HomeMy WebLinkAbout1246 (3)PLUMBING PERMIT APPLICATION
City of Hermosa Beach - Community Development Department
I hereby certify that I have
laws and ordinances gove
allowed to perform work
properly licensed as req
Section 7044).
ad and examined this application and know the same to be true and correct. All provisions of
ng this type of work will be complied with whether specified herein or not. No person shall be
der this permit in violation of the labor code of the State of California. I further state that I am
d by Section 7031.5 of the State Business and Professional Code (or claim exemption under
Signature of Contractor
Signature of Owner (If Owner/Builder)
f... \application\plumbing 9/1/13.xlsx rev 8/31/13
QTY
Amount
JOB ADDRESS:
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Each Plumbing Fixture, Trap or Set of Fixtures
on One Trap (including Water, Drain Piping and
Backflow Protection)
$22
JOB DESCRIPTION:
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1. Building Sewer
2. Trailer Park Sewer
3. RainwaterSystem - Per Drain (Inside Building)
4. Water Heater/Vent
5. Gas Piping Outlets (Enter No. of Outlets):
a. 1-5 Outlets, Total Fee
b. Over 5 (Per Outlet)
$43
$43
$22
$22
$33 Total
$7 Each
PROPERTY OWNER(S) NAME:
Industrial Waste Pretreatment
1. Interceptor, Including Trap and Vent
2. Undersink Grease Trap
$55
ADDRESS:
$33
Each Installation, Alteration or Repair of Water
System (Piping Equipment or Repipe).
Total Repipe = Main + No. of Fixtures
$11
CITY, STATE, ZIP:
Each Repair or Alteration of Drainage or Vent
Piping
$11
PHONE:
Each Lawn Sprinkler System on any One Meter
(Including Backflow Protection Devices)
$22
PLUMBING CONTRACTOR:
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Atmospheric -Type Vacuum Breakers
(Not included in Above item)
a. 1-5, Total Fee
b. Over 5 (Per Breaker)
$22 Total
$7 Each
EMAIL ADD ESS•
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ADDRESS:
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Each Backflow Protective Device , Other
Atmospheric -Type Vacuum Breakers):
a. 2 Inches and Smaller
b. Over 2 Inches
$22 Each
CITY, STATE, ZIP:
{� e,
$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
PHONE:
S55 _ 561'-c3c1
$62
$87
SI-
BUSINESS LICENSE NO:
$134
$186
STATE LICENSE NO:
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$236
$309
TYPE OF BUILDING` %