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APPLOCATMN FOR PLUMSHNG IPE IRMII II
COUNTY OF LOS ANGELES I J
DEPARTMENT OF COUNTY ENGINEES
BUILDING AND cFFET DOUNTY NMSEON ER ADDRESS /O
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITYFOR APPLICANT TO FILL IN NEAREST ST.
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET MAIL
ADDRESS
BATH TUB
CITY NO.
SHOWER t �,�
CONTRACTO
LAVATORY C1
ADDRESS 3
/ SINS 1 r If
CITY TEL. NO.s.
DISHWASHER CONTRACTp.
/ SYATE
LAUNDRY TUB ;LS' REGISTRATION NO. j 7 � 3 C 7 COUNTY
I CLOTHES WASHER I DISTRICT NO. GROUP I ZONE /BEDD BY
WATER HEATER J l 0
INDUS
GAS SYSTEM 1 WASTE APPROVAL LD
99
INSPECTION RECORD
�j // 0
ILD
CL
$1.00 PER ITEM
` OR FIXTURE $ /fL APPROVALS D T INSPECT R'S S URB
/ PERMIT $ 2100 UNDER SLAB WORK �2
TOTAL FEE ROUGH PLUMBING f` �/� ✓ 'V
GAS PIPING $D C
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION /}
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER ?J rr n✓ �7
PLUMBING. ,• ,/
I HEREBY CERTIFY THAT I, AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED A8 REQUIRED BY L09 ANGELES COUNTY AND STATE OF GAS TEST pB K
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL OPERTY. UTILITY CO NOTIFIED
SIGNATURE
OF PERM-ITT E L FINAL 7m�(A
VALIDATION ROBERT A. WOOD
CK. M.0. CASH SUPERVISING MECHANICAL ENG'Rf,
`O 9 8'61�9 JW29 5 D 1625- 1
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1011290018
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT.
(LEGAL ID 1 FEES PAID 1 j BUILDING ADDRESS I
ON FILE
10514 LIVE OAK AV E I
IFEE DESCRIPTION QUANTITY UOM- AMOUNT ARCD CA 910078564 I
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET I
18586-012-017 101 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE 597 GRID D3 LOCALITY TEMPLE CITY, Cl
1 126 MISCELLANEOUS FIXTUR 1 00 FIX 16 30 1 I
ITENANT I TOTAL FEES 44 10 (ISSUED ON PROCESSED BY PLAN BY 1
1 111/29/10 SR
(OWNER TEL NO I IFINPL DATE ` FINAL BY CODE. I
I WANG HERBERT H - I 1
110514 LIVE OAK AVE I I f
(ARCD 910077961 I - ID SCRIPTION OF WORK I
ICLEAN/OUT INSTALLATION TO EWER I
(APPLICANT- TEL NO I I
IRESCUE ROOTER (626) 858-9284- I I
1475 E. ARROW HIGHWAY I ISPECIAL CONDITIONS. - I
4
I I I I
ICONTRACTOR TEL. NO 1 (APPROVALS DATE INSPECTOR SIGNATURE I
IRESCUE ROOTER (626) 858-9284- 1 1 I
1475 E ARROW HWY LIC- NO I (UNDER SLAB WORK I I I
IAZUSA CA 91702 765155 C36 I- „ 1 I I
WATER SERVICE I 1 I
1PLASTIC Y/N METAL Y/N I I
(ARCHITECT OR ENGINEER TEL NO I I I I
- 1 (ROUGH PLUMBING I I
LIC NO (GAS PIPING I I I
I
(GAS VENT I I
I I (HOT WATER HEATER I I I
I IPLUMBING FIXTURES I I I
ILAWN SPRINKLERS I I
I IGAS TEST I
I I (UTILITY COMPANY NOTIFIEDI I I
CWV
I I I I I I
IGRAY WATER SYSTEM I I I
I I I I I I
I I I I I I
I I I I I I
IREPORT ID DPR263 ROUTE TO BS0506
I I I I I I