HomeMy Public PortalAbout4968 SERENO DR_Plumbing__ TeAesT-cLPSIT a `APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERBUIL _
ING
OHNOAN LAMBIEG AND S COUNTY EAFETY INGINGEER ADDRESS 49 8
COLEMAN W JENKINS SUPT OF BUILDING LOCALITY
/(4
FOR APPLICANT TO FILL IN CROSS Bt /.tl/ rA
NUMBER FIXTURE OR ITEM EACH FRE OwIQa
WATER CLOSET SI 78 HAIL
LATH TUB 175 ADDRESS
SHOWER 175 CITY TEL NO
LAVATORY 175 CONTRACTOR _ p (r
I� SUI[ 175 ADDRESS
DISHWASM 175 CRY TE/NOLE C'/7- EL TN0�86-2
LAUNDRY TUB 175 STATE LIC —��
LICENSE NO �� CLASS
CLOTHES WASHER 175 019101 NO P [ P Y
WATER HEATER 150pl
OAS SYSTEM OUTLETS 150 INDUSTIUAL 0
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 50 INSPECTION RECORD U
O
G
w
a
UT
Z
APPROVALS DATE IN[PECTOR[[IGNATURE
PERMIT s 2 OO
TOTAL FEE UNDER SLAB WORK
3 ROUGH PLUMBING
GAS PIPING
1 H[R[OY ACKMOWL[DOE THAT 1 MAK MAD THIS APPLICATION GAS VENT
ANO [TAT[ THAT TH[ A[OY[ 19 CORRECT AND AOR[[ TO COMPLY
WITH ALL COUNTY g1O1MAMC[[ AND [TAT[ LAW[ REGULATING
PLUMEING HOT WATER HEATER
I H[R[[Y C[RTIIY THAT 1 AM PROPERLY RELI[T[RED AND/OR PLUMBING FIXTURES
LICENCED AS R[OUIR[O BY LO[ ANO L[[ COUNTY AND [TATE OF GAS TEST
GLIIORMIA OR THAT I AM TH[ L[ OWNER 01 AMD IMI[MO TO
RERIO[ IN THE A[OY[D[[CRI[[D ID[ IAL IMO RTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL
VALID
CK M 0 O CASH
LAGo2 7 2 0S IM13 5 D 3.25-
-
76AR67OBB APPLICATI OR FPL MBING PERMIT 1
DIVISION OF BUILDING AND SAFEPY
DeplabneW of CoonlT EoQfneer
c.O®ty Of LOe J1II9elee BUILDING �g68 H Sereno DT.
JOHN A LAMBIE, COUNTY ENGINEER ADDRESS
CASSATT D GRIFFIN,SUP T OF BUILDING
LOCALITY Temple City
FOR APPLICANT TO FILL IN NEAREST
m 1. s ID
OWNEGROSS BT R O P �aB4 MAIL DISTRICT NO GROUP I NH READY MR INSPECTION
ADDRESS 4968 N Sereno Dr.
CITY Temple Cit E No AT 67002 INDUSTRIAL
WASTE APPROVAL
PLUMBER Winterhottom Plumbing INSPECTION RECORD
WADDRESS 909 La0 Tunas
CITY San Gabriel TEL NAT 25117
LICENSE NO 338
NUMBER TYPE OP FIXTURE OR RSM PSE
WATER CLOSET (TOILET) a $I OO
BATH TUB Q sl 00
SHOWER Q $100
LAVATORY (WASH BASIN) Q v 00
KITCHEN SINK Q sI DO
DISHWASHER Q sl 00
LAUNDRY TUB OR TRAY a #I 00
CLOTHES WASHER Q sl 00
WATER HEATER Q $I 00 10
GAS SYSTEM 100
APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT $ t 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE 2 OO YEN
i HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION H TER HEATER
AN,
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 57
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT I A PROPERLY REGISTERED AND/OR LASTEST
LICENSED AS RED LO GE NTY AND STATE OF
CALIFORNIA OR HAT 1 Y 6LA WNER OP T E ABOVE UTILITY CO NOTIFIEb
DESCRIBED RESI NTIA T
SIGNATURE
OF PBRMITT 004 FINAL
JOHN A LA69B1E COUNTY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBO INSPECTOR
CR [ . GSR
L&7 2 1 M APR 16 3 200 ID
• COUNTY OP LOS ANGELES T'EIPLR CITY ' P 0508 PLUN®ING PERMIT
' DRPARTMENT OF PUBLIC WORKS 9703 LAS TUNAS - PL 0508 0610030003
BUILDING AND SAFETY / LAND DEVELOPMENT TEmLE CITY CA 91700
-' PHONE (626) 285-0408
LEGAL ID PERS PAID BUILDING ADDRESS
ON PILE — - 4968 SERENO DR
PER DESCRIPTION QUANTITY WM AMOUNT TE" CA 917803036
ASSESSOR INFORMATION NUPSER NEAREST CROSS STREET ROS®BAD
5388-012-015 - - 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID HS LOCALITY TEMPLE CITY, C
07 BATHTUBS/SHOWERS 3 00 PIS 48 60
TENANT 25 LAVATORIES/SIMS 3 00 PIA 48 60 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
45 WATER CLOSET/URINAL 2'00 PIX 32 40 10/03/06 JX 04/01/07
47 WATER HEATERS) 1 00 WIN 16 20
OSIER - TEL EO 51 LOM PRS GAS 5 OUTLET 1 00 SYS 16 20 FINAL DATE FINAL BY - - CODE
CBHH, DAVID (626) 862-7529- TOTAL PEES 109 75 / 1// C* _—N -
4968 SERENO DA - L A
TEND 917803036 DESCRIPTION OF WORK
PLUMHINO FOR BATHROOMS
APPLICANT T8 NO
TSUI/HARVIH FO6G A ASSOCIATES (626) 574-7430- ,
1111 1/2 HIGHLAND OX SPECIAL CONDITIONS
ARCADIA, CA 91006 -
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
A A H CONSTRUCTION CO (323) 721-9206-
866 N GARFIELD AVENUE LIC NO UNDER AW MORE }
MONTEBELLO. CA 90640 509216 B
e MATER SERVICE
PLASTIC Y/N METAL Y/H
ARCHITECT OR ENGINEER TEL NO
ROUGH PLUMBING
LIC NO Al
GAS PIPING
OAS VENT
HOT WATER HEATER
PLUNSING FIXTURES
` - LAWN SPRINKLERS
GAS THS' '
UTILITY CONWANY NOTIFIED -
CNV
GRAY WATER SYSTEM
` REPORT ID DPR263 ROUTE TO BS0508