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APPLICATION FOR .PLUMBING :PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION. BUILDING
JOHN A. LAMBIE, Count Engineer ADDRESS
CASSATT D. GRIFFIN,Supt of Building LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER , FIXTURE OR ITEM
OWNER ,L
WATER CLOSET g
BATH TUB AD RESS
SHOWER CITY TEL. NO.
LAVATORY CO TOR
j SINK ADDRESS
I DISHWASHER _ CITY TEL. NOg��
_CON TOR'S STATE
LAUNDRY TUB REGISTRATION ' a'-1 7. COUNTY ❑
CLOTHES WASHER DISTRICT NO. GROUP ZONE P ESSED BY
WATER HEATER
GAS SYST INDUSTRIAL '
_ WASTE APPROVAL Z ,
IN§1PEC7ION RECORD
1.
oc
APPROVALS
@ $1.00 PER ITEM I d�
08 FIXTURE $ - -DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 00 ROUGH PLUMBING
TOTAL FEE ® GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES � p 6
I HEREBY CERTIFY'THAT I AM PROPERLY REGISTERED AND/OR GAS TEST F1 RL
LICENSED AS REQUIRED BY L S ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM HE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED' RESIDENTIAL PI
ER . -
SIGNATURE '
OF PERMIM FINAL
ROBERT A.Wood.
®e VALIDATION SUPERVISING MECHANICAL ENG'R
CK. M.0.
J1,67 3 7 4 SN it S4I. 5 A
D. B:'.17 4-3s' 25M - -• . - • APPLICATION FOR PERMIT' '
DEPARTMENT 'Of:BUILDING AND SAFETY �� ��Y
COUNTY OF LOS,ANGELES 1v
.. WM. J. FOX.' CHIEF'<ENGINEER'. .:
NATURE OFINSTALLATION DISTRICT;NO. GROUP ZONE PERMIT No
ROUGH t ' r / 1 �.T �'�" �,.•
PLUMBING I I FIXTURES I I';COMPLETE +: - -
READY•FOR RECEIVED BY DATE ISSUED
'HEATER .: CESSP.00L SEPTIC TAN FIRST IN
SPECTION` S- -
_
GAS MISCELLANEOUS
'APPLICANT FILL. -IN HEA VILY".OUTLINED ,PORTION. ONLY_:
_. - ,JOB
NAME 1 I - 'ADDRESS�� .�' _ =' '' ,�,• .
.III ADDRESS- � , f l + 'LOCALITY.
' �j ,NEAREST. _
•❑ CITY.' a '_' :TEL ,/,-.®c ++,, CROSS STCOU .
4. YY
REG•iNO. / 01- EXPIRES i'Jo IJ-1 W NAME. i:�.
LOCATION OF SEPTIC:TANK 'OR CESSPOOL Z MA's'
f 30 - ADDRESS -
NORTH'
.. ...- CITY - TEL No.
CORRECTIONS
-
m
m
`•' 1JJ"t Z
y SOUTH !i"fT 5 .` ✓AP a�„ i
DESCRIPTION OF ,WORK ,.
' ..BATH TuB.�. -. FURNACE -
.: APPROVALS
SHOWER 'DISHWASHER
-/. - - -
'LAVATORY ., REFRIGERATOR ;;a - DATE 1N§Pecroe�s NAME" :• `
KITCHEN SINK -WATER SOFTENER''- 'ROUGH"PL'UMBING.)
.' FLOOR SINK,, SAND TRAP
:,GAS *PIPING"
..
SLOP-SINK • FLOOR DRAIN .GAS,.�VENT-t
;.•. - - , -
WASH' TRAY " : - URINAL "CESSPOOL
WATER CLOSET - DRINKING'FOUNTAIN _
- . ' ... .. _ 'IN -.SEPTIC'.TANK'
WATER ATER:, DENTAL LAVATORY.. -•SEWER
GAS SODA FOUNTAIN UTILITY CO. NOTIFIED
. - OUTL - -FINAL -..�- '.'
1'AM,THE LEGAL OWNER,OF�T' AB- S'A�IGEL{w �a
" COUNTY REGISTRATION NUMBS
TOTAL.NUMBER OF FIXTURES_' - .� ✓ -,, -
.o..�i.SEP.T16 TANK U E��Y#
sem"' 1 AM;THE LEGAL`OWNERqFHE PROPS DESCRIBE
iiCESSPOOL_ ABOVE: �{
TO 'FEE:: GIt„ CJ OWNER
O. B. 17 7-40 25M, APPLICATION FOR 'PERMIT
DEPARTMENT OF BUILDING AND SAFETY
..COUNTY OF LOS 'ANGELES U
WM. J FOX,:CHIEF,ENGINEER PLM-is
NATURE OF INSTALLATION DISTRICT,NO. GROUP {/ZONE` //��PERMIT No,
.ROUGH - Z'Ti F I� -1 T.�'.5 1 _
QP
PLUMBING .".I FIXTURES-. ' COMPLETERECEIVED BY - READY FOR 'D TE ISSUED
~HEATER CESSPOOL '� - - SEPTIC-TANK = EIRST INSPECTION 1 /
GAS - -MISCELLANEOUS.•. I_A I. - {' j6///
L �
P LIC ;4TFILL JN, HEAVILY OUTLINED PORTION ONLY
JOB �"
NAME ��; 'ADDRESS
W, 2X
ADDRESS � �LOCALITY, - ,. _ •
7- - NEAREST.
—CITY' a EL Nb 2-l- CROSS ST.
!Lr?owz:COON - N - ! t ,. `CERT. NO. EXPIRE . NAME
OCATION OF SEP �ICTANK,OR CESSP®OL AOAOREss
NORTH .CITY TEL No.
