HomeMy Public PortalAbout5423 CLOVERLY AVE_Plumbing__ 76A667 DBS 17 7 51 LJ Gam'' APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN i R Sr O. GR P Z 3 �PERIT 7 �J
PLUMB ALLEY BOULEVARDRECEEl IVED BY FIRST READY FOR INSPECTION DATE ISSUED
ADDRESS 8300 EA 4�
BUILDING
CITY ROSEMEAD TEL No AI 9.97 19
ADDRESS
C,UN9 NO 93M EXPIRES �LOCALITY \�1...
NEAREST
PERMIT FEES 7 CROSS ST
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
` WATER CLOSET(TOILET) 0 050 !$ ADDRESS
/ BATH TUB lig Oso CITY TEL No
SHOWER a O 50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIB
/ LAVATORY (WASH BASIN) 13513 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK @ O 50 AND STATE LAWS REGULATING PLUMBING
1 QEm, THAT I POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY O 50
ANL
COUNTY LICENSE, OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL R13PERTY DESCRIBED AS VE.
GAS SYBTrM OUTLETS Q O 50 d
SIGNATURE OF
WATER HEATER O 50 PERMITTE
SLOP BINK ®i 053 INSPECTION RECORD
FLOOR SINK 0 05011
1
FLOOR DRAIN 050 �_�A a.�1 .�+1; 1
DISHWASHER O 50
DRINKING FOUNTAIN O 50 U
URINAL O 50
HOUSE SEWER O 50 _a
MISCELLANEOUB L7
R'
Adel
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING
GAS VENT
CESSPOOL @ 1D0 CESSPOOL
SEPTIC TANK, SEPTIC TANK
DRAIN ( ) PIT ( ) 0 11313 SEWER
PERMIT I t 00 GAS TEST
TOTAL FEEs
So UTILITY CO.NOTIFIED
FINAL
V/
76A667—CE 817468
APPLICATION FOR PLUM ING PERMIT �j
COUNTY OF LOS ANGELES
LJ
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING 5423 M. C1r)Vpr2X
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY Temple Cit
IIIIIIIII
FOR APPLICANT TO FILL IN PR NT OR TYPE) NEAREST Qlive
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
—OWNER M. Lightenbuger
WATER CLOSET 1 50 MAIL
BATH TUB 1 50 ADDRESS 123 N. C overl
SHOWER 1 50 CITY Temple City TEL NO
LAVATORY 150 CONTRACTOR Pacific Installers
SINK 1 50 ADDRESS 10920 EGrand
DISHWASHER 1 50 CITY Temple City TEL NO _ Q Q
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO 211898 CLASS 0320
SWIMMING POOL RECEPTOR 1 50 DISTRICT NOGROUP ZONE P ES ED BY
LAWN SPRINKLER SYSTEM 2 00
C-3 S
1 WATER HEATER 1 500 INDUSTRIAL PROVAL
GAS SYSTEM OUTLETS 1 50 INSPECTION RECORD O
OUTLETS OVER
5 PER SYSTEM 30
H
z
Plan check fee 2S% of above See reverse
PLUMBING PERMIT ISSUING FEE 5 2 00
TOTAL FEE Q
APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GASVENT
City Tel No
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 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 -AT
UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBE�ESIDENTIAL PROPERTY FINAL
SIGNATURE _ JACK R ALLEN, SUPERVISIN,410%CHANICAL ENG R
OF PERMITTEE
PERMIT VALIDATION U, M O CASH
PLAN CHECK VALIDATION CK M o CASH
t8 4 -9 8-0 FEB 20 5 D 3.50-
To
I I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0503090008
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID B
ON FILE 5423 CLOVERLY AV
FEE DESCRIPTION QUANTITY: UOM AMOUNT- TEMP CA 917803108
ASSESSOR 1 _ NEAREST CROSS STREET OLIVE
8588-028-019 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J4 LOCALITY. TEMPLE CITY, C
51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20
TENANT TOTAL FEES 43 95 ISSUED ON- 0
03/09/05 JK 09/05/05
OWNER TEL. NO FINAL DATE FINAL BY COD5-
LEE KYU-CHUNG,YOUNG JA (626) 445-6205-
5423 CLOVERLY AV
TEMP 917803108 DESCRIPTION
GAS LINE FOR HVAC SYSTEM
APPLICANT TEL. Nr
JAMES TSA1 (626) 483-2857-
79 W MAGNA VISTA SPECIAL CONDITIONS
ARCADIA, CA 91007
CONTRACTOR- TEL NO APPR6VALS DATE INSPECTOR SIGNATURE
JAMES TSAI CONSTRUCTION, INC. (626) 445-8786-
79 W MAGNA VISTA LIC NO UNDER SLAB WORK
ARCADIA, CA 91007 701042 B
WET A SERVICE
PLASTIC Y/N METAL Y/N
ARCH I TEET-6FEWMEEF TEL NO ROj
LIC NO
GAS PIPING
GAS VENT
TOT WAT5R HEATER
PLUMBING FIXTURES
SPRINKLERSLAWN
UT9 TEST
COMPANY
CWV
GRAY WATER SYSTEM
i
* ADDITIONAL DATA ON FILE
REPORT ID: DPR263 ROUTE TO- BS0508