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]0A66] CE#817 5/63
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS 7
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS BY
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET $1.25 X77`� MAIL
BATH TUB 1.25 ADDRESS
SHOWER 1.25 / .Zj CITY TEL. NO.
LAVATORY 1.25 J" CONTRALTO
SINK 1.25 ADDRESS
DISHWASHER 1.25 ?,_�. CI TEL. NO
j CONTRACTOR'S STATE
LAUNDRY TUB 1.25
Z REGISTRATION NO. COUNTY
CLOTHES WASHER 1.25 ,) DISTRICT O. GR ZONE P O B
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WATER HEATER 1.50 )
CAS SYSTEM V``-OUTLETS 1'50 _� INDUSTRIAL - 1
WASTE APPROVAL u
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD
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APPROVALS 4DATE INSPECTOR'S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
O ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED A5 REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF.AND INTEND TO
RESIDE N.
THE ABOVE DESCRIBED RE D NTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTE - FINAL .a/,j� /,
VALIDATION ROBERT A. WOOD
CK. M.U. CASH SUPERVISING MECHANICAL ENG'R
LAl,o 5 9 2 5-o FEB 2 5 5 A. 1 7.5 0
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS PL 0508 9811120070
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (818) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 28984 LT: 8 8738 HERMOSA DR E
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SGAB CA 917753020
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BURTON
5387-007-031 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: G3 LOCALITY: TEMPLE CITY
47 WATER HEATER(S) 1.00 WTH 16.20
TENANT: TOTAL FEES 43.95 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON:
11/12/98 UT 11/12/99
OWNER: TEL. NO: FINAL DATE FINAL BY- CODE:
MCCANN ERNESTINE W (818) 286-8501- /� Z./,�/J d
8738 HERMOSA DR (
SGAB 917753020 DESCRIPTION WORK
INSTALL WATER HEATER
APPLICANT: TEL. NO:
JOHN WILDE (626) 448-2175-
4905 BALDWIN AVE _ SPECIAL CONDITIONS:
GEL.ES Co
CONTRACTOR: TEL. N448-2175- �r � ��JAy APPROVALS DATE INSPECTOR SIGNATURE
4905 BALDWIN LIC. NO UNDER SLAB WORK
TEMPLE CITY CA 401407 B
WATER SERVICE
ARCH ITECT OR ENGINEER: TEL. NO: PLASTIC Y/N METAL Y/N
/\ ROUGR PLUMBING
LIC. N0: �' _ ____ y i 1111111 1
GAS PIPING
GAS VENT
HOT WATER NEATER
1 --- - - -- ----- "---- - --7 PLUMBING FIXTURES
LAWN SPRINKLERS
!, � �'•� GAS TEST
UTILITY COMPANY NOTIFIED
q�0 CWV
service
GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508