HomeMy Public PortalAbout9816 KEY WEST ST_Plumbing__ DEIS 17 3 BS /APPLICATION FOR 'PLUMBING PERMIT 1
DBS 17
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles
BUILD]NG�(i f�� d/ l[i� � J
WM.J. FOX, COUNTY ENGINEER ADDRESS G kv i) Vy
CASSATT D GRIFFIN, SUPT OF BUILDING r q� g (7,17-)l
LOCALITY 74/y/AZEz ( iI T)l J
FOR APPLICANT TO FILL IN NEAREST p.,y�Q-EA/
A/m � /��a La�� GAi
J,1� ^}' �) /'''' �/� CROSS ST C G'+�lV Li' /l.,C L �Y
OWNER A Ra//#(,f�'� CI /1/1�11-,,4 q�Et '�'� DISTRICTNO GROUP I ZZZONE READY FOR INSPECTION
MAIL
_ADDRESS 9(I/[O Z �7� 1 , S/ 5 J , .F�� '
CITY / a,A- (0-// Y_ TEL NO A; Z�6nI,^) WASTETAPPROVAL
PLUMBER / INSPECTION RECORD
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ADDRESS 4 /t/zFg
CITY TEL- NO
LICENSE NO
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TO]LET)
BATH TUB
SHOWER
LAVATORY- (WASH BASIN)
KITCHEN SINK -
DISHWASHER '
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO @ O BO APPROVALS
DATE INSPECTOR S SIGNATURE
GAS SYSTEM OUTLETS Q 1 00
UNDER SLAB WORK
WATER HEATER CD Too (J
ROUGH PLUMBING -S`�SS ,X ,rL-.•
PERMIT S 1 00 c
GAS PIPING
TOTAL FEE r GAS VENT
I'HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDE TIAL PROPERT
SIGNATURE
OF PERMITTEE -
. FINAL
WILLIAM J FOX. COUNTY ENGINEER VALIDATION R. A. WOOD, CHIEF PLBG. INSPECTOR
�G0 6 3 2 0 S AUG 4 3 2.0 0 In
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76A667-CE#817 10-62 CHTY OF
APPLICATION FOR PLUMBING PERMIT'
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING C �/ j �C
BUILDING AND SAFETY DIVISION ADDRESS !}
JOHN A LAMBIE, COUNTY ENGINEER
WILLIAM A JENSEN, SUP T OF BUILDING '
LOCALITY 1 1 L
FOR APPLICANT TO FILL IN CROSSSST. �t7 L �/'-1 / E-S 1
NUMBER FIXTURE OR ITEM EACH FEE
/ OWNER )o 1 L L I C. q /4
WATER CLOSET $125 G
BATH TUB 1 25 DRESS O / . t �1 s? t
/ SHOWER 1251 CITY • C TEL.,NO.
LAVATORY 1 25 CONTRACTOR c L F r- e n D /+/T C
SINE 125 ADDRESS f K /5 S!d
DISHWASHER 1 25 CITY /?0 r E M E_A p TEL NO
LAUNDRY TUB 125 CONTRACTOR'S 7 -7 Q J STATE 0
REGISTRATION NO / Q IC7 COUNTY ❑
CLOTHES WASHER 125 DISTRICT NOS/ GgDHP ZgNE P E BY
WATER HEATER 1 50 (fn ��J(� J�/}
/ 150 INDUSTRIAL per,
GAS SYSTEM ( OUTLETS WASTE APPROVAL C
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD u
GC
O
. 1-
U
W
CL
Vf
z
APPROVALS DATE INSPECTOR S SIGNATURE
ERMIT $ 2 00 UNDER SLAB WORK
P
ROUGH PLUMBING
rim"
TOTAL FEEZr GAS PIPING �-s
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LIGATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, TY AND I SEND TO GAS TEST 9 .4
RESIDE IN,THE ABOVE (
/SCRIBED SIDENTIAL PROPERUTILITY CO NOTIFIED �•
SIGNATURE I
OF PERMITTEE ��� t� O
FINAL S/
mmmm
form- �IJDATION," ROBERTA WOOD
M o CASH SUPERVISING MECHANICAL ENG R
- L4 5 9 0 la U 12 5 D 7.25- 11
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1105090016
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
ILEGAL ID FEES PAID BUILDING ADDRESS
ITR 14908 LT 10 1 9816 KEY WEST ST
I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803918
ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET
18589-021-020 101 PERMIT ISSUANCE FEE 27 80 THOMAS PAGE 597 GRID A4 LOCALITY TEMPLE CITY, Cl
1 147 WATER HEATER(S) 1 00 WTH 16 30 I 1
ITENANT 151 LOW PRS GAS 5 OUTLET 1 00 SYS 16 30 JISSUED ON PROCESSED BY PLAN BY
TOTAL FEES 60 40 105/09/11 SR
OWNER TEL NO (FINAL DATE FINAL BY CODE
IXIA, MATTHEW (626) 614-5889-
19816 KEY WEST ST I m
TEMPLE CITY CA 91780 DUCAIPTIO14 OF WORK
I IRELGCATE WATER HEATER AND GAS LINE FOR HVAC SYSTEM
(APPLICANT TEL NO 1
ICLEAN POWER DEPOT INC (626) 614-5887- i -
I2655 LOMA AVENUE ISPECIAL CONDITIONS 1
SO EL MONTE 91733
I
I I I I
ICONTRACTOR TEL NO 1 (APPROVALS DATE INSPECTOR SIGNATURE 1
CLEAN POWER DEPOT (626) 498-2988- I 1
12655 LOMA AVE LIC NO 1UNDER SLAB WORK
S EL MONTE CA 91733 946349 B i WATER SERVICE
(PLASTIC YIN METAL YIN
(ARCHITECT OR ENGINEER TEL NO I I I
1 - IROUGH PLUMBING 1 1
LIC NO
(GAS PIPING 1� �11
I I I GAS VENT ---�1 1
IHOT WATER HEATER
IPLUMBING FIXTURES
ILAWN SPRINKLERS
1 1 (GAS TEST 1
(UTILITY COMPANY NOTIFIEDI II
ICWV I
1 1 IGRAY WATER SYSTEM I
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IREPORT ID DPR263 ROUTE TO ES0508 I I
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