HomeMy Public PortalAbout5508 PERSIMMON AVE_Plumbing__ 76A667 (CE-817)-4/72 ; '„
APPLICATION F04 PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING
ADDRESS 5508 N Persimmon
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
Tem ke City
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST Broadway & .El Monte Ave.
CROSS ST.,. y
NUMBER. FIXTURE OR ITEM ® FEE-` .OWNE �
RA fdanachuk
WATER CLOSET 1.75 MAIL
BATH TUB 1,75
ADDRESS 5508 N Persimmon
SHOWER 1,75 CITY Temple City TEL.NO.
443 2474
LAVATORY 1,75 CONTRACTOR Valley HeatingCo.
SINK 1,75 ADDRESS :JJX 305 E Valley Blvd.
DISHWASHER 1.75 CITY San Gabriel TEL. NO. 288 6812
CLOTHES WASHER 1,75 STATE LIC
SWIMMING POOL RECEPTOR 1,75 LICENSE N0,1478.99 GLASS C 20
DISTRICT NO, GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 1.75 ✓ r
v
WATER HEATER 1,75 INDUSTRIAL
WASTE APPROVAL. CD
' GAS SYSTEM OUTLETS 1.75 1 INSPECTION RECORD 6i
OUTLETS OVER 30
5 PER SYSTEM
W
13
h
Z
Plan cheek fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE 4 7
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant .UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING � r'�
City Tel. No. GAS VENT
HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AN STATE THAT THE ABOVE 1:5 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES 'AND STATE LAWS REGULATING )/T
PLUMBING. GAS TEST -7
1 HEREBY CERTIFY THAT I AM PROPERLY REG R AND/OR UTILITY CO. NOTIFIED v
LICENSED AS REQUIRED BY LOS ANGELES COU Y AND TATE.OF
CALIFORNIA OR THAT I AM LEGAL OWN OF, AND I TEND
RESIDE IN THE ABOVE DES 'BED RESIDENT PROP TY. q
FIN#L �f��'��� � Y✓J�'aL.�
SIGNATURE
OF PERMITTE
PERMIT VALIDATIONcK. M.O. CASH
PLAN CHECK V LIDATION CK. -M.O. CASH
9 07-jUL ,8 .5 0 4.7 5 &
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1303040042
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: I
ITR: 13613 IT: 131 I 1 5508 PERSIMMON AV
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802805
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: FREER I
18573-009-011 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, Cl
107 BATHTUBS/SHOWERS 1.00 FIX 16.20
TENANT: 125 LAVATORIES/SINKS 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLAN BY:
1 I TOTAL FEES 60.20 103/04/13 SR
TOWNER: TEL. NO: I 1FINAL DATE TAT CODE: T
IMANAICHUK ALEXANDER:JEAN M - I
15508 PERSIMMON AV T
ITEMP 917802805 I D CR ION OF WORK
(BATHTUB/SHOWER AND LAVATORIE
(APPLICANT: TEL. NO: T I ]
ISAME AS OWNER - T
I ] ]SPECIAL CONDITIONS:
I I I
1CONTRACTOR: TEL. NO: I ]APPROVALS DATE INSPECTOR SIGNATURE
ISAME AS OWNER -
ILIC. NO I 1UNDER SLAB WORK I I
IWATER SERVICE I I I
T I ]PLASTIC Y/N METAL Y/N I I I
(ARCHITECT OR ENGINEER: TEL. NO:
I LIC. NO: 1 IROUGH PLUMBING T
IGAS PIPING
T I ]GAS VENT I I I
IHOT WATER HEATER I I I
IPLUMBING FIXTURES I I
ILAWN SPRINKLERS I I
IGAS TEST IT-T T
(UTILITY COMPANY NOTIFIED( 1
1 ICWv I I I
(GRAY WATER SYSTEM I I I
] ] I I I I
1 T I ] I
1 I ] I I
] I I I ] I
I I I I
(REPORT ID: DPR263 ROUTE TO: BS0508
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