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APPLICATION FOR PLUMB rs PER
COUNTY OF LOS ANGELES
DEPARTMENT .OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING 101 Olive St.
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS. S,UP'T. OF BUILDING LOCALITY Temple C1•ty
FOR APPLICANT TOFILL IN(PR NT OR TYPE) Ogg S Zadell Ave*
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET 1.50 OWNER
KAM
BATH TUB 1.50 DRESS 10127 Olive St-
SHOWERpan 1.50 1,50 c'nTem 'le Cit TEL. NO.
LAVATORY 1.50 CONTRACTOR Howard Sebler
SINK 1.50 . ADDREs$g : Se Veda Blvd_..
DISHWASHER 1.50 CITY Sepulveda TEL.NO.892-1245
CLOTHES WASHER 1.50 STATEp LIC
LICENSE NO.807 CLASS C-54
SWIMMING POOL RECEPTOR 1.50 1 .
DISTRICT NQ. y E D BY
0 GR ZO
LAWN SPRINKLER SYSTEM 2.00 {JI/ d
� O
WATER HEATER 1.50 INDUSTRW. O
WASTE APPROVAL C
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD v
OUTLETS OVER 30 D-
5 PER SYSTEM
y
Z
i
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE 3-0
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check.applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
LI
Tel. NO.. NOT WATER HEATER
EBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
LL COUNTY ORDINANCES AND STATE .LAWS REGULATING. GAS TEST'
NG.EBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR• UTILITY CO.NOTIFIED
44 0144
D AB REQUIRED BY LOS ANGELES COUNTY A��IIIIjj����111111D STATE OFRNIA OR THAT I AME LEGAL OWNER OD INTEND TO'IN,THE ABOVE DES IBED REBID TI L PROP RTY. FINALURE JACK R. ALLEN, SUPE'RVISIN ECHANICAL ENG'R.
ERMITToe4
PERMIT VALIDATION. CK M.O. CASH
PLAN CHECK VALIDATION CK.. M:O. CASH
L�'tL 5742%0As 5 5 D 3:50" ca
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1
,6A687
DBB.;7 10-515 APPLICATION FOR. PLUMBING PERMIT 1
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of.Los Angeles BUILDING
JOHN A.LAMBIE, COUNTY ENGINEER ADDRESS /O a
CASSATT D.GRIFFIN.SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN I NEAREST
CROSS ST.
OWNER DISTRICT NO. G OUP I ZONE I READY FOR INSPECTION
MAIL
ADDRESS �c•G fi�tt((
CITY TEL.NO.CO3Vo"//0- WATE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS �r y
CITY TEL.NO. (O O '11a7
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 $
BATH TUB @ $1.00
SHOWER @ '$1.00
LAVATORY (WASHBASIN) Q $1.00
t KITCHEN SINK @. $1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER Q $1.00
GAS SYS•CEM @. $1.00
// e.e
APPROVALS
DATE INSPECTORS SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING a
l ZGAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE -LAWS. REGULATING
PLUMBING. PLUMBING FIXTURES LM
1 HEREBY CERTIFY THAT I AN PROPERLY REGISTERED. AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED .o
DESCRIBED RESIDENTIAL PROPERTY,
SIGNATURE V
OF PERMITTEE FINAL •�
IOHN A,L4MBIE.COUNTY ENGINEER VALIDATION ROBERT A.WOOD.CHIEF PLBG. INSPECTOR
CK.
M.0. GSH
L1 IL822 OCT �, i ��:.. ►
fp.r �
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 L(PLUMB-ING-PERMIT.
DEPARTMENT OF PUBLIC WORKS ! 9071 LAS TUNAS �'PL 0508-9609100015
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: FEES PAID 'B ILDING- DDRESS:
TR: 22438 LT: 3 1U127 OLIVE ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: "TEMP CA 917803345
ASSESSOR INFORMATION NUMBER: INEAREST CROSS STREET: BALDWIN
8586-025-004 01 PERMIT ISSUANCE FEE 27.75 ITHOMAS PAGE: 597 GRID: 84 LOCALITY: TEMPLE CITY
47 WATER HEATER(S) 1.00 WTH 16.35 1
TENANT: TOTAL FEES 44.10 ISSUED ON: PROCESSED BY: PLAN EXPIRES ON:
09/1096 TC 09/10/97
OWNER: TEL. NO: FINAL DATE FINAL BY: CODE:
WARD, GEORGE (818) 442-6089-
10127 OLIVE ST to-18
TEMP 917803345 DESCRIPTION 0 OR
NEW WEER HEATER
APPLICANT: TEL. NO:
RBI INC. (818) 594-3686-
&�LENS
SPECIAL CONDITIONS:
CONTRACTOR: TEL. NO: ® APPROVALS DATE INSPECTOR SIGNATURE
RBI INC (909) 594-3686-
3940 VALLEY BLVD. UNIT D LIC. NOUNDER SLAB WOR
WALNUT, CA. 91789 683107 C36
WATER SERVICE
ARCHITECTPLASTIC Y/N METAL Y/N OR ENGINEER:EER: TEL. 0: � �
ROUGNPLUMBING
LIC. NO:
GAS PIPING
PUB"Lc w®RKs GAS VET
HOT WATER HEATER
0 l w Y 1 PLUMBING FIXTURES
�
(7
1�:i ..� / L ��; � LAWN SPRINKLERS
❑ \....
GAS TEST
*0 UTILITY COMPANY NOTIFIED
& CWV
°c a GRAY WATER SYSTEM
REPORT ID: DPR263 ROUTE TO: BS0508