HomeMy Public PortalAbout6002 LOMA AVE_Plumbing__ 76A667 (CE-817) i/75 - =
APPLICATION FOR"PLUMBING PERMIT
COUNTY OF LOS ANGELES
`DEPARTMENT.OF'COUNTY ENGINEER .
' - BUILDING AND SAFETY DIVISION
- MA KE'CH6CKS PAPA-BLE.,TO: FVIL
DING
DDRESS J� 6;eHARVEY T. BRANDT, COUNTY" ENGINEEROCALITY`"!
FOR APPLICANT TO FILL 1•N IPRINYOR TYPE) NEAREST
CROSST.
NUMBER FIXTURE OR ITEM, @ FEE
'OWNER '
WATER CLOSET - .00 / V IGlY "-..% i
MAIL ,,/ y
'BATH TUB 2. 0 ADDRESS '. (')d- /✓ f SOI Cf,�/ CoOe"
SHOWER 00 CITY > TEL.-NO, .ST
! 0. .C1
LAVATORY .2; - -"CONTRACTOR
WWW SINK" 2. 0, ADDRESS
DISHWASHER CT 2 0 LT�� CITY TEL. NO.
CLOTHES WASHER 2
00 STATE' LIC'.
LICENSE NO. CLASS -
SWIMMING POOL RECEPTOR .00
DISTRICT NO.GROUP[ ZONE OC SED.BY
LAWN SPRINKLER SYSTEM'
.00 QB /
WATER',HEATER 00- ' INDUSTRIAL
WASTE APPROVAL ar,
0
GAS SYSTEM OUTLETS 2. 0 INSPECTION RECORD,
OUTLETS OVER 0 0.
5 PER SYSTEM
O.
Cn
-Plan.check feel See Reverse
PLUMBING PERMIT"ISSUING FEE $ �00
TOTAL'FEEL, -7 IS-. APPROVALS DATE' IN5PEC70R'5 SIGNATURE
Plan.check applicant •UNDER'SLAB WORK'
Name ROUGH PLUMBING ✓
' Address .,
GAS PIPING
City Tel: NO. GAS VENT"
HOT WATER HEATER
IHEREBY-ACKNOWL•EDGE'THAT"I' HAVE_READ-•THIS.APPLICATION'
•AND•STATE THAT THE ABOVE IS,CORRECT AND-AGREE TO COMPLY, PLUMBING FIXTURES. _f, •�/'�
WITH ALL COUNTY :O ORDINANCES ES" SAND STATE LAWS REGULATING , - .�® ; rty
PLUMBING-. GAS TEST '"C4
I" HEREBY,CERTIFY (THAT"I AM PROPERLY, REGISTERED AND/OR- UTILI-fY•CO. NOTIFIED
LICENSED :AS REQUIRED- BY, LOS ANGELES, COUNTY ,AND STASE OF _ - - '. -
CAL FO RN I A.,OR'THAT I AM':THE LEGALW
ONER.O F; AND INTEND TO
RES CDE IN THE ABOVE DESCRIBED-RESI DENT I AL'�PAOP ERTY. „T- •,p' " �.
-,FINAL-
S I.G NATU RE
/OF PERMITT `-• /�--,V`...�-G5^�-'a `�"' C -
cK
INEIIIIIIIIIII PERMIT,V LIDAT10N O CASH
PLAN CHECK VALIDATION 'CK.
M.0. cases ;
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 _RL-UMB'ING'PERMItTJ-4
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS *`P0508,L990_T270023
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 5904 LT: 368 &02'.LOMA AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: t-EMP CA 91.7801925
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
5384-013-006 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H3 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:
01/27/99 UT 01/27/00
OWNER: TEL. NO: FINAL DATE FINAL BY: CODE:
GOOD ROSE M TR (818) 286-5646-
6002 LOMA AV
TEMP 917801925 DESCRIP_T,I;ON_OF.=WORK
CHANGE OUTOF WATER HEATER
APPLICANT: TEL. 0:
MR ROOTER OF PASADENA (626) 445-8203-
25 WHEELER ST. #L SPECIAL CONDITIONS:
ARCADIA, CA
�t4GELES C A
CONTRACTOR: TEL. N0: �S �'VA ` APPROVALS DATE INSPECTOR SIGNATURE
MR ROOTER OF PASADENA (626) 445-8203- �r Y
25 WHEELER #L LIC. NO UNDER SLAB WORK
P 0 BOX 661843 706307 C36
ARCADIA CA 91006 WATER SERVICE
PLASTIC Y/N METAL Y/N
.ARCHITECT OR ENGINEER: TEL. NO:
ROUGH PLUMBING
LIC. N0� 1111111 GAS PIPING
j� GAS VENT
if-' L C WOR
R K 61 HOT WATER HEATER
PLUMBING FIXTURES
Illi LAWN SPRINKLERS
" U L GAS TEST
a . y UTILITY COMPANY NOTIFIED
CWV
Ct` erviCe
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508