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APPLICATION FOR PLUMBING PERMIT '
BUIL NG AND SAFETY DI I ION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING /
NUMBER FIXTURE OR ITEM ® FEE ADDRESS
WATER CLOSET LOCALITY IG7 1
NEAREST
BATH TUB
CROSS ST ¢�O�
SHOWER OWNERMAIL
LAVATORY ADDRESS
/ SINK CITYA w.- e' e.,-.- / TEL NO
DISHWASHER CONTRACTOR 61-A,/-%�
CLOTHES WASHER
ADDRESS �1� � S
SWIMMING POOL RECEPTOR
LAWN SPRINKLER SYSTEM CITY G��ti�jy-sr TEL NO
STATE LIC
/ WATER HEATER 3: (y® LICENSE NO 2 y Lf/ CLASS
GAS SYSTEM OUTLETS z �D DI TRGROUP �J�14���Y
OUTLETS OVER v e
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL O
INSPECTION RECORD V
cc
W N
z
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE j
Plan check applicant
APPROVALS DATE INSPECTOR 5 SIGNATURE
Name
UNDER SLAB WORK G
Address ROUGH PLUMBING
City Tel No GAS PIPING S-/g-77 A�
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING HOT WATER HEATER
I HEREBY CERTIFY THAT I AMP OPERLY REGISTERED AND/ LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES UN STATE OF CALIFORNIA O AT I AM THE GAS TEST
LEGAL OWNER OF AND INT T R IDE IN THE ABOVE DESCRIBED IDENTIAL
PROPERTY UTILITYCO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL ,.ZQ►
PLAN CHECK IDATION CK M O CASH PERMIT VALIDATION CK M Q CASH
3 2 O'rZMAY 17 5 D 16-5 0 &jb
DEPARTMENT OF COUNTY ENGINEER PLUMBING I
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING 711-44
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WILLIAM J. FOX, COUNTY ENGINEER ADDRESS 7 1/y.
'/�j��
FOR APPLICANT TO FILL IN LOCALITY ANEAREST
ILDING ,
BUCROSSST / -1-1,-VA,
ADDRESS
DISTRICT NO GROUP ZONE PERMIT NO
LOCALITY
NEAREST v
CROSS ST RECEIVED BY Ready for Inspection DATE ISSUED
OWNER - I 'i s L f f' ✓ �.!
MAIL INDUSTRIAL
ADDRE WASTE APPROVAL
CITY f► TEL No y.(o' INSPECTION RECORD
PLUMBER
ADDRESS
CITY TEL NO
STATE
LICENSE NO []COUNTY
J
PERMIT FEES a
z
.4u Wl ER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET(TOILET) @ 080 $ ti 6 /� ���� "" ""' r6,(/A1Fe-.7-,ch
BATH TUB @ 080 T 'SSA/ yL T /2FrA/lf� �
SHOWER @ 080 1;�d ,4 / I\ ALT/ AJ
LAVATORY(WASH BASIN) @ 0 80 ;'e V }j R dT -7-i) rGI A-n
KITCHEN SINK @ 0 80
LAUNDRY TUB OR TRAY @ 0 80
SLOP SINIC @ 0 80
FLOOR SINK @ 080
FLOOR DRAIN @ 080
DISHWASHER @ 0 80
DRINKING FOUNTAIN @ 080
URINAL @ 080
GAS SYSTEM -OUTLETS @ 1 00 r7 to
WATER HEATER @ 100
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING 2
TOTAL FEE /-/ (-e-' GAS PIPING
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVED RESID NTIAL PROPERTY UTILITY CO NOTIFIED --
SIGNATURE kfiI
V .r
OF PERMITTEE J
FINAL O
76A667 DBS 17 1/53
n$S;17j;,25M SETS 6-46 APPLICATION FOR PERMIT
IMPARTMENT OF BUILDING AND SAFETY 1
ACOfJNTY OF LOS ANGELES- �`�ALAlft
�
Wm J. FOX,CHIEF ENGINEER G
NATURE OF INSTALLATION DISTRICT . GROUP ZONE —PERMIT NO.
