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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES BUILDING AND.SAFETY
FOR APPLICANT TO FILL INIPRINTORTYPE) BUILDING
5
NUMBER FIXTURE OR ITEM ® FEE ADDRE
WATER CLOSET LOCALITY
NEAREST Js ��
BATH TUB CROSS ST. f/
SHOWER OWNER fy ,VMAIL
LAVATORY ADDRESS /00' i✓� DL/!�F
SINK CITY 7. (- TEL.NO.
DISHWASHER CONTRACTOR A',Jqr/ A ��
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR
CITY MA 7v ' TEL.NO.
LAWN SPRINKLER:SYSTEM ATEG u
WATER HEATER rGASPIPING ATE
O 7 CLASSGAS SYSTEM OUTLETS DATE INSPECTOR'S SIGNATURE
OUTLETS OVER K5 PER SYSTEM
GAS VENT
29
HOT WATER HEATER
PLUMBING FIXTURES
GAS TEST
Plan check fee UTILITY CO.NOTIFIED g
PLUMBING PERMIT ISSUING FEE$ 6-'C) FINAL
TOTAL FEE /0
Plan check applicant PLAN CHECK VALIDATION
Name
Address
City Tel.No.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES :2'6 2 6 8 A
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS # O O O O a 5
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE
LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE D -RIBED R ENTIAL
PROPERTY. I a 0 q 1 0.0 O
.SIGNATURE a 0 0 1 Q O G
OF PERM ITTE
DISTRICT 110. PROCE D BY D a 2 2—7 9
S. 8�
INDUSTRIAL
WASTE APPROVAL
)8A667
)ISS-17 Io.ss• APPLICATION FOR PLUMBING. PERMIT 1
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of.Los Angeles BUILDING
JOHN A.LAMBIE. COUNTY ENGINEER ' ADDRESS 1614
CASSATT D.GRIFFIN,SUPT OF BUILDING
LOCALITY
FOR APPH�jM TO FILL IN NEAREST
ell-
CROSS ST.
F
OWNER i DISTRICT NO. GP I ZONE I READY FOR INSPECTION
MAIL
•ADDRESS
INDUSTRIAL
CITY TEL.NO. WASTE APPROVAL
PLUMBER c INSPECTION RECORD
ADDRESS
CITY �f✓/
LICENSE N
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET). @ $1.00 $
BATH TUB @ $1.00
SHOWER @ $1.00
LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @. $1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING I
GAS PIPING
TOTAL FEE .
• GAS VENT �/
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION H07 W�1TER.HEATER .!�•-i
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING. r
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST �if� `.•1 r asl s.. �/
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT-I AM THE. LEGAL 0 ER OF E-ABOVE UTILITY CO..NOTIFIED .?.;,z
DESCRIBED RESIDENTIAL PROPERTY. qq
SOF PERMITTEEc FINAL ,� P -J
IOHN A.LAMBIE.COUNTY ENGINEER' ALIDATION ROBERT A.WOOD.CHIEF PLBG. INSPECTOR
N.®. CASH
'L[&6 ll2 P-.-. mAR 21 3 2.00 11
BS-177 f0-SB
) APPLICATION 'FOA PLUMBING' PERMIT .
)86.1
DIVISION OF BUILDING AND SAFETY �p
Deportment of County Engineer
County of 'Los AngelbB BUILDING / d
JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN,SUPT OF BUILDING //��//��
LOCALITY /'��/���
FOR APPLICANT TO. FML IN I NEAREST
CROSS ST.
OWNER DISTRICTNO GROUP ZONE READY FOR INSPECTION
MAIL
ADDRESS /1
INDUSTRIAL
CITY TEL.NO. WASTE APPROVAL
PLUMBER IV19 � INSPECT!ION RECORD
ADDRESS ®-r� B / d:v
CITY oXJ S/074 ,e��TTEEL.NO. Tv� � " � C E+�`N^�: /bGrs�-�! ud A r�
LICENSE NO.
NUMBER TYPE OF FIXTURE.OR ITEM FEE
WATElt CLOSET (TOILET) Q. $1.00 $ D`D lir A� r
BATH TUB @ $'1.00 OD � �n�i.n sem" �,� �J� r �r•
'SHOWER @ $1.00
LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ $1.00
DISHWASHER @ $1.00 r Il':a/ 4'r" A.,
LAUNDRY TUB OR TRAY @ $1.00 R�
CLOTHES WASHER @..$1.00 v�r"
WATER HEATER @ $1.00 l
GAS SYSTEM @ $1.00
• {�/moi - iF��/r//�A Rte'-� ,
°1A,0 t W' -e APPROVALS 01
4r,- r '
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK o� ° /
l
PERMIT $ 1 OD ROUGH PLUMBING
TOTAL FEE
GAS PIPING
� -
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 d�
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING.FIXTURES p �f
PLUMBING.
I HEREBY CERTIFY T I AN ROPER EGISTERE AND/OR' GAS TEST
LICENSED AS REOUI BY L09 GELE LINTY AND STATE OF
CALIFORNIA OR T T I AM -T LEG WNE HE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDE TIAL PRO Y. q 1
SIGNATURE
OF PERMITTEE .FINAL `F7/�� ����eil'l•�f�.
OHN A.LAMBIE.COUNTY ENGINEER ^VALIDATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR
�( M.0. CASH
�;%Y'aE� ';%,;�►!fi '•..� t ., Ika
314 0 6 Ma DEC 17 3 8.0 0 N
p -
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0108130002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
�► PHONE: (626) 285-0488 EXT:
BUILDINGLEGAL nYi-- FEES PAID SS:
TR: 11290 LT: 01 10668 OLIVE ST
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 91780
5 SS 0 NEAREST CROSS STREET: EL MONTE
8585-031-001 01 PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY
07 BATHTUBS/SHOWERS 2.00 FIX 32.40
TENANT: 11 CLOTHESWASHER(S) 1.00 FIX 16.20 ISSUED ON: PROCESSED B EXPIRES ON:
13 DISHWASHERS) 1.00 FIX 16.20 08/13/01 JK 02/09/02
21 HOSE BIBB(S) 2.00 FIX 32.40
OWNER: TEL. NO: 25 LAVATORIES/SINKS 4.00 FIX 64.80 FINAL DATE FINAL BY: CODE:
LEE SALINA (626) 442-2223- 45 WATER CLOSET/URINAL 2.00 FIX 32.40 y� 0
10668 OLIVE ST. 47 WATER HEATERS) 1.00 NTH 16.20 �� -�� '
TEMPLE CITY, CA 51 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 DE3.RIPTTON OF WORK
63 WATER PIPING BR/FIX 3.00 FIX 20.25 PLUMBING FOR ADDTION
TOTAL FEES 274.80
E .
SAME AS OWNER -
_ r SPECIAL CONDITIONS:
CO TRACTOR: TEL. 0: :`f'� �/� • . APPROVALS DATE I CTOR SIGNATURE
SAME AS OWNER - �•���`"�
LIC. NO L� �.��-"a \` UNDER SLAB O K
( � WATER SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT 0 ENGINEER, EL. 0:
ROUGH PLUMBING
LIC.-NO:''. �j-�—
+ ' q-"---GAS PIPING
FM
'j IN: HOT WATER HEA
TER
� - - -- - - - - --- - PLUMBING TRS J�r-
LAWN SPRINKLERS
UTILITY COMPUT OT F
GRAY WATER 97STEW
REPORT ID: DPR263 ROUTE TO: SS0508