HomeMy WebLinkAbout132 (2)From:
05/13/2014 11:32
PLUMBING PERMIT APPLICATION
City of Hermosa Beach - Community Development Department
#760 P.005/021
695199
NEW DEVELOPMENT/ADDITION/REMODEL
JOB ADDRESS:
132 35 PL
PLUMBING FIXTURE, TRAP OR SET OF
FIXTURE ON ONE TRAP (INCLUDING WATER
AND DRAIN PIPING AND BACKFLOW
PROTECTION)
$ 17
Q'TY
AMOUNT
PROPERTY OWNER(S) NAME:
THOMAS, STACEY
1. BUILDING SEWER
$ 5Z
2. TRAILER PARK SEWER
$ 52
ADDRESS:
PARK ON MANHATTAN AV[
3. RAINWATER SYSTEM - PER DRAIN (INSIDE
$ 17
"—
„...BUILDING:) --- ---y_��
ATER HEATERNENT).
$ 22
4V
CITY, STATE, ZIP:
NEEDS 1ST SPOT,
_>lGi�,S PIPING: a) 1-5 OUTLETS, Total Fee
$ 22 total
b) OVER 5 (per outlet)
$ 3 each
`
3 3
PHONE:
(310)344-9028
INDUSTRIAL WASTE PRE1REATMENT
INTERCEPTOR, (INCLUDING TRAP AND VENT,
AND KITCHEN -TYPE GREASE INTERCEPTORS)
$ 41
PLUMBING CONTRACTOR:
FAST WATER HEATER COMPAN
EXISTING DEVELOPMENT
EACH INSTALLATION, ALTERATION OR REPAIR
OF WATER SYSTEM (PIPING EQUIPMENT OR
REPIPE)
$ 9
ADDRESS:
11715 N. CREEK PKY. S., SI
EACH REPAIR OR ALTERATION OF DRAINAGE
OR VENT PIPING
$ 9
CITY, STATE, ZIP:
BOTHELL, WA 98011
EACH LAWN SPRINKLER SYS. ON ANY ONE
METER, (INCLUDING BACKFLOW PROTECTION
DEVICES)
$ 29
PHONE:
425-636-7054
BUSINESS LICENSE NO.:
01130127
ATMOSPHERIC -TYPE VACUUM BREAKERS
(NOT INCLUDED IN ABOVE ITEM)
A. 1-5, Total Fee
$ n total
ST1 S
.cIC F IX
3 ll»
8. OVER 5 (per breaker)
$ 3 each :
EACH BACKFLOW PROTECTIVE DEVICE
OTHER THAN ATMOSPHERIC -TYPE VACUUM
BREAKERS:
1. 2 INCHES AND SMALLER
TYPE OF BUILDING:
#3n -
V/ Z
NO. OF STORIES:
2. OVER 2 INCHES
$ 52
NO. OF METERS:
FIRE SPRINKLER PIPING SYSTEM
A. 1-10 HEADS
B. 11-25 HEADS
$ 22 plus
L1
$ 61
NO. OF FAMILIES:
C. 26-50 HEADS
L. 8
NEW DEVELOPMENT:
D. 51-100 HEADS
.
$ 133,
E. 101-200 HEADS
$ 184
EXISTING DEVELOPMENT:
F. 201- 300 HEADS
$ 234
G. 301-500 HEADS
$ 306
DATE ISSUED:
5--29—/ Lk
H. 501-1000 HEADS
$ 459
I. 1001 OR MORE HEADS
$ 660
ISSUED BY:
NT
MISCELLANEOUS
SUPPLEMENTAL PERMIT FEE
$ 14PERMIT
NO.:
f .1 ��
ISSUANCE FEE
$ 52
/
�j-D
TOTAL FEE
/ /
Y
I HEREBY CERTIFY THAT 1 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 1 AM
PROPERLY LICENSED AS REQUIRED BY SECTION 7031.5 OF THE STATE BUSINESS AND PROFESSIONAL CODE (OR
CLAIM EXEMPT • UNDER SEC O 044).
SAW&J 'Vt.-VAN
• CTOR „ SIGNATURE OF OWNER (IF OWNER BUILDER)
SIGNATUR •F
ove ? CZ-t21ac--r
jct, \r -co L -A-vtvd-csS
\4-t cam, / vv‘ soviet& lG C kt tAi•
as ems! J /1-1 , -
F:b95/cd/applicaUon/plumbing - 911/2008.t