I. AM THE LEGAL PO S R OF T E' ABOYE E LOS -
ANGELES COUNTY CERT F $ OF, ALIFICAT IO .
_ f
�
I AMTHE-LEGAL O R OF TH ROPERTY DESCRIBED
- _ 'ABOVE..-
F m
- 1 - '. OWNER _.
CORRECTIONS. "
• � Vii` .
-SOUTH `
DESCRIPTION,.OF WORK z
BATH -TuB FURNACE
SHOWER, DISHWASHER - - 0 -
.i-:
LAVATORY, - REFRIGERATOR -
KITCHEN SINK_ __ _WATER-SOFTENER
FLOOR-SINK SAND:TRAP
SLOP,.:SINK' _ FLOOR DRAIN - -
°! WASH, TRAY. URINAL
APPROVALS
WATER CLOSET. DRINKING FOUNTAIN + DATE' IN4PecToa's NaME `
WATER HEATER DENTAL•.LAVATORY: ROUGH PLUMBING. 'L
°METER •-'GAS SODA FOUNTAIN GAS PIPING �- 1- •V
• GAS VENT -
N � CESSPOOL .
TOTAL NUMBER OF FIXTURES ( -SEPTIC TANK
SEWER
CESSPOOL: SEPTIC TANK
g UTILITY CO. NOTIFIED
TOTAL FEC" ` FINAL �`y
D. a. -4a 28M ' APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF.LOSANGELES
WM; J. FOX, CHIEF ENGINEER
NATURE OF INSTALLATION D] No. GROUP Z-aOrN�E PERMIT No.)q,�/
_ ROUGH .. :. ..I 11 Gi �'. ! (76&1
PLUMBING I. FIXTURES COMPLETE -71VEC;Y READY FOR DATE ISSUED
FIRST INSPECTIONHEATER. - CESSPOOL SEPTIC TANK •� /GAS - MISCELLANEOUS L
APPLIC,(ANT FILL; IN HEAVILY OUTLINED PORTION ONLY
.NAME- /1� t��^s { '°�� "// (^(O4. t°4'hese+ DDRESS ., �r
f ADDRESS I.6"' O14
6w..s'I_ l.i rod,. Y` �. - LOCALITY
'�� NEAREST'
A
CITY jj`� TEL No. CRESS 'ST.
COUNT .
N
CERT. NO. EXPIRESW NAME
OCATION Off' SEPTIC TANK, OR CESSPOOL 3 ADDRESS
NORTH U %O -
CITY TEL No.
1 AM THE LEGAL POSSESSOROF THE ABOVE LOS
TE-
ANGELES COUNTY CERTIFIC ORA, QUALIFICATIO
! P PLUMBER
- I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
V
.. ABOE. - - -
m
w a
hl { - OWNER
3 CORRECTIONS
- SOUTH
DESCRIPTION OF WORK V _z
BATH TUB FURNACE -
0.'
SHOWER: DISHWASHER t+ 0..
LAVATORY REFRIGERATOR
KITCHEN SINK- WATER SOFTENER
.FLOOR SINK BAND TRAP
GLOP SINK FLOOR DRAIN y
APPROVALS
WASH TRAY URINALS -
WATER CLOSET DRINKING FOUNTAIN DATE INSPECTOR'S NAME
WATER HEATER DENTAL LAVATORY`. -ROUGH PLUMBING
METER GAS CODA FOUNTAIN 'GAS PIPING. '
OUTL '
GAS VENT -
CESSPOOL
TOTAL NUMBER OF FIXTURES ;y- SEPTIC,TANK -
SEWER -
- CESSPOOL SEPTIC TANK
- $ UTILITY CO. NOTIFIED
TOTAL FEE I I FINAL �`F" I
r
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1308260020
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID I BUILDING ADDRESS:
ITR: 6561 LT: 241 I °` - 9559 LAS TUNAS DR
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 TEMP CA 917802107 1
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY
18587-014-014 101 PERMIT ISSUANCE FEE .27.80 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY CAI
147 WATER HEATER(S) 1.00 WTH 16.20
(TENANT: I TOTAL FEES 44.00 JISSUED ON: PROCESSED BY: PLAN BY: 1
ITEMPLE CITY CAMERA 1 108/26/13 SR I
(OWNER: TEL. NO: 1 (FINAL DATE FINAL BY: CODE:
ITEMPLE CITY CAMERA
19559 LAS TUNAS DR 1- 1
ITEMP 917802107 1 IDESCRIPTION OF WORK I
IWATER HEATER I
(APPLICANT: TEL. NO: I I I
IERSTAD ENGINEERING (818) 249-8400- I I I
13463 OCEAN VIEW BLVD I ISPECIAL CONDITIONS: I
IGLENDALE CA 91208 I 1
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE
(AMERICAN TECHNOLOGIES INC. (818) 700-5060- I (-" 1
1210 W. BAYWOOD LIC. NO I (UNDER SLAB WORK I
IORANGE,CA 92865 571784 I 1_ I 1
I IWATER SERVICE 1 1 1
IPLASTIC Y/N METAL Y/N I I I
1ARCHITECT OR ENGINEER: TEL. NO: I 1 I 1
IERSTAD ENGINEERING (818.) 249-8400- I IROUGH PLUMBING
13463 OCEAN VIEW BLVD LIC. NO: I I I I 1
IGLENDALE CA 91208 NONE 1 IGAS PIPING
IGAS VENT -I
IHOT WATER HEATER
PLUMBING FIXTURES
ILAWN SPRINKLERS I
IGAS TEST
(UTILITY COMPANY NOTIFIEDI II
CWV
IGRAY WATER SYSTEM 1 I
I I I 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: BS0508 I i
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