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APPLICATION FO PLUMB G PERMIT
COUNTY OF LOS ANGELES BUILDING AN UY
FOR APPLKANT TO RLL IN(PPJNIT OR TY PE) BUILDING q f
,ADDRESS
NUMBER FIXTURE TEM C 8 W.Qs
OCALITY
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DkSHWASHER r, CONTRACTOR
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LAWN SPRINPa.ER SYSTEM STATE LIC,
WAT�RHE�ATHR LIC&L&F NO. CLASS
f pW SYSTEM
E Otm S' APPROVALS DATE INSPECTORS SwMATUNE
1 S PER SYSTFJA� UN DR SLAB WORK
ROUGH PLUMQING
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FLXTURE5
GAS TEST
Plan check fee LFF I LITY CO.NOT]F I ED _
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL
Pion aleck applicant r PLAN CHECK VALIDATION
Name L
Addrea .Cyd
Cr T.I.No.ZQs��9 X4491 A-
L HERE AC T I HAVE READ-ails APPLJCI.TLON AND STATE , r-+
THAT THE ADOVE)S CORRECT AND AGREE TO COYP�LY WITH Ail COUNTY ORDINANCES # O O O 0-0 5: .
AND STATE L.AWS REGULATLNG PU MBING_ PERMIT VALIDATION y
I HEREBY C-e RTIFY THAT I AY PAOEERLOIS
,Y RETERE.D LU
AND/OR CEkSED As Z C p 1 9.00
REOUWO DY LOS ANGELES COUNTY AND-STATE Of LALFORNIA OA TKAT I AY THE '
PI RO ER OF,ANP INTEND TO RESIDE IN THE ABOVE DESCRIBED RlsIDEwnA1 O O rO 1 9.rQ7 O
91G IdATt1 RE O 2 "' / 9
OF PERM
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IN IAL
WASTE APPROVAL
COUNTY OF LOS ANGELES TEMPLE CITY 0508 '0' MG pp
DEPARTMENT OF PLBLIC WORKS 9701 LAS TUNAS 084 0004
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE; (626) 285-0488 EXT:
TR: 14832 LT: 24 t947 V
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 17803938
NEAREST CRASS STREET: LOWER AZUSA
8589-018 020 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A5 LOCALITY: T LE CITY
13 DISHWASHER(S) 1.00 FIX 16.20
TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PEXR-S77 EXP I RFeS ON
12/22/99 UT 06/ /00
STENORTH•DEREK (626) 614-0007-
4947 GOL6EN WEST AV
TEMP 917803938MMPTION OF WORK
CHANGE OUT OF DISHWASHER
APPLICANT: TEL. NO:
APPLIANCE INSTALLERS, INC. (562) 599-4500-
3823 INDUSTRY AVE. SPECIAL CONDITIONS:
LAKEW()DD, CA
GE ES C
CONTRACTOR: APPROVALS DATE INSPECTOR SIGNATURE
APPLICANCE INSTALLERS (562) 595-4500- t
3823 INDUSTRY AVE LIC. NO
LAKEWOOD CA 90712 594252 C36WATER�SERVICE
I
PLASTUC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TEL. NO:
LIC. NGAS MPING
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U L C W_ ❑❑KS
FIXTURES
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1cl GAS TEST
UTILITY COMFfi3N_VU=
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GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508