HomeMy Public PortalAbout5327 CLOVERLY AVE_Plumbing__ 76A667 .CER817 5/63
" APPLICATION FOR PLUM ING PERMIT
COUNTY OF LOS ANGELES q Q
DEPARTMENT OF COUNTY ENGINEER ADDRESS Com. ��l/(
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER �/
WILLIAM A JENSEN SUPT OF BUILDING LOCALITY �/
FOR APPLICANT TO FILL IN NEAREST
CROSS ST / L
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 3125 MAIL
BATH TUB 125 -� ADDRESS
SHOWER 125 ; CITY TEL NO
LAVATORY 125 /�
CONTRACTOR 14 1 U rh
SING 125 ADDRESS Q
DISHWASHER 125 CITY TEL O _/
LAUNDRY TUB 125 CONTRACTOR S STATE
REGISTRATION NO ��� COUNTY ❑
CLOTHES WASHER 1 25 DISTRICT NO GROUP ZONE OCE D,
WATER HEATER 150 S L �) }
GAS SYSTEM OUTLETS 150 r, INDUSTRIAL a
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD
00,
CL
APPROVALS DAT SP CTORL SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK i
r
ROUGH PLUMBING
TOTAL FEE I
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 HOT WATER HEATER
PLUMBING d ^�
1 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 O AND INTEND TO
RESIDE IN THE ABOVE DESC BED RESID �r,.�P RTY UTILITY CO NOTIFIED F r
SIGNATURE r $!� / ..
OF PERMITTEE
FINAL
,,,�LIDATION ROBERT A WOOD
M o CASH SUPERVISING MECHANICAL ENG R
4 8 9 81 JAN 7 5 D 1 2.5 0- :1
r
COUNTY OF LAS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1006210025
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
FEES PAID I BUILDING ADDRESS
LEG ON FILE I 5327 CLOVERLY AV I
IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803106 I
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET OLIVE
18590-004-010 101 PERMIT ISSUANCE FEE 27 75 I THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY, Cl
145 WATER CLOSET/URINAL 1 00 FIX 16 20 I I
(TENANT I TOTAL FEES 43 95 (ISSUED ON PROCESSED BY PLAN BY I
106/21/10 SR I
(OWNER TEL NO I IFINAL DATE FINAL BY CODE I
IDOWNEY, ELVIN? (626) 286-4618- I I
15327 CLOVERLY AV I a� ,• I
(TEMP 917803106 ID SCRIPTION OF WORK I
(REPLACE WATER CLOSET I
I I
(APPLICANT TEL NO I I I
(SAME AS OWNER
(SPECIAL CONDITIONS I
(CONTRACTOR TEL NO I (APPROVALS DATE INSPECTOR SIGNATURE I
_ ISAME AS OWNER LIC NO I (UNDER SLAB WORK I I I
WATER SERVICE I I I
(PLASTIC YIN METAL YIN I I I
(ARCHITECT OR ENGINEER TEL NO I I I I I
IROUGH PLUMBING I I I
LIC NO 1 I I
IGAS PIPING I
I I
_ I
IGAS VENT I I I
I I
IHOT WATER HEATER I I I
1PLUMBING FIXTURES I I I
(LAWN SPRINKLERS I I I
IGAS TEST I I I
(UTILITY COMPANY NOTIFIEDI I I
I ICWV I I
(GRAY WATER SYSTEM I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
I I I I
(REPORT ID DPR263 ROUTE TO BS0508 I I I
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