HomeMy Public PortalAbout9521 PENTLAND ST_Plumbing__ 76AS67c (ce-61713) -e/76 & // O , �y ,
a� APPLICATION(/FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
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FBA
LICANT TO FILL IN (PRINT OR TY PEI BUILDING
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FIXTURE OR ITEM FEE
CLOSET LOCALITY E pGc C' T
UB NEAREST
CROSS ST
R OWNER
ORY - MAIL ^'Y L D
ADDRESS O77
CI g/&jrL t' �r TEL NO
SHER CONTRACTOR
ES WASHER
ADDRESS
NG POOL RECEPTORCITY TEL NO
PRINKLER SYSTEM
STATE LIC
WATER HEATER LICENSE NO CLASS
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DISTRICT NO I GROUP IZONE Pq0 SED BY U
GAS SYSTEM OUTLETS r
OUTLETS OVER D J v� �"� CD
5 PER SYSTEM INDUSTRIAL W
WASTE APPROVAL
INSPECTION RECORD Z,- 2<
Plan check fee
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LUMBING PERMIT ISSUING FEE S
TOTAL FEE 7 "v
check applicant
APPROVALS DATE INSPECTOR s SIGNATURE
UNDER SLAB WORK
ess
ROUGH PLUMBING
Tel NO GAS PIPING
ERE BY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
TATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
ALL COUNTY OROINANC ES AND STATE LAWS REGULATING HOT WATER HEATER
ING
EREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR PLUMBING FIXTURES
ED AS REQU I REO BY LO
5 ANGELES COUNTY AND STATE OF GAS TEST
RNIA OR THAT 1 AM THE LEGAL OWNER OF AND NTENO TO
E IN THE ABOVE 0 BED ESIDENT L OP RT UTILITY CO NOTIFIED
ATURE �l
PERMITTE FINAL
PLAN CHECK VALIDATION CK M o k1ASH PERMIT VALIDATION cK M 0 CASH
NAPR.Z9 5 i b 750 A5d
COUNTY OF LAS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9901 LAS TUNAS PL 0508 0903310010
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID - FEES PAID BUILDING ADDRESS 1
TR 14572 LT 309521 PENTLAND ST
IEEE DESCRIPTION QUANTITY DOM AMOUNT TEMP CA 917803B45
(ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 1
18590-007-019 101 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY CI
1 107 BATHTUBS/SHOWERS 3 00 FIX 49 60
1TENANT 13 DISHWASHERS) 1 00 FIX 16 20 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 1
1 125 LAVATORIES/SINKS 4 00 FIX 64 80 103/31/09 SR 09/27/09 I
1 45 WATER CLOSET/URINAL 2 00 FIX 32 40 1
10WNER TEL NO TOTAL FEES 189 75 FINAL DATE FINAL BY CODE
1LIN, XUANDONG (626) 589-8298-
9521 PENTLAND ST
TEMP 919803845 DESCATPTION OF WORK I
PLUMBIGN FOR KITCHEN AND 2 BATHROOMS REMODEL
APPLICANT TEL NO I
SAME AS OWNER -
ISPECIAL CONDITIONS
I I I
CONTRACTOR TEL NO
_ (APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC NO
I
UNDER SLAB WORX
(WATER SERVICE
I IPLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER TEL NO
IROUGH PLUMBING
LIC NO
1GAS PIPING
(GAS VENT
114OT WATER HEATER
I I
PLDMBIMG FIXTURES
_ I I I
I (LAWN SPRINXLERS
IGAS TEST
UTILITY COMPANY NOTIFIED
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CWV
(GRAY WATER SYSTEM
I I
I I II I I I
1 1 I I I
I I 1 I I I
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I I I
IREPORT ID DPR263 ROUTE TO 9S050B
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