMI B (626) 285-1735-
6219 GOLDEN WEST AV
TEMPLE CITY, CA DESCRIPTION OF WOR
CHANGE OUT OF WATER HEATER
APPLICANT: TEL. NO:
A-BUDGET ROOTER (909) 592-5855-
525 W. ALLEN AVE.#1 SPECIAL CONDITIONS:
SAN DIMAS, CA
A NTRACTOROOTER TEL. N334-3533- APPROVALS DATE INSPECTOR SIGNATURE
525 W ALLEN AVE # 1 LIC. NO UNDER SLAB WORK
SAN DIMAS, CA 91773 763519 C36
WATER SERVICE
i PLASTIC Y/N METAL Y/N
ARCHITECT OR GINEER: TEL. NO:
ROUGH PLUMBING
LIC. N0: 1111111
GAS IPING
r— A ENT
UE
L � \��/\1�/ O�K 8 HOT ER HEATER
PLUMv BING FI
O 0
LAWN SPRINKLERS
O O �—� GAS ST
® ®g UTILITY COMPANY NOTIFIE5
0 0cWV<
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508