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Home My Public Portal About5724 CLOVERLY AVE_Plumbing__ RJL" 95M°ET° 1-48 APPLICATION FOR PERMIT 7 DEPARTMENT OF BUILDING AND SAFETY �� COUNTY OF LOS ANGELES Wm J FOX. CHIEF ENGINEER _ Umnlimw NATURE OF INSTALLATION DISTRICT GROUPI ZONECP MIT O ROUGH FIXTURES k"d COMPLETE ' 2 2 d�'- HEATER CESSPOOL SEPTIC TANK RECEIVED BY READY FOR DATH ISSUED FIRST INSPECTION AH MISCELLANEOUS x -a APPLICANT FILL IN HEAVILY OUTLINED PORTI N ONLY JOB !J NAME /j ADDRESS p. ADDRESS �� / LOCALITY .J D CITY NEAREST �I.( TEL No CROSS ST COUNTY CERT NO EXPIRES E NAME LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL No I AM THE LEGAL POSSESSOR OF THE ABOVE LOS ANGELES COUNTY CERTIFICATE OF QUALIFICATION. 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE. 3 � - OWNERCORRECTIONS SOUTH J DESCRIPTION OF WORK z z_ BATH TUB FURNACE 5 Q' SHOWER DISHWASHER D LAVATORY REFRIGERATOR KITCHEN SINK WATER SOFTENER FLOOR SINK SAND TRAP SLOP SINK FLOOR DRAIN WASH TRAY URINAL APPROVALS WATER CLOSET DRINKING FOUNTAIN DATE INSPHCTOR 0 NAME WATER HEATER DENTAL LAVATORY ROUGH PLUMBING I METER GAB SODA FOUNTAIN GAS PIPING OUTL JI GAS VENT 1 CESSPOOL TOTAL NUMBER OF FIXTURES �v� SEPTIC TANK CESSPOOL---------SEPTIC TANK l/ SEWER I / Z$ TOTAL S"v FEE � ' UTILITY CO NOTIFIED c, v FINAL (J �� D s s i7 25M SETS 12-45 { �`' � t ' APPLICATION FOR PERMIT ,-DEPARTMENT OF BUILDING AND SAFETY COUNTY OF LOS ANGELES 1 Wm J FOX. CHIEF ENGINEER NATURE OF INSTALLATION DISTRICT NO GROUP ZONEI PERMIT NO ROUGH __ FIXTURES COMPLETE � g / Q_-2 RECEIVED BY READY FOR DATE ISSUED HEATER CESSPOOL -I SEPTIC TANK l r � FIRST INSPECTION ^ ��j� GAS MISCELLANEOUS .0L Com' ' °" APPLICANT FILL IN HEAVILY OUTLINED PORTION` ONLY G NAME L Y�/9/� �,G,C�iP 1DDRE88 ® A CL®V ADDRESS �a�„7 ;6 LOCALITY y LOCALITY 2( e� • C ' IL CITY .5;4AI �p NEAREST �/�/./ TEL No /�.Qty�/�P�`+ CROSSST O'+ CERT No 6 EXPIRES �� ` / I NAME R K LOCATION OF SEPTIC TANK, OR CESSPOOL Z MAIL 3 ADDRESS NORTH O CITY TEL NO IAM THE LEGAL POSSESSOR OF THE ABOVE LOB ANGELES COUNTY CERTIFICATE OF QUALIFICATION vV PLUMBER .01 1 AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED ABOVE OWNER CORRECTIONS o - SOUTH - a DESCRIPTION OF WORK ATH TUB FURNACE _ a.i ROWER nISHWASHER LAVATORY REFRIGERATOR / KITCHEN SINK WATER SOFTENER FLOOR SIN RAND TRAP - /Ji✓TO w'9SM c'Q IJ20.8"#K FLOOR DRAIN i Cf S WASH TRAY URINAL APPROVAL ' WATER CLOSET DRINKING FOUNTAIN DATE C IMBPQCTOR'0 NAM! / WATER HEATER DENTAL LAVATORY ROUGH PLUMBING -METER-AV GAB SODA FOUNTAIN OUTL GAS PIPING GAS VENT CESSPOOL TOTAL NUMBER OF FIXTURES _ SEPTIC TANK CESBPOOl (SEPTIC TANK SEWER UTILITY CO NOTIFIED I ' I TOTAL FEE S Oa I FINAL �1 • COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT • DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9610210016 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE (818) 285-0488 EXT LEGAL ID FEES PAID BUILDING ADDRESS TR 6561 LT 699 5724 CLOVERLY AV FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917802551 ASSESSOR I M T ON NUMBER NEAREST CROSS STREET 8587-011-022 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J3 LOCALITY TEMPLE CITY 47 WATER HEATER(S) 1 00 WTH 16 35 TENANT 51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 35 ISSUED ON PROCESS —PLAN BY EXPIRES ON TOTAL FEES 60 45 10/21/96 TC 10/21/97 OWNER TEL NO FINAL DATE FINAL CODE CHUNG, CHIU PING (714) 288-0808- _(� 