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-76A 667-CE#617 4-67
i APPLICATION FOR "PLUMBING PERMIT
Ali' I COUNTY OF LOS.ANGELES
DEPARTMENT OF COUNTY ENGINEERFNEAREST
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BUILDING AND SAFETY DIVISION BUILDING
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JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING �PaTi{2�2 Cay
FOR APPLICANT TO FILL IN .
NUMBER FIXTUREOR ITEM EACH FEE
WATER CLOSET " ;OWNER 3S2ob U3no�
S Q S1- 5 MAIL
BATH TUB 1 25 ADDRESS /aaffle
1
SHOWER 1 25 CITY TEL. NO.
LAVATORY 125
CONTRACTOR PCo&e,;L P&M
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SINK I ADDRESS 1417 1-. PLawn-CL Ott.
DISHWASHER 1 25 CITY flQ,f-dwin 67wk TEL. NO.3381 19,7
T ST-ATE LIC
LAUNDRY TUB mp LICENSE NO 197747 CLASS 3151
CLOTHES WASHER 1. 5 DISTRICaT N GROUP ZONE PROCESSED BY
WATER HEATER 1.50 CJ
GAS SYSTEM--OUTLETS- 3.50 O INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM T30 INSPECTION RECORD p� '
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CD
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W
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APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT g 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE
GAS PIPING
I 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
PLUMBING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,A NTEN
RESIDE IN, THE ABOVE DESCRIBED RESI&Nj4<L RT UTILITY CO NOTIFIED
SIGNATURE
OF PERMIT
FINAL
�VSALIDATION .LACK . ALLEN
cK✓/ M-O CASH SUPERVISING MECHANICAL ENG'R.
,1:�`'�`y 53s. 5. APR 25 5 D 3.5-0-
76A667-CE817 6-60 � '
APPLRCATION FOR PLUMB1;1JPERMIT �
RENOCTYGENDEPATTMENTT F COUNTY
BUILDING AND SAFETY DMSION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET
BATH TUB ADDRESS
CITY TEL NO.
SHOWER
:Z LAVATORY CONTRACTOR
e
SINK ADDRESS r� `
+ DISHWASHER CITY nM- NO. 2
CONTRA OH' ATE
LAUNDRY TOB REGISTRATION NO, COUNTY
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CLOTHES WASHER DISTRICT O. I GROUP /ZONE P CESSED Y
WATER HEATER V�,
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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JQ :,!51 /1417.W z .D
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0 $1.00 PER ITEM �� � d LJ✓T/��Il��
OR FEMRE S d� APPROVALS -� DATE INSPECTOR'S SIGNATURE
FDESCRIBED
PERMIT 2 00 UNDER S B WORK -TOTAL FEE Go ROUGH PLUMBING •DGAS PIPING
BY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ;; GAS VENTLL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER / AG.EBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES :D AS REQUIRED BY LOS ANGELES COUNTY AND STATENIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE GAS TESTED RESIDENTIAL PROPERT . UTILITY CO NOTIFIEDURE � ��RMITTE
L FINAL
®� VALIDATION ROBERT A. WOOD,
m.0. c"B SUPERVISING MECHANICAL ENG'R
UCO 3 4 1 3 ' '�%R 6 5 ® 1 1 .G )
COUNTY OF LOS ANGELES - TEMPLE CITY - #+0508 PLUMBING PERMIT
' DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0510210009
BUILDING AND.SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT-
LEGAL ID FEES PAID BUILDING ADDRESS:
ON FILE 9530-LIVE OAK AV
FEE DESCRIPTION QUANTITY: UOM: AMOUNT TEMP CA 917802513
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET
8588-006-014 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: S96 GRID J3 LOCALITY: TEMPLE CITY, C
07 BATHTUBS/SHOWERS 2.00 FIX 32 40
TENANT 25 LAVATORIES/SINKS 2.00 FIX 32.40 ISSUED ON- PROCESSED BY. PLAN BY EXPIRES ON
45 WATER CLOSET/URINAL 2.00 FIX 32.40 10/21/05 VG 04/19/06
TOTAL FEES 124.95
OWNER TEL NO FINAL DATE FINAL BY ODE
CHIU, CHAO WEN
9530 LIVE OAK AV
TEMP 917802513 DESCRIPTION OF WORK
PLUMBING FOR 2 BATHROOMS
APPLICANT TEL NO _
SAME AS OWNER -
SPECIAL CONDITIONS
CONTRACTOR: TEL NO: AP?ROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO UNDER SLAB WORK -
WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER TEL NO
- ROUGH PLUMBING
LIC NO
GAS PIPING
GAS VENT
HOT WATER HEATER
PLUMBING FIXTURES
LAWN SPRINKLERS
GAO TEST
UTILITY COMPANY NOTIFIED
CWV
GRAY WATER SYSTEM
REPORT ID DPR263 ROUTE TO. BS0508