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APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING r/ /-
ADDRE6S "7 l01
JOHN A. LAMBIE. COUNTY ENGINEER
CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY Y/
FOR APPLICANT TO FILL IN NEAREST pp
CROSS
NUMBER FIXTURE OR'ITEM
OWNER
WATER CLOSET MAIL j
BATH SUB ADDRESS �7-
SHOWER
CONTRACTOR T
LAVATORY P �a�
SINK ADDRESS
DISHWASHER CIT L. O,
LAUNDRY TUB CONTRACTOR STATE
REGISTRATIO NO. COUNTY ❑
CLOTHES WASHER
_DISTRICT NO. ROUP ONE a[aov FOR irvsveciiory
WATER HEATER
GAS SYSTE INDUSTRIAL '
WASTE APPROVAL
. INSPECTION RECORD
APPROVALS
DATE INSPECTOR'5 SIGNATURE
OR
@ $1.00F PER ITEM �_
OR FIXTURE S UNDER SLAB WORK
PERMIT S 1 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE 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
LICENSEDAS REOUIREO BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT i AM THE LEGAL OWNER OF THE ABOVE UTILITY CO. NOTIFIED
DESCRIBED RESIDEN AL PROPERTY ,.
SIGNATURE '
-�I� FINAL
OFPERMITT
ROBERT A. WOOD.
OOH VALIDATION SUPERVISING MECHANICAL ENG'R -
CK. M.O. CpSx
y LR�1 4 75S .FEB 24 3 A 2.00 PI
TBABBT
OBS IT'IAPPLICATION FOR PLUMBING PERMIT 1
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los-Angeles - BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS Q/f
CASSATT O. GRIFFIN,SUP'T OF SUILOING - - _' y
LOCALITY �A - C-7
FOR APPLICANT TO FILL IN I NEAREST /p��
• CROSS ST. /JLI/.Ci r
OWNER r,/ '{ %�/+�Q - DISTRICT NO. GROUP ZONE I READY FOR INSPECTION
MAIL F7 /^' Cid✓TTU�IJ%U i7
ADDRESS
INDUSTRIAL
CITY /TEL. NO. WASTE APPROVAL
PLUMBER �thy /�/Uh1�7/N4 �dL'� INSPECTION RECORD
ADDRESS tt
CITY c-G Q 'L TEL. NO
LICENSE NO. ��^.J JJ,�✓ �� 3fb \{.�3�+ Ii"`\�- ti"l_ \)
NUMBER TYPE OF FIXTURE OR ITEM FEE _ �� \ems. )A ) Vp'
/ j V
WATER CLOSET (TOILET) @ $1.00
BATH TUB @ $1.00 _
SHOWER @ $1.00
LAVATORY (WASH BASIN) @ $I.00 �1 t
KITCHEN SINK @ $1.00
DISHWASHER - @ $1.00 �� 4���• �b -�+r� �a��1 ��1
LAUNDRYTUBORTRAY @ $1.00 L
CLOTHES WASHER @ $1.00
% WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
�IAJ
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK 1
PERMIT $ 1 00 ROUGH PLUMBING
- GAS PIPING
TOTAL FEE -
GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM. PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS AN Y AND STATE OF - --_
CALIFORNIA OIL,THA TyiE EGA OWN OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RE IDEN •.�t ER
SIGNATURE
OF PERMITTEE a FINAL //7 -
-
JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A, WOOD, CHIEF PLBG. INSPECTOR
CH. N.O. CASH
: �3897� GOT 30 3 8.00 / '
' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 9909230020
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
ON FILE 9642 1/2 BROADWAY
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917803206
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY BLVD.
8588-023-013 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, C
07 BATHTUBS/SHOWERS 1.00 FIX 16.20
TENANT: 25 LAVATORIES/SINKS 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
45 WATER CLOSET/URINAL 1.00 FIX 16.20 09/23/99 VG 03/21/00
51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20
OWNER: TEL. NO: TOTAL FEES 92.55 FINAL DATE FINAL BY: CODE:
COMBE, JEFF/CINDY (626) 451-0730-
9642 1/2 BROADWAY
TEMP 917803221 DESCRIPTION OF WORK
PLUMBING FOR ADDITION
APPLICANT: TEL. NO:
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: PNCELES Co,, APPROVALS DATE INSPECTOR SIGNATURE
SAMMEEASSOWNER
�j
ER TEL. N0:
LIC. NO UNDER SLAB WORK
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TEL. NO:
ROUGH PLUMBING
LIC. N0: 1111111rl
GAS PI PI N G
F� n �1BED
n n (moi q (A� � (��,p ([� G S VENT
FU p 11 1111 \l I/1\!/®I`r�'C 1KC \ HOT R HEATER
U LLL SS llII�QV �{ VV 'VV" l� 1 llll lJ�l �l PLUMBING FIXTURES
LAWN SPRINKLERS
❑ , . � %
�J E GAS TEST
h,
A ❑ ® �5 UTILITY COMPANY NOTIFIED /
`b,XO Servii P ThatcWV
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508