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OUN�E'Y 0�'4:OS'ANGEliES" �'
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION . BUILD c� ! ^�
AIA KE CHECKS PAYABLE TO: ADDRESS / O TIOSA
HARVEY T. BRANDT, COUNTY ENGINEER
LOCALITY j FJyip ' Ci
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
® FEE
NUMBER FIXTURE OR ITEM CROSS ST. OLde.v 1.L�
l ('�
WATER CLOSET 1,75 OWNER /5L QE` J T12A- •�T N
BATH TUB 1.75 ADDRESS L'p Q,Y Q yZ
L SHOWER 1.75 ( "7S CITY e"Yl e 5—/- �i� J TEL. NO. 7 726
LAVATORY 1,75 / 75- CONTRACTOR
/ SINK 1.75 L 7S ADDRESS
DISHWASHER 1.75 CITY TEL. NO.
CLOTHES SMASHER 1.75 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.75
DISTRICT NO. GROUP 2 N OCESSED e
LAWN SPRINKLER SYSTEM 1.75
J WATER HEATER 1.75 7s INDUSTRIAL y /
WASTE APPROVAL a
GAS SYSTEM OUTLETS 1.75 L 7 I PECTION RECOREXV
OUTLETS OVER 30 3 ( o
5 PER SYSTEM
H
U
W
CL
H
z
Plan check fee Sea Re Ve,S.
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE .1
A AbL DATE INSPECTOR', BI.NATURE
Plan check applicant UNDER-4r+ `WO K
Name ROUGH PLUMBING —/0=7
Address GAS PIPING —/D 7Al 977
City TCI. NO. GAS VENT r
HEREBY ACKNOWLEDGE THAT HOT WATER HEATER HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT ANO AGREECOMPLY PLUMBING FIXTURES `, '
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING Z/V Y �' /
PLUMBING. GAS TEST
HEREBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED 4/Al
LICENSED AS REDO(RED BY L05 ANGELES COUNTY AND STATE OF MA
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO / Ir
RESI BE IN THE ABOVE DESCR ED RESIDEN AL PROPERTY. FINAL `l/
SIGNATU RE /(/
OF PERMITTE 1
PERMIT VALIDATI N _ CK. M.O. cnsH
PLAN CHECK VALIDATION CH. M.0. CASH Ujnt/
5 9 5.^n FEB 5 5 D 1 ..1 7 5 &98
COUNTY OF LOS ANGELES TEMPLE CITY N 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1002040029
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
ITA: 9481 LT: 13 BL: .001 1 9808 LA ROSA DR
I IEEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 910803920
IASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET: GOLDEN WEST
18589-022-004 101 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY, Cl
1 125 LAVATORIES/SINKS 1.00 FIX 16.20 I
TENANT: 145 WATER CLOSET/URINAL 1.00 FIX 16.20 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON
( :
TOTAL FEES 60.15 02/04/10 SR 02/04/11
1
(OWNER: TEL. N0: IFINAL DATE FINAL BY CODE:
IYD, R 01 217-1161-
19808 LA ROSA DR.
902494326 �1GARD1144CR �
�•
WORK
REPLACE LAVATORIE AND WATER CLOSET
(APPLICANT: TEL. N0:
SAME AS OWNER
SPECIAL CONDITIONS:
1 1 I I
CONTRACTOR: TEL. NO: JAPPROVALS DATE INSPECTOR SIGNATURE
(SANE AS OWNER -
LIC. NO (UNDER SLAB WORK
IWATER SERVICE IIII
(PLASTIC YIN METAL YIN
ARCHITECT OR ENGINEER: TEL. NO: 1 11
IROUGH PLUMBING I
LIC. NO:
GAS PIPING III
(GAS VENT
IHOT WATER HEATER
1
IPLUMBING FIXTURES
LAWN SPRINKLERS
I I IGAS TEST
1 I
(UTILITY COMPANY NOTIFIED(
I 1 Illcwv II I II
1 (GRAY WATER SYSTEM
I I II
I II I I I VIII
1 i I I I II
I I I I II II
REPORT ID: DPR263 ROUTE TO: BS050B
I I I II II II