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APPLICATION FOR PLUMBING PERMIT
_ ,COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
OWILLIAM A. JENSEN, SUBUILDING 37
JHN A. LAMBIE. COUNTY ENGINEER ADDRESS
PT of Bw LolNc LOCALITY FOR APPLICANT TO FILL IN Nenxexi
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
2 S(oOWNER
WATER CLOSET 51.25 MAIL
' BATH TUB 1,25 / as ADDRESS
' SHOWER 1.25 / as CITY TEL. NO.
1
LAVATORY 1.25 sO CONTRACTOR KALL
SINN 1,25 ADDRESS 26
DISHWASHER 1.25 CITY TEL. NO. f( 3_ Q
LAUNDRY TUB 1,25 CONTRACTOR'S STATE
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRI T NO. Gf{OUP_ Z( PRO ED BY
WATER HEATER AA 1.50 , a dT
GAS SYSTEM`OUTLETS 1.50 () INDUSTRIAL ( G
WASTE APPROVAL C
OUTLETS OVER 5 PER SYSTEM .70 INSPECTION RECORD u
O
F
13
u
W
d
YI
Z
OD APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
l
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IB CORRECT AND AGREETO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY ANO STATE OF GAS TEST 2
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN, THE ABOY ESC O RESIDENTIAL P oPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL � 1A
ALIDATION ROBERT A. WOOD
U
0 M.O. CASH SUPERVISING MECHANICAL ENG'R
LM0 7 4 6 IG JAN 1 2 5 D 1 5.00-
COUNTY OF LOS ANGELES TEMPLE CITY H 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1212180008
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91760
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID BUILDING ADDRESS:
10637 DAINES DR
ON FILE IFEE DESCRIPTION: QUANTITY: UOM: AMO UNT: I TEMP CA 919802815 1
ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET:
118586-010-047 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY CAI
151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 1
(TENANT: I TOTAL FEES 44.00 (ISSUED ON: PROCESSED BY: PLAN BY:
112/18/12 SR
TOWNER: TEL. NO: FI/N�AL DATE FINAL BY: CODE:
IYANG JAMES;RAMONA (626) 443-2175- I //
110637 DAINES DR t�/
ITEMP 917802815 HESCRIPTION OF WORK
IGAS LINE FOR HVAC SYSTEM
APPLICANT: TEL. NO:
CONTRERAS, CARRA (626) 286-3157-
14931 N ENCINITA AVE (SPECIAL CONDITIONS:
TEMPLE CITY CA 91780 I j
I I II
CONTRACTOR: TEL. NO: 1APPROVALS DATE INSPECTOR SIGNATURE
CONNOR AIR CONDITIONING AND (626) 286-3157- 1
1
REFRIGETATOR INC LIC. NO (UNDER SLAB WORK
14931 N ENCINITA AVENUE 403735
TEMPLE CITY CA 91780 (WATER SERVICE
T (PLASTIC YIN METAL YIN
(ARCHITECT OR ENGINEER: TEL. NO: I I
IROUGH PLUMBING
LIC. NO:
(GAS PIPING
IGAS VENT
IHOT WATER HEATER
(PLUMBING FIXTURES
LAWN SPRINKLERS
IGAS TEST
1 (UTILITY COMPANY NOTIFIEDI
ICWV
GRAY WATER SYSTEM
II 1 III II I II
III iII I � III
II I I II II I
I II I I I II
I IREPORT ID: DPR263 ROUTE TO: BS0508
-I
i
COUNTY OF LOS ANGELES TEMPLE CITY tl 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0501030006
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL D- FEES PAID BUILDING ADDRESS:
ON FILE 10637 DAINES OR
FEE DESCRIPTION: QUANTITY: LOM: AMOUNT: TEMP CA 917802815 -
ASSESSOR
INFORMATION NUMBER: NEAREST CROSS STREET: EL MONTE
8586-010-047 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLEC CITY,
27 PRESS REG DEVICE(S) 1.00 DEV 16.20
TENANT: 63 WATER PIPING BR/FIX 10.00 FIX 67.50 ISSUED ON: PROCESSED BY: P Y: E PIRES ON:
64 WATER PIPNG <= 1 1/2 1.00 LIN 16.20 01/03/05 JK 07/02/05
TOTAL FEES 127.65
OWNER: TEL. NO: FINAL DATE FINAL BY: CODE:
YANG JAMES;RAMONA (626) 443-2175- ////
10637 DAINES DR &4/-L�-
TEMP 917802815 DESLHIPTION OF WOR
COPPER REPIPE
APPLICANT: TEL. NO:
BROOKS (800) 649-7511-
1371 TITAN WAY SP-ECTAL CONDITIONS:
BREA, CA 92821
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
CAL-COAST REPIPING INC. (800) 649-7511-
1371 TITAN WAY LIC. NO UNDER SLAB WORK
BREA, CA 92621 SAME
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TEL- N0:
- ROUGH PLUMBING
LIC. NO:
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FIXTUR
LAWN SPRINKLERS
GAS TEST
UTILITY COMPANY 0 IFIED
CW
GRAY WATER SYSTEM
* ADDITIONAL DATA ON FILE
REPORT ID: DPR263 ROUTE TO: 9S0508