HomeMy Public PortalAbout9823 KEY WEST ST_Plumbing__ 76A667A
GE 817(REy 6/76) .d -
L APPLICATION FOR PLUM B ING 'PERMIT
COUNTY OF LOS ANGELES BUILDING AND.SAFETY
FOR APPLICANT TO FILL'IN(PRINT OR TYPE) BUILDING
ADDRESS
NUMBER FIXTURE OR ITEM ® FEE �•
LOCALITY
WATER•CLOSET
NEAREST n
BATH TUB CROSS ST GCS 'Z
/ SHOWER OWNER
LAVATORY MAIL
,ADDRESS
SINK CIT /1�nL �% TEL NO
DISHWASHER CONTRACTOR
CLOTHES WASHER ADDRESS'
SWIMMING POOL RECEPTOR
• CITY � TEL NO
LAWN SPRINKLER SYSTEM STATE LIC n
WATER HEATER LICENSE NO a CLASS
GAS SYSTEM OUTLETS APPROVALS DATE NSPCC AOR S SIGNATURE
OUTLETS OVER UNDER S_tF B"WORK
5 PER SYSTEM ROUGH PLUMBING �i�Z� `� Dl�P7l�cLY
GAS PIPING
GAS VENT u
99
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST2 Z;t*
Plan ChOCIC f22 UTILITYCO NOTIFIED
PLUMBING PERMIT ISSUING FEE$ '
TOTAL FEE o1 FINAL
PPLAN CHECK VALIDATI'ON'
Pion check applicant
Name
/ P �a`''
Address -�
City Tel No
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE _ O
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES '
AND STATE LAWS REGULATING PLUMBING PERMIT,VALIDATION t
HEREBY CERTIfY,THAT I AM P PERLY REGISTERED ND/OR LICENSED AS' # 0 O'O O O'5.
REQUIRED BY LOS ANGE 5 _OUN �14D•STATE OF CALIFORNI R THAT I AM THE -
LEGAL OWNER OF AND N ND T (SIDE IN THE ABOVE DESCR D RESIDENTIAL 2 O•Q 2 2 00
PROPERTY
SIGNATURE i 0 00-22005
OFPERMITTEE O OPV
DISVCT yO Cf PR D BY
INDUSTRIAL
WASTE APPROVAL
76AG67 (CE-817) - 1/75
APPLICATION R P PERMIT
_ LU ING
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO- ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TY PEI NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET
2 00 OWNER a�
MAIL
BATH TUB 2 00 ADDRESS 0 SIP--
SHOWER 200 CITY TEL NO
LAVATORY 200 CONTRACTOR s ��
SINK 200 ADDRESS
DISHWASHER 2 00 CITY _ " TEL. NO
CLOTHES WASHER 200 ap STATE ZZZ LIC �+
LICENSE NO CLASS C:
SWIMMING POOL RECEPTOR 2 00
DISTRICT NO.GROUP NE ZPZC:ESS
BY
LAWN SPRINKLER SYSTEM 2 00 ^O Q j
Aof
WATER HEATER 2 00 0v INDUSTRIAL -.L`
WASTE APPROVAL a
GAS SYSTEM OUTLETS 2 00 INSPECTION RECORD U
OUTLETS OVER
5 PER SYSTEM .30 O
F—
C
• � W
a
N
Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ N
TOTAL FEE
APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING ��.z.'-e
City Tel NO. GAS VENT
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 A�
PLUMBING. GAS TEST i w
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AHD/,OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS/#LES COUNTY N_D STATE OF
CALIFORNIA OR THAT Ql �*.WNEFI TY A INTEND TO
RESIDE IN THE ABOVEAL PROP Y. FINAL
51 GNATU RE
OF PERMITTEE
PERMIT VALIDATIONC M.O. CASH
PLAN CHECK V ATION CK. M O. CASH
2 6 41�rrT 21 5 "0 1 3.5 0 ,698
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0906170031
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT-
ILEGAL ID I FEES PAID I BUILDING ADDRESS I
ITR. 13986 LT: 33 BL- 001 9823 KEY WEST ST I
I IFEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803919 I
(ASSESSOR INFORMATION NUMBER. I NEAREST CROSS STREET.
18589-022-024 101 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE 597 GRID. A4 LOCALITY TEMPLE CITY, Cl
' 1 147 WATER HEATER(S) 1 00 WTH 16 20 I
ITENANT I TOTAL FEES 43.95 (ISSUED ON PROCESSED BY PLAN BY: EXPIRES ON 1
106/17/09 SR 12/14/09
I I I I
OWNER TEL NO I IFI14AL DATBY: CODE
IBELL MARK E (626) 285-1446- 1 1 1
19823 KEY WEST ST I EXPIRU)
ITEMP 917803919 1 IDESCRIPTION OF WORK
(INSTALL A WATER HEATER I
(APPLICANT TEL NO I I
IRESCUE ROOTER (626) 858-9284- 1 I 1
1475 E ARROW HIGHWAY ISPECIAL CONDITIONS I
IAZUSA, CA 91702 I I I
I I I I
I I I I
ICONTRACTOR TEL NO- I IAPPROVALS DATE_ INSPECTOR SIGNATURE 1
IRESCUE ROOTER (800) 269-6942- 1 1 1 I
1475 E ARROW HIGHWAY LIC. NO I 1UNDER SLAB WORK I
1ASUZA, CA 91702 765155 C36 I I I I
I _ - IWATER SERVICE I 1 I
1PLASTIC YIN METAL YIN 1 I I
(ARCHITECT OR ENGINEER TEL. NO: I 1 I I
1 - I IROUGH PLUMBING I I I
LIC NO I 1 1-1 1
• I IGAS PIPING
I I I I I I
1 1 IGAS VENT I I I
I I 1 -1-1 1
I I IHOT WATER HEATER I I I
I ! 1 1-1 1
IPLUMBING FIXTURES I1
I I I I I I
ILAWN SPRINKLERS I I 1
I I I I I I
IGAS TEST I I I
I 1 1-1 1
1 1 (UTILITY COMPANY NOTIFIED( I I
I I I I I I
I I ICWV I
I (GRA:' WATER SYSTEM I I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
I I I I I I
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IREPORT ID DPR263 ROUTE TO BS0508 I I I I
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