5724 CLOVERLY AV t TEMP 917802551 DESCRIPTION APPLICTEL �� ADDITIONAL PLUMBING AND ELECTiICAL PERMITS FOR ADDITION SAME AS T �� S OWNER - Q SPECIAL CONDITIONS CONTRACTOR EL NO APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - a L I C NO !y 0 UNDER SLAB WORK �� WATER SERVICE 0 �(f( IIIJ PLASTIC Y/N METAL Y/N CHITE R EER — (d ROUGH MBI a 7� LIC NO tltltlGAS PIPING � GAS VENT HOT WATER HEATER PLUMBING fIXTURES LAWN SPRINKLERS GAS TEST � UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID DPR263 ROUTE TO BS0508 =WORKERS'COMPENSATION DECLARATION APPLICATION FOR PLUMBING PERMIT I herby, affirm that I have a certificate of consent to self in- �60026 DPW 490 sure,or`b certificate tf Workers'Compensation Insurance,or a ` certified copy thereof (Sec 3800, Lab C ) Policy No Company COUNTY OF LOS ANGELES DEPT�OF PUBLIC WORKS Certified copy is hereby furnished BUILDING FOR APPLICANT TO FILL IN(PRINT OR TYPE) ADDRESS Certified copy is filed with the county building inspection department NUMBER FIXTURE OR ITEM @ FEE LOCALITY WATER CLOSET(TOILET) Ddte Applicant ' NEAREST 1 CERTIFICATE OF EXEMPTION FROM WORKERS I BATH TUB CROSSST � COMPENSATION INSURANCE k SHOWER OWNER V (This section need not be completed if the work involved by MAIL the permit is for one hundred dollars($100)or less) 21, LAVATORY ADDRESS I certify that in the performance of the work for which this per- SINK CITY TEL O Tit is issued I shall not employ any person in any manner so as to be me st blecZ the Workers' ompensation Law DISHWASHER 1 CONTRACTOR Date /` Applicant 'ilA CLOTHES WASHER NOTICE TO APP (CANT If, after making this ertrfi ate of E SWIMMING POOL RECEPTOR ADDRESS L4( emption,you should become subject to the Workers'Compen CITY TEL NO sation provisions of the Labor Code, you must forthwith comp- LAWN SP ly with such provisions or this permit shall be deemed revok- STATE LIC ed ATER HEATER - LICENSE NO CLASS LICENSED CONTRACTORS DECLARATION DISTRICT NO PROCESSED BY I hereby affirm that I am licensed under provisions of Chapter GAS SYSTEM OUTLETS 9(commencing with Section 7000)of Division 3 of the Business OUTLETS OVER and Professions Code, and my license is in full force and ef- 5 PER SYSTEM FINAL NFALIDATION fect HOSE BIBS"' DATE >_ License Number Lic Class ACCT.Y a FINAL 0 Contractor Date ✓ BY 3.0,E 107.4 I am exempt under Sec / 1 ITEMS F4 B aP C for this reason Plan check fee D d TOTAL 107 ®� , 83 (� SINGLE FAMILY TOTAL FEE Date PLUMBING PERMIT ISSUING FEE$ D (HECK 10708 Signature �y� CHMGE .0( HOME OWNER-BUILDER DECLARATION Plan check applicant - I hereby affirm that I am exempt from the Contractor's License Name WOO-W01 6/14/96 Law for the following reason (Section 7031 5, Business and 6924 1 AM11�40 Professions Code) Address I as owner of the property, will do the work and the City Tel No structure is not intended or offered for sale(Section 7044, Business and Professions Code) ► CONSTRUCTION LENDING AGENCY _I I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097, Civ C ) v Lender s Name Lender s Address I certify that I have read this application and state that the above information is correct I agree to comply with all County ordinances and State laws regulating Plumbing, and hereby authorize representatives of this County to enter upon the abov mentioned property fpr inspection pugposes 1!J-� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of P rmitte Date