HomeMy Public PortalAbout5066 SERENO DR_Plumbing__ 7GA"a&C9dp1f 5/03 T
APPLICATION FOR PLUMB NG PERMI'i"
COUNTY OF LOS ANGELES
DEPARTMENT OF OAj�F COMM FETY IO� _ /�/
JO-IiN A L.i.M�IE OUNTY MNGINEER ADDREi� V ��
WILLIAM A JQNSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN CROSS T
NUMBER PI%TURQ OR REM fiACH PE6 OWNER
a WATER CLOSET Ills
I BATH TDB 175 ADDRm
I SHOWER 175 CITY TEL NO
LAVATORY 125 RA CA,
COBTBACTOS
SDFK 173 Z ADD1iFJ18 a,
DIRHWASHER 175 CITY TEL NO 7�
LAUNDRY TUB 125CONTRACTORS STATE
REGISTRATION NO COUNTY
CLOTHES WARM 175 DIBTR�NOp' GROUP ONE RROCESB
WATER HEATER 150
aAS SYSTEM__4— WASTE APPROVAL OIa.
OUTLETS OVER S PER SYSTEM 50 INSPECTION RECORD
of
!74 i _ -� o
w Aq
I APPROVALS .._ DAT D ON A SIGNATURE
PERMIT j 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE 1.5 o O GAS PIPING
1 HEREBY ACKNOWLEODE THAT I HAVE READ THIS ATLICATION GAS VENT
AND ETAW THAT THE AEOVE lE CORIIECT AND AORE[ TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGH
OT WATER HEATER
PLUMBING
I NERMY CERTIFY THAT I AN PROPERLY REGISTILWO AND/ON PLUMBING FIXTURES
LICENSSO AS REOUIRED BY LOS AHOEI2S COUNTY AND RATE OP GAS TEST
CALIFORH IA OR THAT I AM THE LEOAL OWNSR OP AND INTEND TO
RSBIDE IN THE ABOVE D NEEIDENTIAL RO"E UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL
11SAMATION ROBERT A WOOD
l/ c✓K/ N G CASH SUPERVISING MECHANICAL ENG R
L�LO4 6 9 1�- JAN21 5 D 15.00-
COUNTY OF LOS ANGELES TEMPLE CITY A 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0104270011
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 DUPLICATE
PHONE* (626) 285-0488 EXT.
LEGAL ID: FEES PAID BUILDING ADDRESS:
ON FILE 5066 SERENO OR
FEE DESCRIPTION* QUANTITY- UOM AMOUNT: TEMP CA 917803037
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET' ROSEMEAD/SULTANA
53BB-012-025 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE: 596 GRID H5 LOCALITY. TEMPLE CITY
25 LAVATORIES/SINKS 1.00 FIX 16 20
51 LOW PRS GAS 5 OUTLET 1.00 SYS 16 20 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
64 WATER PIPNG <- 1 1/2 1.00 LIN 16 20 04/27/01 JK 10/24/01
TOTAL FEES 76.35
OWNER TEL NO: OWE
PETERSON RAYMOND B,SHIRLEY A - lO 2- U
5066 SERENO DR
TEMP 917803037
PLUMBING FOR HOUSING RE PROJECT
APPLICANT TEL NO
NICK TIMKO -
9941 HOWLAND SPECIAL CONDITIONS:
TEPLE CITY, CA
CONTRACTOR- TEL P1IGELES CO APPROVALS DATE INSPECTOR SIGNATURE
NICK'S REMODELING (626) 442-7985- 05 ��Ty
9941 NOYLAND DRIVE LIC NO UWN-3LAB WORK
TEMPLE CITY, CA 91780 409663 B WATER SERVICE
PLASTIC Y/N METAL Y/N
TEL NO.
ROUGH PLUMBING
LICGAS PIPING
NO/� hills
ll'FUUU-'--I—LLLGAS VENT
)U B��C M1®�Il O
3 HOT WATER H9MR-
PLUMBING FIXTURES
LAWN SPRINKLERSGAS TEST
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Ser CWV
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REPORT ID OPR20 ROUTE TO: BW508