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HomeMy WebLinkAbout814 (3).f 07 7. PLUMBING PERMIT APPLICATION City of Hermosa Beach - Community Development Department Each Plumbing Fixture, Trap or Set of Fixtures on One Trap (Including Water, Drain Piping and Backflow Protection) $ 22 QTY AMOUNT 1. Building Sewer 2. Trailer Park Sewer 3. Rainwater System - Per Drain (Inside Building) 4. Water HeaterNent 5. Gas Piping Outlets (Enter No. of Outlets): a) 1-5 Outlets, Total Fee b) Over 5 (Per Outlet) $ 43 $ 43 $ 22 $ 22 2. $ 33 Total $ 7 Each Industrial Waste Pretreatment 1. Interceptor, Including Trap and Vent 2. Undersink Trap *0114 „1N.. . $ 54. $ 33 �. . Each Installation, Alteration or Repair of Water System (Piping Equipment or Repipe). Total Re -pipe = Main + No. of Fixtures $ 11 Each Repair or Alteration of Drainage or Vent Piping $ 11 Each Lawn Sprinkler System on any One Meter (Including Backflow Protection Devices) $ 22 Atmospheric-Typ-3 Vacuum Breakers (Not Included in Above Item) a. 1-5, Total Fee b. Over 5 (Per Breaker) $ 22 Total $ 7 Each Each Backflow Protective Device (Other Than Atmospheric -Type Vacuum Breakers): a. 2 Inches and Smaller b. Over 2 Inches $ 22 Each $ 22 Each 1. Fire Sprinkler Piping System a. 1-10 Heads b. 11-25 Heads c. 26-50 Heads d. 51-100 Heads e. 101-200 Heads f. 201- 300 Heads g. 301-500 Heads h. 501-1000 Heads i. 1001 or More Heads 2. Sprinkler Riser Pipe $ 22 Plus $ 37 $ 61 $ 86 $133 $184 $234 $306, $459 $660 $ 11 Each Miscellaneous $ 33 Supplemental Permit Fee $ 17 Issuance Fee $ 59 TOTAL FEE *PLEASE CONTACT THE PUBLIC WORKS DEPARTMENT AT (310) 318-0214 IF JOB ADDRESS: 81 9- Oc-,, ) Dfilm -4 ✓S g0 25-Y JOB DE��CRIPTION: \�.g� C-4 /I6.442 Q pL4�th aIJ 5 Att /L PROPERTY OWNER(S) NAME: U/A�✓✓z OLso,�% ADDRESS: /� /J J /J 8 t 4 ©C Y2 4N /J CITY, STATE, ZIP: ,*,tc5.1 cA 9o26 -j PHONE: 3/0 33-(r o 2G3 PLUMBING pONTRACTOr3.: PLUAz ')Cc %IS/r4CL✓z2S` EMAIL ADDRESS: ADDRESS riaf Q S ^ /3 (3o SA o), 51:445- /. CITY, STATE, ZIP: /)1 /10 14-90 0 9(6 OO P8(/ 9?2 6 9-5-2, BUSINESS LICENSE NO.: STATE LICENSE NO.: TYPE OF BUILDING: NO. OF STORIES: NO. OF METERS: NO. OF FAMILIES: DATE ISSUED: `n' c ISSUED BY: PERMIT NO.: WORK IS GOING TO BE DONE IN THE PUBLIC RIGHT OF WAY (SIDEWALK OR STREET). I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. No person shall be allowed to perform work under this permit in violation of the labor code of the State of California. I further state that I am properly licensed as required by Section 7031.5 of the State Business and Professional Code (or claim exemption under Section 7044). Signature of Contractor Signature of Owner (If Owner/Builder) F:b95/cd/forms-handouts/application/plumbing 9-1-11 Revised 10/3/11