HomeMy Public PortalAbout9122 HERMOSA DR_Plumbing__ 76A667PMEA517BI 11/76 (`y / ✓ 11 .
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POLICY NUMBER, BUILD ING AND.SAFETY DIVISION
FOR APPL ICANT TO FILL IN(PRINT OR TYPE) BUILDING �
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NUMBER FIXTURE OR ITEM ® FEE ADDRESS
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST.
SHOWER 3 Li O OWNER
LAVATORY MAIL
O ADDRESS v
SINK CITY TEL.NO.
DISHWASHER
CONTRALTO
CLOTHES WASHERp �.i"
ADDRES , _
SWIMMING POOL RECEPTOR 16 —
GAS
YLAWN SPRINKLERSYSTEM
STATE / LIC.WATER HEATER LICENSE O. (p CLASSYSTEM � OUTLETS 0DISTRICT NO. GRTOUP ZON RO SEBY
OUTLETS OVERv ._C.�
5 PER SYSTEM INDUSTRIAL d
WASTE APPROVAL O
INSPECTION RECORD V
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Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check applicant
APPROVALS DATE R'S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel.No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY W ITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE GAS TEST 3
LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. l UTILITYCO,NOTIFIED
SIGNATURE
OFPERMITTEE �,/ FINAL
PLAN CHECK VALIDATION CK. M.O. CASH. PERMIT VALIDATIO CK. WO. CASH
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TB^BST APPLICATION FOR PLUMBING PERMIT 1
DEBIT 8 DO
AND SAFETY DIVISION
Department of County Engineer
County of Los Angeles BUILDING
JOHN A. LAMBIE.COUNTY ENGINEER ADDRESS i
CASSATT D.GRIFFIN.SUPT OF BUILDING /J
LOCALITY G
FOR,APPLI TO FILL IN NEAREST
CP.OBS ST.
OWNER DISTRICT NO. GROUP Z/py)NE READY FOR INSPECTION
MAIL
ADDRESS
INDUSTRIAL
CITY
TEL. NO. W.SSTEAPPROVAL
PLUMBER _ INSPECTION RECORD
ADDRESS Z
CITY
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ S1.00 S
BATH TUB @ $1.00
SHOWER @ $1.00
T
LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ $1.00
DISHWASHER @ $1.00
LAUNDRY TUSORTRAY @ $1.00
CLOTHESWASHER @ S1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL C NR OF THE, ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERT
SIGNATURE
OFPFINAL r/ n Nhor 11'A '
ROBERT A.WOOD'.
JOHN A. LAMBIE. COUNTY ENGINEER VALIDATION SUPERVISING MECHANICAL ENG'R
CX:i M.p, CASH
o.l 2 3 0 V AUG 1.6 3 2.0 0 'n
COUNTY OF LOS ANGELES TEMPLE CITY _ k 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0506 0505190017
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: - FEES PAID BUILDING ADDRESS:
TR: 5905 LT: 84 9122 HERMOSA DR
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801918
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LOM
5387-016-030 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 LOCALITY: ,TEMPLE CITY, C
07 BATHTUBS/SHOWERS 1.00 FIX 16.20
TENANT: 11 CLOTHESWASHER(S) 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
21 HOSE BIBB(S) 2.00 FIX 32.40 05/19/05 JK 11/15/05
25 LAVATORIES/SINKS 1.00 FIX 16.20
OWNER: TEL. NO: 45 WATER CLOSET/URINAL 1.00 FIX 16.20 FI AL DATE FINAL BY: CODE:
SHEN, PATRICIA (626) 757-5536– 47 WATER HEATER(5) 1.00 WTH 16.20 .
9122 HERMOSA DR 51 LOW PER GAS 5 OUTLET 1.00 SYS 16.20
TEMP 917801918 TOTAL FEES 157.35 DESCRIPTION OF WORK �(J�Sr
PLUMBING FOR NEW SOD3T N 01A.r—
APPLICANT: TEL. NO:
LIN (909) 946-5789-
1746 N. EUCLID AVE SPECIAL CONDITIONS:
UPLAND, CA 91784
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
PAUL LIN CONSTRUCTION CO. (909) 946-5789-
1746 N. EUCLID AVENUE LIC. NO UNDER SLAB WORK
UPLAND, CA 91784 420907B
WATER SERVICE
PLASTIC YIN METAL YIN
ARCHITECT OR ENGINEER: TEL. NO:
SENT WE ARCHITECT (626) 966-4975– ROUGH PLUMBING
1274 E. CENTER COURT LIC. NO: e �—
STE. 211 NONE GAS PIPING
COVINA, CA 91724
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
(7A PR
UTILITY COMPANY NOTIFIED
CWV
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508