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APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
NUMBER FIXTURE OR ITEM CROSS ST a-�
WATER CLOSET OWNERMAIL
BATH TUB ADDRESS'/
SHOWER CITY TEL NO
z LAVATORY CONTRACTOR Valley PlumbingCo
SINK ADDRESS 442 W. Fleetwood P
DISHWASHER ; CITY GlendorUL NO Ed 5 129J5
LAUNDRY TUB CONACTORS STATE
REGISTRATION ON NO 160847 COUNTY
CLOTHES WASHER
^ DISTR�NO GROUP ONE READY FOR INSPECTION
WATER HEATER / j
` GAS SYSTEM INDUSTRIAL _r ' J
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
al $1 00 PER ITEM V DATE .INSPECTOR S SIGNATURE
OR FIXTURE $ `7 UNDER SLAB WORK
6 ROUGH PLUMBING
PERMIT S 1 00
GAS PIPING
TOTAL FEE ��f OG
GAS VENT
1 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
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIB,D RESIDENTIAL PROPERTY r ��
SIGNATURE
OF
//�t���, ,
OF PERM ITTEE
ROBERT A WOOD
VALIDATION
O SUPERVISING MECHANICAL ENG R
CK M 0 CASH
I ACO 4 0 5 6 u° AUG 2 0 5 A 1000
1
COIJNT-= .74: LOS ANGELES TEMPLE CITY # 0508 - wG PERMIT
DEPARTMr---,.- ^C D!!BLIC WORKS 9701 LAS TUNAS ::410250001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY 91,780
PHONE: (626) U488 EXT:
ILEGAL ID: —� FEES PAID --�' BUILDING ADC?CCC. _
TR: 24389 LT: 13 5310 FARAGO AV
_ FFF DESCRIPTION: DUANTITY: UOM: ""^""'T I TEMP CA 917807'"
INFORMATION NUMBER: NEAREST CROSS STREET:
,,SSISSOR
=1' 036-007 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: CR!D: D3 LOCALITY. TEMPLE CITY, C
47 WATER HEATER(S) 1.00 WTH i6.20
TFNPNT: _ TOTAL FEES 43.95 ISSUED ON: PROCESSc g} FLAN BY: EX—PI R S Uig:
10/25/04 JK 04/23/01
Nil d'(: CC
(OWNER: TEL. NO: l--- - -
ICHRISTENSEN, MEDRIC (626) 444-4660- i (FINAL DA`T`E '
5310 FARAGO AV ' T C
17=MP 917803531I DESCRIPTION OF WO
j
i IWATER HEATER CHANGE Ci!-`
IAPPICANT: TEL. NO: !
;LPZ%DABLE ELECTRIC (818) 898-7401- I _
j5115TH ST #G !SPECIAL CONDITIONS
USAN FERNANDO 91340
t
i
II'ONTRACTOR: TEL. NO: ! (APPROVALS DATE INSPECTOR SIGNATURE
DEPENDABLE ELECTRIC (818) 898-7401- --
511 5TH STREET LIC. NO IUNDE SLAB WORK
UNIT G 382175 C36
SAN FERNANDO CA 91340 WATER SERVICE
_
ARCHITECT OR ENGINEER: TEL. N0: PLASTIC Y/N METAL Y/N
ROUGH PLUMBING
LIC. N0: _
GAS PIPING — ----
GAS VENT
HOT WATER HEATER
PLUMSING FIXTURES - -- _—~—
LAWN SPRINKLERS
GAS TEST2
f �t f7 I L I TY COMPANY N-0-7 D I ---- — -
�
i CaV —`
I GRAY WATER SYSTEM _
* ADDITIONAL DATA ON FILE
REPORT ID: DPR263 —_ROUTE TO: BS0508