HomeMy Public PortalAbout4912 CLOVERLY AVE_Plumbing__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0701290017
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
ITR 11454 LT 20 4912 CLOVERLY AV
IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803810
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET
18590-020-001 101 PERMIT ISSUANCE FEE 27 75 1- THOMAS PAGE 596 GRID J5 LOCALITY TEMPLE CITY, Cl
1 107 BATHTUBS/SHOWERS 1 00 FIX 16 20 I
ITENANT 125 LAVATORIES/SINKS 1 00 FIX 16 20 (ISSUED ON PROCESSED BY PLAN BY EXPIRES ON 1
I 145 WATER CLOSET/URINAL 1 00 FIX 16 20 102/21/07 JK 08/20/07 I
TOTAL FEES 76 35 1
(OWNER TEL NO I IFINAL DATE FIN 'CODE I
ICHIANG, TOM _ (626) 378-1126- I
14912 CLOVERLY AV 1 l 1
ITEMP 917803810 I 1D SCRIP ION OF WORK 1
1 I IPLUMBING FOR NEW BATHROOM
(APPLICANT TEL NO 1 1 I
IMO (626) 202-6548-
1515 S PALM AVE 47 I ISPECIAL CONDITIONS I
ALHAMBRA, CA 91803 I I
(CONTRACTOR TEL NO 1 (APPROVALS DATE INSPECTOR SIGNATURE
ICHIANG, TOM (626) 378-1126- 1 1
14912 CLOVERLY AVENUE LIC NO I (UNDER SLAB WORK I 1
ITEMPLE CITY, CA 91780 NONE I I 1 I 1
I IWATER SERVICE 1 I 1
I 1 (PLASTIC YIN METAL YIN 1
JARCHITECT OR ENGINEER TEL NO II
1LIULIU, TIENKUANG (626) 279-2865- TROUGH PLUMBING
14852 RIO HONDO AVE LIC NO 1 I
ITEMPLE CITY CA 91780 C040889 1 IGAS PIPING
I r I IGAS VENT 1 1
IHOT WATER HEATER I 1
1 IPLUMBING FIXTURES
I 1 ILAWN SPRINKLERS I 1
1 I IGAS TEST 1
I (UTILITY COMPANY NOTIFIEDI I
CWV
I I
(GRAY WATER SYSTEM
I I I I I I
I I I I I I
IREPORT ID DPR263 ROUTE TO BS0508 I 1 1
I I I I I I
76;667-C°E817 3-594 ,
APPLICATION F"OR"PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
IOHN A LAMBIE, County En eer ADDRESS ��
CA D GRIFFIN Sup t of Bmldinq LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
sxowER CITY TEL NO j aj Q f
LAVATORYle- CONTRACTOR
sum vADDRESS/ /13 yy IF
DISHWASHER CITY (� �'O� TEL NO A/ 417.>4k
CONTRACTOR S 7 y'�L L COUNTY
LAUNDRY TUB REGISTRATION NO El
CLOTHES WASHER DISTRICT NO GR NE
IA PR CESSED BY
WATER HEATER VJ I
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
f 0 $1 00 PER ITEM /
OR FIXTURE $ APPROVALS ..DATE INSPECTOR S SIGNATURE
PERMIT $ I $0 UNDER SLAB WORK ;-
TOTAL FEE ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ^
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT ;
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA-OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENT PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF-PERMITTEE
FINAL
®� VALIDATION ROBERT A WOOD,
CK m o CASH SUPERVISING MECHANICAL.ENG R
-9 2S JM 15 5 A ' 3.0,0