HomeMy Public PortalAbout10233 GREEN ST_Plumbing__ 76A667.CEN817 4-64
APPLICATION FOR PLUM ING PERKK�177T
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS Q
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY �� L
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. !c
NUMBER FIXTURE OR ITEM EACH FEE
OWNER ri 'q
WATER CLOSET $1.25MAIL �•
BATH TUB 1.25 ADDRESS fJ CDrc tom.
SHOWER 1.25 CITY R, r EL. NO. `
CONTRACTOR
LAVATORY 1.25
SINK 1.25 ADDRESS t
DISHWASHER 1.25CITY f� / �`�" TEL. NO.;8ss-Js
LAUNDRY TUB 1.25 BEGINS RAT ON NO. ff3eiC> COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GR nE_ FtR EWKD 6
WATER HEATER 1.50 L_
INDUSTRIAL
OUTLETS 1'� �� WASE APPROVAL 0
O
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U
/1 W
0-
0)h
(
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE el GAS PIPING -7 4,--
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
LANATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
L COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
G.BY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
ASREQUIRED BY LOS ANGELES COUNTY AND STATE OFGAS TEST
IA OR THAT 1 AM TH LEGAL OWNER OF,AN NTEND TO,THE ABOVE DE 1{`B RESIDENTIAL PROP UTILITY CO. NOTIFIEDRERMITTE
VALIDATION ROBERT A. WOOD
CK, M.O. CASH SUPERVISING MECHANICAL ENG'R
LfLo 0 6 9 7�-_': MAR 2 3 5 D 3.5 0 N
COUNTY OF LOS ANGELES TEMPLE CITY Q 0508 PL4BI9G PERMIT
DEPARTMENT OF PUBLIC WORXS 9701 LAS TUNAS PL 0508 0901060016
BUILDING AND SAFS'PY / LAND DEVE7,OPFBNT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 ETT:
LE3AL TO: FEES PAID BUILDING ADDRESS:
ON F= 10233 GREEN ST
FEE D&SCRIPTION: QUANTITY: DON: AMOUNT: TEMP CA 917803337
ASSESSOR INFORMATION NUMBER: NEAREST CRbBS�STRETiT: -
8585-005-022 01 PERMIT ISSUANCE FEE 27.75 Tl"19,9 PAGE: 597 GRID: B4 LOCAL TTY: TEMPLE CITY, C
47 WATER HEATER(S) 1.00 MITI 16.20
TENANT: - TOTAL FEES 43.95 ISSUED ON: PROCE9SED BY: PLAN BY: EXPIRES ON:
01/06/09 SR 07/05/09
OWIffi2:
TEL. NO: FINALDA;XpMBY: CODE:
MORROW, HAROLD - .
10233 GREEN ST
TEN4P 917803337 DESCRIPTIO V'wokk
O
. R334DVE/REPLACE GAS WATER HEATER
APPLICANT: TEL. N0:
HCNE DEPOT (800) 454-&955-
12601 132 NO. AVE NE SPECIAL CONDITIONS:
3IR![LAND, WA 98034
CONTRACTOR: TEL. NO: APPROVALS TE INSPECTOR SIGNATURE
HOME DEPOT (800) 454-8995-
12601 132ND AVE NE LIC. NO UNDER SLAB WORK
KTRCAND WA 98034 602331
WATER SERVICE
PLASTIC Y/N MEIAL Y/N
ARCWLI= OR ENGIIZ3ER: TEL. NO:
- ROUGH PLUMBING
LIC. NO:
GAS PIPING
GAS VENT
HOP WATER HEATER
PLUMB IM FIXTUR&.9
LAWN SPRINKLERS
GAS TEST
U=TY COMPANY NOTIFIED
CKV
GRAY WATER SYSTEM
- - REPORT ID: DPR263 ROUTE TO: B90508
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