HomeMy Public PortalAbout6043 CLOVERLY AVE_Plumbing__ i
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer
DIVISION OF BUILDING & SAFETY
WILLIAM J FOX, County Engineer
GROUP
F❑ APPLICANT TO FILL IN +� 1 V�ry ^, I
PLUMBERECEIVED BY READY FOR DATE ISSUED
— ^ A FIRST INSPECTION
ADDRESS —0,711? �` _ \
+./.� BUILDI /► v
CITY / TEL NQ•v uQtJ / ADDRESS ff
•
COUNTY .¢ LOCALITY
LICENSE 6Z EXPIRES ✓
NEAREST •
PERMIT FEES CROSS BT
PERMIT f ,
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNE ti
MAIL /�
WATER CLOSET(TOILET) a s0 ADDRESS Q
BATH TUB @ OlO CITY TEL 4&tt— `
SHOWER a Oka I HER ACKNOWLE THAT I HAVE READ THIS
LAVATORY (WASH BASIN) g0 APPLICAT N AND STAT HAT THE ABOVE 19 CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK 0 DID AND STATE LAWS REGULATING PLUMBING
I CERTIFY THAT 1 OBSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY a OL 0 ANGELES COUNTY LIC BE, OR 1 AM THE LEGAL OWNER
OF THE REBIDENTIA R RTY D CRI AA D
OAS SYSTEM OUTLETS O O
SIGNATURE OF `
WATER HEATER O O PERMITTE
SLOP SINK 0 O INSPECTION RECORD
FLOOR SINK Q O O
FLOOR DRAIN O O
DISHWASHER Q O O
DRINKING FOUNTAIN 1 @ O O
URINAL � O D -.1
a
HOUSE SEWER 0 liso _Z
MISCELLANEOUS L7
Q'
O
r �
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING
GAB VENT
CESSPOOL (11 100 CESSPOOL
SEPTIC TANK* SEPTIC TANK
DRAIN ) PIT ) ® 1 00 SEWER
PERMIT 100 GAS TEST
UTILITY CO NOTIFIED
TOTAL FEE
*ci
FINAL
76A667 DBS#17 10/52
r
7GA667 CE#817 10 67 4
City of Temple City
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING L
JOHN A LAMBIE COUNTY ENGINEER ADDRESS 604 1 Cloverl
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY
Temple City
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST Las Tunas
NUMBER FIXTURE OR ITEM EACH FEE }�T _
WATER CLOSET 1 50 OWNEIi.H♦ Ti._ Christ
MAIL
BATH TUB 1 50 ADDRESS 6043 Gloverl
SHOWER 1 50 CITY Temple Cit -TEL' NO At6-7738'
LAVATORY 1 50 CONTRACTOR Pacific Installers
SINK 1 50 ADDRESS _ 20 E Grand Ave. V
DISHWASHER 1 50 CITY"Tem le City TEL NO 442-7070
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO 211898 CLASS C-20
SWIMMING POOL RECEPTOR 1 50
DISTRICT NO GROUP ZONE P O SS BY
LAWN SPRINKLER SYSTEM 2 00 V
1 WATER HEATER 1 50 1 0 INDUSTRIAL-
v
WASTE APPROVAL C
GAS SYSTEM OUTLETS 1 50 INSPECTION RECORD - U
OUTLETS OVER 30 d
5 PER SYSTEM
CO
- - - Z
Plan check fee 257, of above See reverse _
PLUMBING PERMIT ISSUING FEE S 2 00
TOTAL FEE 3 0
APPROVALS DATE INSPECTOR S SIGNATURE
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 CAT
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 DESCRIBED RESIDENT AL PROPERTY FINAL
SIGNATURE JACK R ALLEN, SUPERVISIN ME HANICAL R
OF PERMITTEE
PERMIT VALIDATION cK M o CASH
PLAN CHECK VALIDATION CK M o CASH
' 1 o°5'G C�-"a 3 i'2`C� 5 D
#.,v 3-.50