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~ COUNTY OF IAS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1209180001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: I
ITR: 24579 IT: 12 I I 10756 LYNROSE ST 1
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:[ TEMP CA 917802924 I
[ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I
18573-011-020 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, Cl
I 107 BATHTUBS/SHOWERS 1.00 FIX 16.20 [ [
ITENANT: 125 LAVATORIES/SINKS 2.00 FIX 32.40 [ISSUED ON: PROCESSED BY: PLAN BY: 1
I 145 WATER CLOSET/URINAL 1.00 FIX 16.20 109/18/12 SR
I I TOTAL FEES 92.60 1 I
(OWNER: TEL. NO: ( [ 1FIN8,L DATE FINAL CODE:
IYU, VIVIAN (323) 253-3885- [ [ 1
110756 LYNROSE ST [ I��
ITEMP 917802924 I [DESCRIPTION OF WORK [
IREPLACE TUB, LAVATORIE, WATER CLOSET AND KITCHEN SINK
I [ IFOR BATHROOM AND KITCHEN REMODEL
[APPLICANT: TEL. NO: [ [ [
ISAME AS OWNER
I [ [SPECIAL CONDITIONS: [
ICONTRACTOR: TEL. NO: [ [APPROVALS DATE INSPECTOR SIGNATURE [
ISAME AS OWNER - [ I I
LIC. NO i JUNDER SLAB WORK I I
I [ IWATER SERVICE I 1
I [ IPLASTIC YIN METAL YIN
[ARCHITECT OR ENGINEER: TEL. NO: 1 I • I
I - I IROUGH PLUMBING [ I
[ LIC. NO:
I I ICAs PIPING
I I I
IGAS VENT I I I
I HOT WATER HEATER
I [ 1PLUMBING FIXTURES
I I I
I [ ILAWN SPRINKLERS I I I
I I I
I [ IGAS TEST I I I
(UTILITY COMPANY NOTIFIED
I I ICWV I I
I [ IGRAY WATER SYSTEM
I I I I I I
I I I I I I
1 I 1 1 I I
1 I I I I I
IREPORT ID: DPR263 ROUTE TO: BS0508 [ [ I
I I I I I
78A887--CE817-11-57
APPLICATION FOR PLUMBING PERMIT ' 1
COUNTY OF LOS ANGELES Job /-6-o
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY.DIVISION BUILDING
JOHN A.LADDIE, Count Engineer ADDRESS 1076 L y n r Oise
CASSAIT D. GRIFFIN.Sup t of naldiag LOCALITY amp 1 e C' t
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
2 WATER CLOSET / OWNER LarkwoodConstruction
1 BAM T= /.' DRESS 1022 owerAzusa .. . d
SHOWER
TY TEL.NO.
LAVATORY 'Y c;NTRACTOR Richard Cavanaugh P l b e
1 SINK A DRESS " 13354 S. Central
LW!n r c Chino TM NO.
LAUND TUB • ONTRACTOWS STATE ❑
GISTRATION NO. 15516 COIINTY
CLO WASFIER �( DISTRI NO. GR UP ONE R R INSPECTION
1 WATER TER
1 GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
0 $1.00 PER ITEM I 'S-4 DATE INSPECTOR=S. IGI[ATIIRE
O8 FIXTURE S 00 :: UNDER-SL-ikB'VOORK -IV I �, -1 k.
PERMIT $ 00 ROUGH'PLUMBING
TOTAL FEE 1-19-100 GAS PIPING!
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE. THAT THE ABOVE IS CORRECT AND AGREE T.0 COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING V
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST V 1 �%�
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY GO.NOTIFIED.
DESCRIBED RESIDENTI ROPERTY.
SIGNATURE FINAL
OF PERMITTE
ROBERT A.WOOD.
®� VALIDATION SUPERVISING MECHANIOAL ENG:R
CK.
M.0. CASH
15066°; OR 14 5 A 12.00
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