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DBS �I2 34 APPLICATION FOR PLUMBING PERMIT
D85
DIVISION OF BUILDING AND SAFETY
Department of County Engmeer
County of Los Angeles
WM J FOX COUNTY ENGINEER BUILDING
ADDRESS
CASSATT D GRIFFIN SUP T OF BUILDING +
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
ROSS ST
OWNER a jf.�(�+IS�1l 6T-V DISTRICT NO GROUP I 7„ON� READY FOR INSPECTION
MAIL p.-,
ADDRESS I/
INDUSTRIAL
CITY TEL NO WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS _Zm At.4 .� r' 5► C_ E1 tj
CITY I I TEL NO — p-4
LICENSE NO Q 2., I I
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET)
BATH TUBt�A55 L�'t t� OLS O N
SHOWER
Q
LAVATORY (WASH BASIN) P_4
KITCHEN SINK 0 J.-r VS A.LJ— L&1'T""0� 0
DISHWASHER
LAUNDRY TUB OR TRAY ,.
CLOTHES WASHER
.� TOTAL NO J @ 0 80 T Q APPROVALS
� 00 - DATE INSPECTOR S SIGNATURE
GAS SYSTEM OUTLETS ® 1 00
WATER HEATER ® 100 J UNDER SLAB WORK
ROUGH PLUMBING
PERMIT E I 1 00 GAS PIPING
TOTAL FEE / oo GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APP ICATION 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 ' rt F
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
y LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF UTILITY CO NOTIFIED A
CALIFORNIA OR THAT 1 AM THE LEGAL O NER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPE TY
SIGNATURE N
OF PERMITTEE /F FINAL k
WILLIAM J FOX, COUNTY ENGINEER VALIDATION
337E MAY 4. 3 7.00 m
BY / gyp e
DCPUTY
D . �
O
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0504200026
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT
LEGAL ID: S PAID BUILDINGADDRESS:
ON FILE 5430 CLOVERLY AV
FEE DESCRIPTION• QUANTITY: UOM AMOUNT TEMP CA 917803107
ASSESSOR RTMAMN NUMBER NEAREST CROSS STREET.
8588-026-005 01 PERMIT ISSUANCE_FEE 27 75 THOMAS PAGE 596 GRID. J4 LOCALITY. TEMPLE CITY, C
51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20
TENANT TOTAL FEES 43 95 ISSUED ON- PROCESSEDA
04/20/0 JK 10/17/05
OWNER. TEL. NO F DAL CODE
ARTHUR MAXINE F TRUSTEE;ARTHUR MAXI -
5430 CLOVERLY AV
TEMPLE CITY CA 91780 TrESCRIPTION OF WORK
GAS LINE FOR HEATING SYSTEM
APPLICANT: -TEL NO
LESLIE (626) 285-9014-
6344 N. LEMON AVE SPECIAL 0 DITIO .
SAN GABRIEL
CONTRACTOR- TEL. NO- APPROVALS DATE INSPECT09ATUR
TEMPO AIR CONDITIONING (626) 285-1218-
5937 N. OAK AVENUE LIC NO UNDER SLAB WORK
TEMPLE CITY, CA 91780 27488OC20
WATERSERVICE
PLASTIC Y/N METAL Y/N
ROUGHARCHITECT OR ENGINEER: TEL. Nb:
B
LIC. NO
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING
S
SPRINKLERSLAWN
GAS TEST
UTILITY COMPANY NOTIFIED
CWV
GRAY WATER SYSTEM
REPORT ID DPR263 ROUTE TO• BS0508