HomeMy Public PortalAbout8624 WORTHINGTON DR - Plumbing - 2007-06-20 - PL 0508 0706200002 COUNTY OF IAS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0706200002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BIIILDING ADDRESS: I
ITR: 25341 LT: 5 1 8624 WORTHINGTON DR 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( SGAB CA 917752647
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: BURTON
15386-007-047 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY, CI
I Ill CLOTHESWASHER(S) 1.00 FIX 16.20 I 1
TENANT: 125 LAVATORIES/SINKS 1.00 FIX 16.20 (ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: I
151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 106/20/07 SR 12/17/07 1
I 160 DWV REPAIR OR ALTER 1.00 SYS 16.20 1 1
(OWNER: TEL. NO: 163 WATER PIPING BR/FIX 1.00 FIX 6.75IF T FIN CODE: 1
IKIM, EUNICE ( 1 TOTAL FEES 99.30 I I
18624 WORTHINGTON DR. I I I
ISAN GABRIEL 91775 1 IDESCRIP ION OF WORK I1
I I IWASHER AND DRYER RELOCATION ALSO INSTALL A MOP SINK I
(APPLICANT: TEL. NO: 1 1 I
ISAME AS OWNER
I i (SPECIAL CONDITIONS: 1
I
I
ICONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE I
[SAME AS OWNER - 1
LIC. NO I (UNDER SLAB WORK
I I I
IWATER SERVICE I I I
I [PLASTIC YIN METAL YIN I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 I I
I - I IROUGH PLUMBING
LIC. NO:
(GAS PIPING [
IGAS VENT I 1 1
I I IHOT WATER HEATER
I I IPLUMBING FIXTURES I
ILAWN SPRINKLERS
I I
IGAS TEST I I I
I I I
I (UTILITY COMPANY NOTIFIED( I
I ICWv
I I
I I IGRAY WATER SYSTEM I I
I I I I I
I I I I 1 I
I 1 I I I I
I I I I
I I I I I I
I IREPORT ID: DPR263 ROUTE TO: BS0508 I I I I
I I I I I I
7SM67--CES17-B-58
APPLICATION FOR -PLUMBING PERMIT :
C6UNTY OF LOS ANGELES
DEPARnam dF COIINTY ENGumm
BII�ip<.DII�iG AND SAFETY D�M�S�ION BIIILDDIG �/
C 1OHN T DGRIFFIN.LSup o!8�rilding ADDRM a ��yy
LOCALITY ��/. 0, .`—
FOR APPLICANT TO FILL IN NEAREST
csoss or. o6a
NUMBER FIXTURE OR ITEM OWNEB
e /w Its
WATER caossT n
RATE TUB ADDRESS
SEOWER crrY TEL NO.
LAVATORY cOMACTOBFONTANA PLUMBING ^
sm ADDEM 13329 L Ecfor s+ran+
DR;EWASEER CITY CW of Indus
LAUNDRY TUB CONTBACTOR'S S A
REGISTRATION NO. #96496 couNTY
/ CLOTHES WASTER OISTR1 NO. GROUP Z NE P CESSED BY
/ WATER SUTER Z
GAS SYSTEM DIDUSTBIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS OB OFIPER
TtJr $
DATE INSPECTOR'S SIGNATURE.
UNDER 6EA W RK y
PERMIT $ .2100 ROUGH PLUMBING
TOTAL FEEH /15 ® GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST — O i
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL ER
SIGNATURE
OFPERMI'ITE ` FINAL
ROBERT A.WOOD.
®P VALIDATION SUPERVISING MECHANICAL ENG'R
Cx. M.c. case
UL8 9 5 1 m APR 7 5 A 13.00 to
76A667A
CE 617(REV.6/781
as
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING � {
ADDRESS
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET LOCALITY 7
NEAREST
BATH TUB CROSS ST. e tVn
SHOWER OWNER
MAIL `
LAVATORY ADDRESS
SINK. CITYS.-W 0-7 me TEL.
{
DISHWASHER. CONTRACTOR Xum 1 )
CLOTHES WASHER ADDRESSJ
/� CFi
SWIMMING POOL RECEPTOR -
CITY TEL.NO.
LAWN SPRINKLER SYSTEM STATE / LIC.
WATER HEATER LICENSE NO. (� CLASS C-3,11.
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT
@S
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST UD
Plan check fee UTILITY CO.NOTIFIED g
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE v FINAL
Plan check applicant PLAN CHECK VALIDAT N
Name
Address # 6 8 7.3
000
City Tel.No. 00
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES O p
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION I o O I Q 0 O
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REOUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE 0 925-79
LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY.
SIGNA+URE
OF PERM ITT
S RICT NO.
PED BY
r
INDUSTRIAL
WASTE APPROVAL