HomeMy Public PortalAbout6430 TEMPLE CITY BLVD_Plumbing__ 63
TawaeT•cE"elT 'APPLICATION FOR PLUMBING PER IT
COUNTY OF LOS MENT ANGELES
DEPARTOF COUNTY ENGINEER
HIIIkDINGL�IN IESAFETY DIVISION 7AMUMMsame
JO N A MBI COUNTY ENGINEER 61130 N. Ta=ip City l3lycl
• WILLIAM A JENSEN SUP T OF BUILDING FOE APPLICANT TO FILL R1 S.
BY
RAYNUMBER FIXTURE OR ITEM EACH FEEWATER CLOSET 51 u son
BATH TUB 145
SHOWER 115 CITY TEL NO 8
LAVATORY 145 CONTBACTOB
Baa 125 ADDRESS 10920 E. Grand
DISHWASHER 125 1 City TEL NO —12 (J[
LAUNDRY TUB 1 15 REGISTRATION NO 211898 COUNTY ❑
CLOTHES WARNER 145 FA"PPROVAL
GROUP NE SSED BY
WATER HEATER 15O 1 0 -OAR SYSTEMOUTLETS 156 a 0
OUTLETS OVER 5 PER SYSTEM 40SPECTION BEGGED V
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APPROVALS DATE IN[KCTOR 8 SIGMATURE
PERMIT f 2 00 UNDER BLAB WORK
ROUGH PLUMBING
TOTAL FEE 0 GAS PIPING
I HER[[Y AC[NOWL[OOE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND
[TAT[ THAT THE ABOVE 1[ CORRECT ANO APRT[ TO COMPLY
WITH ALL COUNTY ORDINANCES AND [TAT[ LAW[ REGULATING
PLUMING HOT WATER HEATER
1 HERESY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR PLUMBING FIXTURES
LICENSED AS MQUIR[O BY LOS ANGELES COUNTY ANO [TAT[ OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AMG INTEND TO
RESIDE IN THE AGaV[D[ RI[[D R[nG[Ni1AL PERr UTILITY CO NOTIFIED
SIGNATURE �^
OF PERMITTEE
FINAL -
AMATION ROBERT A WOOD
CK M D CASH SUPERVISING MECHANICAL ENG R
LALO 3 2 0 l b DEC 5 5 D 3-50-
OE917 APPLICATION FOR PLUMBING PERMIT y
DOE
1T IRDMSION OF BUUMM AND SAFETY ,
DmIxrtmeet of County EnytaNr
County of Lot Angel" BUILDING `
WM J FOX COUNTY ENGINEER ADDRESS G�caO o�pT.+.�.lA.
CAteATT D ORIPFIN Sun T on GUILOING r
LOCALITY �4
FOR APPLICANT TO FILL RY NEAREST
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OWNER DISTRICT NO 6ROUp �ryfi E[eor FOR INSPECTION
MAIL .J4/ l�/�� I
ADDRESS 00 �S_/�
1 a INDUSTRIAL
1 QTI/YlaYtIJ QQ T WASTE APPROVAL
PLUMBER 4i.E.T/ INSPECTION RECORD
ADDRESS G/
CITY TEL NO .e -i/2
LICENSE NO / 4-3 F
NDNe" TYP[On FIXTURr OR ITFN rt[
WATER CLOSET (TOILET) s
IF BATH TUB
SHOWER _
LAVATORY (WASH BASIN) _
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTA NO
080 0 APPROVALS
/ DATE INSPECTOR 8 SIGNATURE
_GAB SYSTEu OUTLETS ® 100 / 00
WATER HEATER 1 00 / 00 UNDER SLAB WORK
ROUGH PLUMBING �1
PERMIT t 1 00 OAS PIPING
TOTAL FEE 00 GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FGIXTURES
PLUMBINGHEREBY
GAB TEST 1 ANT
I HEflEBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF UTILITY CO NOTIFIED
CALIFORNIA SI THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY
SIGNATURE ( _
OF PERMITTEE FINAL
WILLIAM J FOX.COUNTY ENGINEER VALIDATION
;T,1 9 5 21, 'W25 3 700
BY
y O i DEPUTY
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 IAS TUNAS PL 0508 1201120003
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ON FILE U�Q,e ZT'EMPLE CITY BL
PEE DESCRIPTION QUANTITY UOM AMOONT TEMPCA 917801436
A95ESSOR INFORMATION NUMBER I INEAREST
EST CROSS STREET
5383-013-017 101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 596 GRID S1 LOCALITY TEMPLE CITY, C
I 163 WATER PIPING BR/FIX 1 00 FIX 6 70 1
1 TENANT TOTAL FEES 34 50 11SSUED ON PROCESSED BY PIAN BY
101/12/12 SR
10WNER TEL NO IFINAL DATE FIljkL Jay CODE
1GRBAVAC DRAGO _ I
16424 TEMPLE CITY BL
1TEMP 917801436 I IDE CRIPTION OF WORK Y
REPLACE ONE PLUMBING FIXTURE
I I
1APPLICANT TEL NO
1NIKOS CONSTRUCTION INC (818) 845-0126- 1
SPECIAL CONDITIONS
CONTRACTOR TEL NO 1 APPROVALS DATE INSPECTOR SIGNATURE
NIKO'S CONSTRUCTION INC (310) 365-5244- 1
13821 W CLARK LIC NO 1 UNDER SLAB WORK
BURBANK, CA 91505 924392
WATER SERVICE
PLASTIC Y/N METAL YIN
ARCHITECT OR ENGINEER TEL NO
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LIC NO I IRO[KiN PLUMBIMG
fGAS PIPING
I I LGA$ VENT
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HOT WATER HEATER I I
IPLUMBING FIXTURES
LAWN SPRINKLERS
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IGAS TEST
fUTILITY COMPANY NOTIFIEDI
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(REPORT ID DPR263 ROUTE TO BS0508
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