ROUGH FIXTURES COMPLETE 15— ( / 4�
HEATER CESSPOOL I—I SEPTIC TANK RECEIVED�Y READY FOR DATE ISSUED
\ FIRST INSPECTION
GAS MISCELLANEOUS �vG�:J ��'
APPLICANT FLL IN HEAVILY OUTLINED PORTION ONLY
JOB
IY NAME /�&,l A eJ,o _ ADDRESS GO
W �ILLLG(�
m ADDRESS � LOCALITYNEAREST
a CITY i� TEL 71 CROSS ST
COUNTY /
CERT No EXPIRES m NAME
LOCATION OF SEPTIC-TANK, OR CESSPOOL 2 MAIL
3 ADDRESS
NORTH O
CITY TEL NO
IAM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
D
3 Vi OWNER
'1 CORRECTIONS
SOUTH J
DESCRIPTION OF WORK z
BATHTUB FURNACE E3
f �
SHOWER DISHWASHER ❑
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
- A
FLOOR SINK SAND TRAP 41 /
SLOP SINK FLOOR DRAINS/ �
/ WASH TRAY URINAL ROVALS
WATER CLOSET DRINKING FOUNTAIN
/ DATE INSPECTOR 6 pNAME
WATER HEATER
DENTAL LAVATORY ROUGH PLUMBING
Y .1�-
—METER R—GAS SODA FOUNTAIN -
OUTL GAS PIPING
GAS VENT I I
/^',�� CESSPOOL
TOTAL NUMBER OF FIXTURES f'�V SEPTIC TANK
CESSPOOI AEPTIC TANK � /� ^ SEWER I I
$ �J UTILITY CO NOTIFIED
TOTAL FEE ov
FINAL
D e_S.-Iv 25,"11 SETS 11-46 1 APPLICATION FOR PERMIT
DEPARTME.N.T OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
Wm J FOX.CHIEF ENGINEER PLUMBING
NATURE OF INSTALLATION DISTRICT . GROUP ZONE PERMIT N5.
r--
ROUGH FIXTURES COMPLETE '�',
READY FOR
REC VED BY DATE ISSUED
HEATER CESSPOOL SEPTIC TANK i�/�j � ��r FIRST INSPECTION. ^
AB :�J_ MISCELLANEOUS
fJ/�/15 -~ 4 1 4
APP ICANT FILL IN HEAVILY OUTLINED PORTION ONLYJOB - 9
pp��
L. NAME _„�`A ADDRESS t1a
III ADDRESS
LOCALITY
f
NEAREST
J CITY TEL No CROSS 9T.
COUNTY �.
CERT No EXPIRES m NAME
LOCATION OF SEPTIC TANK, OR CESSPOOL 2 MAIL
3 ADDRESS
NORTH O
CITY TEL No
I AM rfHZ LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFI OF QUALI�FICCA,TIION. 4,
$/[') PLUMBER
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE.
OWNER
CORRECTIONS
SOUTH J
DESCRIPTION OF WORK z
BATH TUB FURNACE [7
SHOWER DISHWASHER O
LAVATORY REFRIGERATOR
KITCHEN SINK WATER SOFTENER
FLOOR SINK SAND TRAP
SLOP SINK FLOOR DRAIN
ASHTRAY URINAL APPROVALS
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR S NAME
WATER HEATER DENTAL LAVATORY ROUGH PLUMBING
METER GAB AODA FOUNTAIN GAS PIPING
OUTL
GAS VENT A
It I
CESSPOOL I 9
TOTAL NUMBER OF FIXTURESSEPTIC TANK I I
—�.CE86POOI AEPTICTANK �� SEWER I
S —UTILITY CO NOTIFIED I I
TOTAL FEE
FINAL
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0401140011
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE. (626) 285-0488 EXT-
LEGAL S PAID SM-115' G ADDRESS. - _..
TR- 14396 LT: 3 - - 9114 EMPEROR AV
FEE DESCRIPTION. QUANTITY: UOM: AMOUNT: SGAB CA 917752019
ASSESSOR OR ATiO NUMBER NEAREST CROSS STREET:
5382-015-003 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE 596 - GRID• H1-• -LOCALITY. TEMPLE CITY, C
51 LOW PRS GAS 5 OUTLET 1 00 SYS 16.20
TENANT TOTAL FEES 43.95 ISSUED ON: PROCESSED L BY: EXPIRES 0 :
01/14/04 VG 07/12/04
OWNER. TEL NO: 72��-
NALA AL BY• CO
BERSANE TED L (626) 285-6690-9114EMPEROR AV
SGAB 917752019 DESCRIPTION OF WORK
GAS FOR FAU
APPL TEL NO:
WUKMIR (626) 442-2148-
SPECIAL CONDITIONS:
CONTRACTOR: TEL NO. APPROVALS DATE INSPECTOR SIGNATURE
JAMES WUKMIR CO , INC (626) 442-2148-
11500 RAMONA BLVD. LIC NO UNDER SLAB WORK
EL MONTE, CA 91731 285626 C20
WATER SERVICE -
PLASTIC Y/N METAL Y/N
ARCHITECT OR GINEE 0
UGH PLUMBING
LIC. N0:
GAS PIPING
GAS TENT
HOT WATERHEATER
PLUMBING-FIXTURES
LAWN SPRINKLERS
GAS TES
UTILITYCOMPANY NOTIFIED
uV
AY WATER SYSTEM
* ADDITIONAL DATA ON FILE
REPORT ID: DPR263 ROUTE TO: BS0508