HomeMy Public PortalAbout5447 MCCULLOCH AVE_Plumbing__ 1 ; '
76A667A (CIE 81713) -4/77 _
'`• APPLICATION FOR PLUMBING PERMIT
2
BUILDI ND SAFETY DIVISI
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING ,/ '
NUMBER FIXTURE OR ITEM @ FEE ADDRESS S 7 7
WATER CLOSET LOCALITY 'TEM t_t C d
1 BATH TUB NEAREST
CROSS ST.
/ SHOWER OWNER ' '&. EIR T M/, S. /1 re
LAVATORY MAIL
DDRESSS7� e llw e A .
SINK CITY T:gg TEL.NO. 35?�
DISHWASHER CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING POOL RECEPTOR
CITY TEL.NO.
LAWN SPRINKLER SYSTEM
STATE _ LIC.
WATER HEATER LICENSE NO. `1QLASS
GAS SYSTEM OUTLETS DISTW NO.. 9RUP 1,7.QN E ESSE BY
OUTLETS OVER �./ `� 3 �I
5 PER SYSTEM INDUSTRIAL v
WASTE APPROVAL
INSPECTION ORD
i W
y
Plan check fee !/
-PLUMBING PERMIT ISSUING FEE$
TOTALFEE
Plan check applicant
v A VALS DATE INSP9CTOR'S SIGNATYd
Name
UNDERUB WORK ' -
Address ROUGH PLUMBING
City Tel.No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE GAS VENT
THATTHE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS. PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I'AM THE GAS TEST
LEGAL OWNER OF.AND 1 D TO RESIDE I THE ABOVE DESCRI ID : %L ...
PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF RERMITT .FINAL �(l+ Z/d
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
748nJUN 5 5 I 22.00A.
78A887-CE#877 4-87 e;Y1� ue
APPLICATION FOR PLUMBI G PERM!;�,
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING lye-e-1
LL®L'
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNED
WATER CLOSET $1.25 MAIL
BATH TUB 1.25 ADDRESS
SHOWER 1.25 CITY IA I TEL.$0.
LAVATORY 1.25 CONTRACTOR
SINK 1.25 ADDRESS
DISHWASHER 1.25 CITY 4 AQ
LAUNDRY TUB 1.25 STATE / LIC
LICENSE NO. � �[ CLASS
CLOTHES WASHER 1.25 'DISTRICT rNO. GR ZONE P O (MEwl)-SGB
WATER HEATER 1.50 ,pVT
GAS SYSTEM--OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 log
INS ION OR p�
CD
O
H
V
y
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE I GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS A ICATION GAS VENT
AND STATE THAT THE A06VF -16 CORRECT AND AGREE TO COMPLY _
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATU — _ A �
OF PER o
FINAL
LIDATION JACK R. ALLEN
CK. M.0. CASH SUPERVISING MECHANICAL ENG'R.
LAGO 3 5 M29 D 3.50-' Aw
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1208020003
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: F88S PAID BUILDING ADDRESS: I
ITR: 13613 IT: 100 I I 5447 MCCULLOCH AV 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:[ TEMP CA 917803516 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I
18573-007-028 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: D3 LOCALITY: TEMPLE CITY, Cl
I07 BATHTUBS/SHOWERS 1.00 FIX 16.20 I I
(TENANT: 125 LAVATORIES/SINKS 2.00 FIX 32.40 ]ISSUED ON: PROCESSED BY: PLAN BY: 1
I 145 WATER CLOSET/URINAL 1.00 FIX 16.20 108/02/12 SR
I TOTAL FEES 92.60 1 I
[OWNER: TEL. NO: I IF DATE FI AL BY: CODE:
1CHIU, YOR YEfi (626) 807-5716- [ ] ����
5447 MCCULLOCH AV
TEMP 917803516 ID SCRIPTION OF WORK ]
IREPLACE BATHTUB, LAVATORIEY WATER CLOSET AND KITCHEN SINK
1 [ [FOR KITCHEN AND BATHROOM REMODEL [
(APPLICANT: TEL. NO:
ISAME AS OWNER _ 1
I I [SPECIAL CONDITIONS:
I 1 [ 1
[CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
ISAME AS OWNER _
ILIC. NO [ (UNDER SLAB WORK I I
IWATER SERVICE I ] I
[PLASTIC YIN METAL YIN [ I
(ARCHITECT OR ENGINEER: TEL. NO:
- I IROUGH PLUMBING
LIC. NO:
[ [ [GAS PIPING
1 I IGAS VENT I I I
[ IHOT WATER HEATER ] I I
[ I IPLUMBING FIXTURES I I I
[ ILAWN SPRINKLERS I I I
[ IGAS TEST I I I
[ [�LITY COMPANY NOTIFIED( [ I
1 [ I I
[ [GRAY WATER SYSTEM [ I
[ I [ I I
I I I I I I
I I I
I I I I I I
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[ IREPORT ID: DPR263 ROUTE TO: BS0508 1 I I I
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