HomeMy Public PortalAbout6466 LOMA AVE_Plumbing__ 76A667C (CE-8178) -975
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS �p (? �J ,• G_(`f A�P-
WATER CLOSET LOCALITY
NEAREST
BATH TUB CROSS ST. LJ
SHOWER OWNERMAIL
��/L G ! �� �✓�
LAVATORYADDRESS LG7 +` -� Ld.•�•� l`T
SINKCITY TEL. NO,2,pf- JO,?D
DISHWASHER CONTRACTOR
C� aj ao � S.
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR CITY 2 Q�,[7i� TEL. NO.If �- l� Z-
LAWN SPRINKLER SYSTEM
WATER HEATER L CENSE NO� T CSTATE ILAS 3 CD
DISTRICT NORO Z U
PR CE ED BY
GAS SYSTEM OUTLETS � G e)OUTLETS OVER CK � o '( 4 C:)
5 PER SYSTEM INDUSTRIAL '
rp w
Ofl A T �. WASTE APPROVAL Z
c�7
INSPECTION R RD
Plan check.fee
PLUMBING PERMIT ISSUING FEE S L�
TOTAL FEE
Plan check applicant
Name C� APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address S Gly ROUGH PLUMBING
City Tel. No. ^ GAS'PIPING
I 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 HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS R ullre B NGELES COUNTY AND STATE OF ;
CALIFORNIA OR AT I AM THE •L L O ER OF, AND INTEND TO 'GAS TEST / 'I°,..�f�'" Z/'�/"' �✓, +�*=c__,__.
RESIDE IN THE AB E DESCRIBED RESI L PROPERTY` UTILITY CO. NOTIFIED
SIGNATU RE
OF PERMITTEE P FINAL ®7-7? 8 ,
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDA I N M,0: CASH
z
1.a 5`rs P s3 1::'3.5L d
76A667 (CE-817)-4/72 S
APPLICATIO FOR P MBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: FADDRESS
VQ�
HARVEY T. BRANDT, COUNTY ENGINEER FOR APPLICANT TO FILL IN (PRINT OR TYPE) /
NUMBER FIXTURE OR ITEM @ FEE .
OWNER
WATER CLOSET 1.75 173
MAIL
BATH TUB 1.75 ADDRESS
SHOWER 1.75 CITY. TEL. NO.
LAVATORY 1.75 CONTRACTOR f r r-
SINK 1.75 ADDRESS 1
DISHWASHER 1.75 CITYTEL. NO.
CLOTHES WASHER 1.75 STATELIC
LICENSE NO. �y O CLASS
SWIMMING POOL RECEPTOR 1.75
DISTRICT Na I GROUP JZQIE PROC SSED Y
LAWN SPRINKLER SYSTEM 1.75
WATER HEATER 1.75 I/ �J
INDUSTRIAL
fi -5 WASTE APPROVAL
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD
OUTLETS OVER
5 PER SYSTEM .30 p
H
U
W
G.
y
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INS PEC R'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING 7
Address GAS PIPING
City
Tel. NO. GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
PWITH LUMB NGL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICNSED CALEFORNI AAS REQU OR THAIT EID AMAND STATE OF
THES LEGALL OWNEANGESOR OFY AND INTEND TO � W� 1
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PR ERTY. FINAL
SIGNATURE T
OF PERMITTEE -
PERMIT VALIDATION • M.0. CASH
PLAN CHECK VALIDATION CK. M.D. CASH
o eR e s o 1 1.7 5 Ay8,
�' v p
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0105240068
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 5904 LT: 274 6266 LOMA AV
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917801634
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN
5384-011-010 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY
51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20
TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
05/24/01 UT 11/20/01
OWNER: TEL. NO: FINAL D TE F Y: CODE:
BESSER PHYLLIS M TRUSTEE (818) 285-8872- c v
6266 LOMA AV i7
TEMP 917801634 DESCRIPTION OF WO
NEW HVAC SYSTEM
APPLICANT: TEL. NO:
AIR TECH HEATING AND AIR (626) 795-8880-
204 S. ROSEMEAD BL SPECIAL CONDITIONS:
PASADENA CA
CONTRACTOR: TEL. NO: /���� 'p, APPROVALS DATE INSPECTOR SIGNATURE
AIR TECH HEATING AND AIR CONDITIONI (626) 795-8880- n
204 S ROSEMEAD BLVD LIC. NO % / p; „^ �� `; UNDER SLAB WORK
PASADENA, CA 91107 541161/C20
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TEL. N0: ��� � �' �•� '" � V'�':
ROUGH PLUMBING
LIC. NO:r' r ( ��� i I I � j - �,'•
GAS PIPING
---- - ------- - - — —- --— GAS VENT
HOT WATER HEATER
- -- --- PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
i
UTILITY COMPANY NOTIFIED
CWV
GRAY WATER SYSTEM
r
REPORT ID: DPR263 ROUTE TO: BS0508