HomeMy Public PortalAbout5328 CLOVERLY AVE_Plumbing__ 76A667 DBS 17 11-50 APPLICATION FOR PERMIT
..DEFAI3TMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN D17ICT NO. GROUPI ZONE
F MIT
3a /
PLUMBER Lymn F. Me RE EIVED Y READY FOR DAT ISSUED
716FIRST INSPECTION .21 -6-1
ADDRESS 825 E• BroadwaJp
San Gabriel AT BUILDING Cloverly ot Tract
CITY TEL No ADDRESS Ave.,> >
COUNTY 4686 LOCALITY Temple City
LICFNSE NO EXPIRES NEAREST Blackley
PERMIT FEES CROSSST
OWNER '1 T T\�'. tt
NUMBER TYPE OF FIXTURE OR ITEM FEE Paul j.
MAIL
1 WATER CLOSET(TOILET) a O 50 $ ADDRESS
1 BATH TUB ® 1350 CITY TEL NO
SHOWER 050 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
1 LAVATORY (WASH BASIN) @ O 50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK !BZ 050 AND STATE LAWS REGULATING PLUMBING
1I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 050 ANGELES COUNTY LICENBE. OR 1 AM THE LEGAL OWNER
OF THE RESIDENTI L PROPERTY DESCR BED ABOVE.
1 GAS SYSTEM OUTLETH (� D 50 SIGNATURE Of
1 WATER HEATER @ 050 PERMITTEE �r ` • ��{ //'
SLOP SINK @ DSO INSPECTION RECORD U
FLOOR BINK 050
FLOOR DRAIN 050
DISHWASHER Q 050 /D��- d� r» Gdu 1LriJ3 0 ✓�✓!d
DRINKING FOUNTAIN a O 50
URINAL O SO
Q
HOUSE SEWER @ 050 2.c�3/� Z_
MISCELLANEOUS Cl
13
elt>4V1049 ft
IM N 44d 4S4'4100
d
If
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING /
GAS PIPING
GAS VENT vI
CESSPOOL @ 1 00 CESSPOOL Ir
SEPTIC TANK SEPTIC TANK p�
DRAIN ( ) PIT ( ) @ 1 00 SEWER
PERMIT I 100 vas TEST i
UTILITY CO NOTIFIED O
TOTALFEE /+ 50 E
FINAL
76A667—CE 817468 4e- 17y _
a • V
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANG
DEPARTMENT OF COUNTY ENGINEER BUILDING �
BUILDING AND SAFETY DIVISION ADDRESS J n U r
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN(PR NT OEAREST
R TYPE) N
CROSS ST ►'
NUMBER FIXTURE OR ITEM EACH FEE /,�/
WATER CLOSET 1 50 OWNER ,
MAIL
BATH TUB 1 50 ADDRE J
SHOWER 1 50 f^8 CITY / .{ ` TEL NO �3
LAVATORY 1 50 �,p CONTRACTO y /
SINK 1 50 �C7 ADDRESS
DISHWASHER 1 50 CITY TEL NO
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 150 DISTRICT NO GROUP ZONE P OCESSED/BY
LAWN SPRINKLER SYSTEM 2 00 ' 0 2 / e-", I` Q
WATER HEATER 1 50 INDUSTRIAL {{,,J�
WASTE APPROVAL z
GAS SYSTEM OUTLETS 1 50 INSPECT N IAECPRD 0
OUTLETS OVER
5 PER SYSTEM 30 1 PA'jA
N
z
Plan check fee 25% of above See reverse
PLUMBING PERMIT ISSUING FEE S 2 00
TOTAL FEE Q
APPROVALS DATE i SPECTOR S NATURE
Plan Check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel No HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 'UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF C
CALIFORNIA OR THAT I AM TN AL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESC RESIDENTIAL PROPERTY FINAL
SIGNATURE JACK R ALLEN PERVISING MECHANICAL
OF
PERMSIGNATURE.
PERMIT VALI ATION CK M o CASH
PLAN CHECK VALIDATION cK M o F
Co-`7 6 61 DEC 16 5 D 6:50^'
4
j 76A667 OBB 17 11-50 APPLICATION FOR PERMIT
-DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES P L U B I G 1
WILLIAM J. FOX, CHIEF ENGINEER
DISTRICT O. .
FOR APPLI1rANT/�TC) FILL IN _/< -;?-96.2.7 96.2.
PLUMBER (/ RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS
Z £ ' dm
-S
/ BUILDING
CCOUNITY 5 `l TEL NO ADDREBB -77LICENSE NO EXPIRES CO �JLOCALITY " C'
NEAREST
PERMIT FEES CROSSST
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER 400
MAIL
WATER CLOSET(TOILET) 0 050 111 �$'G ADDRESS
BATH TUB @ O SO CITY 7_`' TEL No
SHOWER @ ago I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ O 50 �V APPLICATION AND STATE THAT THE-ABOVE 18 CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ O 50 AND STATE LAWS REGULATING PLUMBING
I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ O 50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIS D ABOVE.
GAS SYSTEM OUTLETS @ O 50
SIGNATURE OF
WATER HEATER @ O 50 PERM ITTEE_
SLOP SINK @ O 50 INSPECTION RECORD
FLOOR SINK @ O 5O
FLOOR DRAIN @ 050
DISHWASHER @ O 5O
DRINKING FOUNTAIN @ 050
URINAL @ 050 J
Q
HOUSE SEWER @ O 50 Z_
MISCELLANEOUS 6
(Y
O
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
OAS PIPING
GAS VENT
CESSPOOL @ 1Do CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1 OO I SEWER
PERMIT I t 00 GAB TEST
TOTAL FEE $ a G� urILITY co NOTIFIED
/ FINAL
1
-- Ll
70A667A
CE 817(REV 11/78)
4F
APPLICATIONO LU M B G PE
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS n C�
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET LOCALITY
NEAREST
BATHTUB CROSSST
SHOWER OWNER
LAVATORY MAILADDRESS
SINK CITY TEL NO
DISHWASHER CONTRACTOR
CLOTHES WASHER ADDRESS o ) / J
U (�
SWIMMING POOL RECEPTOR u
CITY �� J TEL NOOZD�
LAWN SPRINKLER SYSTEM ATE LIC
WATER HEATER LICENSE NO 7�� CLASS
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING ���
96
GAS PIPING g V
GAS VENT pp
HOT WATER HEATER 0
PLUMBING FIXTURES A bj
GAS TEST --$I f' , /I d �
Plan check fee UTILITYCO NOTIFIED 'ter J
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL
Plan check applicant PLAN CHECK VALIDAON
Name
Address J-9 9 2 514 A
City Tel No #'o'— o o 5
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES 'Z t0 O 1 O Q
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED OR LICENSED AS 3001
U
REQUIRED BY LOS ANGE COUNTY STATE OF CALIFO NIA O HAT AM THE
LEGAL OWNER OF AND NT ND 70 IDE INT ABOVE D CRIBE RESIDENTIAL 0a06'
O 6'- 0
PROPERTY
SIGNATURE
OF PERMITTEE
PR SSE D Y
INDUSTRIAL
WASTE APPROVAL