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76A667 17 11-49 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER PLUMBING 2
FOR APPLICANT TO FILL IN DISTRIrGRO P ZO
NE PERMIT N13.
PLUMBER _. �RECE V BY READY FOR DATE ISSUED
�l �w _ FIRST INSPECTION si
-
��AC BUILDING
�.�,F
CITY� !(:" L TEN .` J � � ADDRESS i -e �.
COUNTY -f
LICENSE NO. �/I• V f� EXPIRES C�`m3£f c d LOCALITY`! _�/^
NEAREST
PERMIT FEES CROSS 5T.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER /C:Z
WATER CLOSET(TOILET) @ 0.50 S ADDRESS)//413,-,��//je- I�
BATHTUB @ 0.50 CITY7 �� •��•'J,rJ /q,A_ TEL. No.
SHOWER 0.50 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
p LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
O KITCHEN SINK @ 0.50 AND STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
A LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPE ESC ISED ABOVE.
GAB SYSTEM 00
OUTLETS @ .5 � 'C1t� � r ��-
SIGNATURE OF 0
Y WATER HEATER @ 0.50 PERMITTEE �. '
SLOP SINK @ o.5o INSPECTION RECORD
FLOOR BINK @ O.SO
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50
HOUSE SEWER @ 0.50 (]
IWISCELLANEOUS J
I o
APPROVALS
DATE INSPECTOR'S NAME
I I I ROUGH PLUMBING I
GAS PIPING
GAS VENT
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT 1.1313 GAB TEST
UTILITY CO.NOTIFIED
TOTAL FEE .9 ,8
FINAL
76AB67 A, I-49�~� APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
' COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER PLUMBING 1
FOR APPLICANT TO FILL IN L DISTRIC,,TUP OPERMIT NU.
PLUMBER A � A��('�✓ d�ECEIVED BY READY FOR L90/7BU1/®
r�jj �/ • . 14/ _ FIRST INSPECTION -a
REEIG
BUILDING
CITY j •• �/O/ TEL.Nq_ 'J �O(y
ADDRESS /y�/�(J A.1/✓`C�
LICENSE NO. L - pO- �DOUN
LOCALITY
EXPIRES
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL �/ f
WATER CLOSET(TOILET) 0.50 $ ADDRESS
BATH TUB @ 0.50 CITY ��IJJ /rj�� TEL No.
SHOWER 0 0.50I HEREBY ACKNOWLED E THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
KITCHEN SINK 0.50 AND STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT I POSSESS THE ABOVE VALID LOB
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
OF THE RESIDENT AL PRO ERfj ESC BED pVE
GAS SYSTEM OUTLETS @ 0.50
e SIGNATURE OF
6 WATER HEATER @ 0.50 PERMITTE���a.n!
SLOP BINK @ 0.901 INSPECTION RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.501 1
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50 -I
Q
HOUSE SEWER @ 0.50 Z_
MISCELLANEOUS 1 0
lz
O
14
APPROVALS
DATE .4INBPECTOR'B NAME
1 ROUGH PLUMBING I ,,00 ' I
1 GAB PIPING
r
1 GAB VENT
CESSPOOL @ 1.130 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT . I 1.00 GAB TEST
UTILITY CO.NOTIFIED
TOTAL FEE
FINAL
-COUIITY OF LbS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1304220010
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
(LEGAL ID: I FEES PAID 1 BUILDING ADDRESS:D
ITR: 17107 LT: 41 I I4814 AV
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:I TEMP CA 917804032 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I
18585-011-021 101 PERMIT ISSUANCE FEE 27.80 I THOMAS PAGE: 597 GRID: B5 LOCALITY: TEMPLE CITY CAI
1 107 BATHTUBS/SHOWERS 1.00 FIX 16.20 1 1
(TENANT: 125 LAVATORIES/SINKS 2.00 FIX 32.40 (ISSUED ON: PROCESSED BY: PLAN BY:
1 145 WATER CLOSET/URINAL 1.00 FIX 16.20 04/22/13 SR
151 LOW PRS GAS 5 OUTLET 1.00 SYS 16.20 1 I
10WNER: TEL. NO: 1 TOTAL FEES 108.80 F-TIVAL DATE FIN BY: CODE: 1
ITANG, YU HANG (626) 264-0482- 1 I r 1
14814 RYLAND AVE 1 ( 1
TEMPLE CITY CA 91780 DESCRIPTIONF WORK IBATHTUB/SHOWER, LAVATORIES, TER CLOSET AND GAS LINE 1
[SAME AS OWNER TEL. NO: - I I I
I ISPECIAL CONDITIONS: 1
I I
(CONTRACTOR: TEL. NO: 1 [APPROVALS DATE INSPECTOR SIGNATURE
[SAME AS OWNER - 1
I LIC. NO 1 [UNDER SLAB WORK 1 1 1
I I IWATER SERVICE I I I
I I IPLASTIC YIN METAL YIN 1 I
[ARCHITECT OR ENGINEER: TEL. NO: [ I I I
1 - 1 [ROUGH PLUMBING I
1 LIC. NO: 1 I I
IGAS PIPING
1 IGAS VENT I I 1
I I IHOT WATER HEATER I I I
1 I IPLUMBING FIXTURES I I I
ILAWN SPRINKLERS I I
I I I I I
GAS TEST
[UTILITY COMPANY NOTIFIED( I 1
I I I� i I I
IGRAY WATER SYSTEM 1 I 1
I i I I
I
IREPORT ID: DPR263 ROUTE TO: BS0508 1 I I I
_ I I I I I