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76A667-CE817-8-57
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APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION A
DLD
DRIN
ESS LT/l G /i ,
JOHN A. LAMBIE. COUNTY ENGINEER
CA SSATT D. GRIFFIN, SUP of BUILDING
FOR APPLICANT TO FILL IN
NUMBER FIXTURE OR ITEM
WATER CLOSET Tu 15.5 F��RA IYBATH TUB SHOWER TEL.NO.
LAVATORY CONTRACTORFONTANA PLUr,4MtIC C^,,,!T^ T .T
SINK ADDRESS 13329 E. Eczo, Street
DISHWASHER CITY City of InclustryVI:QI . ED, 7-mn
LAUNDRY TUB CONTRACTOR'S #96496 STATE Lj
REGISTRATION NO. COUNTY ElCLOTHES WASHER
DIST NO. GROUP ZONE READY FOR INSPECTION
WATER HEATER -ter
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
i
APPROVALS,
DATE INSPECTOR'S SIGNATURE
$1.00 PER ITEM17 -
OR FIXTURE $ /!y 06
UNDER SLAB WORK
PERMIT 8 1100
ROUGH PLUMBING
GAS PIPING
TOTAL FEE 6 0 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 1A,
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORA'IA OR THAT I AM THE L L OWNER OF THE ABOVE UTILITY CO. NOTIFIED _
DF.SCRIB:D RESIDENTIA RO E Y.
SIGNATURE
OF PERMITTEE V �`�— FINAL
VALIDATION ROBERT A. WOOD,
SUPERVISING MECHANICAL ENG'R
CK. M.O. CASH
ACO 5 2 8 7 SEP 2 9 5 A 8.0 0
I
COUNTS'OF LOS•ANi31 L&S TEMPLE CPTY 0508
PLi94BI19G FER}QT
DEPARTICKWP OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1403100007
BUILDING AND SAFETY / LAND DEVE'LOPHEXT TFifPT,F. CITY CA 91780
PI-20NE: (626) 285-0488 ETP:
LEGAL ID: FES PAID BUILDING ADDRESS: �
ON FILE 10150 GREEN ST
FEF DESCRIPTION: QUANTITY: OOH: AMOUNT: TERP CA 917803333
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STRS1 ; BALDWIN
8585-007-068 01 PERMIT ISSUANCE FES 27.60 TF C61k9 PAGE: 597 GRID: B4 LOCALITT: T70GI E CTPY CA
47 WATER HEATPE (S) 1.00 WTH 16.20
TT2qAN T: TOTAL FEES 44.00 ISSUED ON: PROCESSED BY: PLAN BY:
03/10/14 SR
OWNER: TEL. NO: FZMT DATH, YllllkL 5Y: CODE:
QAYANE AVE5fP2HY9+N -
DEJCRIPTION OF PARR V
RELDCATE MATER HEATER
APPLICANT: TEL. NO:
COVARRUBIAS, JESUS (626) 215-7318-
2213 FATLIM LEAP AV SPECIAL CONDITIONS:
ROSEMEAD CA 91770
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
QUALITY RESTORATION AND (626) 215-7318-
REFAF31LITA.TION LIC. NO UNDER SLAB MOR};
2213 FALLING LEAF AVE 656275
ROSE24EAD CA 91770 PATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER: TEL. NO:
.ROUGH PLYING
LIC. NO:
GAS PIPING
GAS VENT
HOT MATER HlQkTER
PLUFlBING FIXTUR&S
L.ANN SPF TIT ERS
GAS TEST
UTILITY TY COt4FANY NOTIFIED
Cwv
GRAY IZATER SYSTEM
+ ADDITIONAL DATA. ON FILE
REPORT ID: DPR263 ROUTE TO: 13SO508