HomeMy Public PortalAbout5803 PRIMROSE AVE_Plumbing__ 7GA667A
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APPLICAT0WtFOR PLUMBING PERMiT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR?YPE) BUILDING Q�
NUMBER FIXTURE OR ITEM FEE ADDRESS a C .
LOCALITY ��, Irr
WATER CLOSET
NEAREST
BATH TUB CROSS ST.
SHOWER OWNER A
LAVATORY MAIL
ADDRESS • QBE %!')Rv a t'
SINK CITY 4 e-L� TEL.NqX
DISHWASHER CONTRACTOR Lpn,��. �/�U)��
CLOTHES WASHER ADDRESS d y Li Ili it �/'/�,
SWIMMING POOL RECEPTOR QA•� /
CITY /�(�, TEL.NO.
LAWN SPRINKLER SYSTEM
STATE /}�1(J�41� CLASS
WATER HEATER LICENSE NO fJfj.,v
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S'SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING.FIXTURES
GAS TEST
Plan check fee UTILITY CO.NOTIFIED
PLUMBING PERMIT ISSUING FEE$ �' o
TOTAL FEE FINAL
Plan check applicant PLAN CHECK VALIDATION
Name
Address N C,
City Tel.No.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 2�] L 6 L. A
A
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION J] v V
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS i1 O O O 0 O 5
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE
LEGAL OWNER OF.AND INTEND TO RESIDE IN TJIE ABOVE DE RIBED RESIDENTIAL
PROPERTY. 2 0 - 10.00
SIGNATURE 0 0 0 1 000V
OF PERM IIIJ-ft4W ,
DISTRICT NO. O ESSED BY 0222-79
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INDUSTRIAL
WASTE APPROVAL
COUNTY OF LOS.AIQGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1109190007
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: I FEES PAID I BUILDING ADDRESS: I
TR: 6561 LT: 663 1 5803 PRIMROSE AV I
IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:( TEMP CA 917802115 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: WORKMAN
18587-012-001 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl
I 125 LAVATORIES/SINKS 1.00 FIX 16.30 1
ITENANT: I TOTAL FEES 44.10 11SSUED ON: PROCESSED BY: PLAN BY: ]
[ 1 109/19/11 SR [
OWNER: TEL. NO: I (FINAL DATE FINAL BY: CODE:
1WHITLOCK VERA E TRUSTEE (573) 651-1877- I 1 rzen
12145 BELLERIDGE PIKE I 1 ��
1CAPE GIRARDAEU MO I IDESCRIPTION OF WORK v1
I I IREPLACE KITCHEN SINK
(APPLICANT: TEL. NO: I I I
DAN & SANDY PROVINES (909) 418-7174- I 1 1
[SPECIAL CONDITIONS: I
I I
I I I
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1
(DANNY AND SANDY PROVINES (909) 418-7174- [ 1 1
LIC. NO I ]UNDER SLAB WORK I I I
NONE 1
I [ IWATER SERVICE 1 I [
[ [ IPLASTIC YIN METAL YIN 1 [ I
(ARCHITECT OR ENGINEER: TEL. NO: I I I I
[ - [ IROUGH PLUMBING [ [
LIC. N0:
1 IGAS PIPING 1 [
] 1 [GAS VENT 1 I 1
I ] I I I I
I I IHOT WATER HEATER
I I I I I I
[ [ [PLUMBING FIXTURES I ] ]
I I ] I ] I
1 I ILAWN SPRINKLERS I [ 1
I I I I I I
1 [ IGAS TEST 1 I I
I [ I ] I 1
I 1 [UTILITY COMPANY NOTIFIEDI I I
I I 1 1-1 1
I I 1CWV I I I
I I I I I I
I I ]GRAY WATER SYSTEM [ I I
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I IREPORT ID: DPR263 ROUTE TO: BS0508 1 1 [ [
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