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APPLICATION FOR PERMT
DEPARTAIENT OF BUILDING AND SAFETY PLUMBING
COUNTY OF LOS ANGELES
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZONE PERMIT NO
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PLUMBER CEIVED BY EADYFOR DATE I8SUED
FIRST INSPECTION ti S-6 O
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CITY TEL NO ADDRl98 O L /M N M J
COUNTY LOCALITY
LICENSE O MPIREB
NEAREST LAND
PC.p�AT�P �.�. CR0888T {� 1�V�^ (�
NYYBRR T Pt of FIt RK OR IT[Y FEE OWNER A (►L J
MAIL �` Sr
WATER CLOSET (TOILET) O S ADDRESS � /'l /,
BATH TUB 080 CITY Wp i`� TEL NO 6 AI
SHOWER O SO 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY IWASH BASIN) a 050 APPLICATION AND STATE THAT THE ABOVE IE CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING PLUMBING
KITCHEN SINK O SO 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY O SO ANLCERTIFY
COUNTY LICE SH OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL P P TY DEB IBED BOVE
GAS SYSTEM-OUTLETS ® O SO
SIGNATURE OF
WATER HEATER ® O SO FERMI EE
SLOPSINK a 0501 11 INSPECTION RECORD
FLOOR SINK a O SO
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FLOOR DRAIN 050
DISHWASHER O SO d�
DRINKING FOUNTAIN O SO
URINAL 42 O SO ,J
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HOUBH SEWER O 60 elZ
MISCELLANEOUS L7
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APPROVALS
DATE INRPtc It t MAY[
ROUGH PLUMBING
GAB PIPING I+ I V•
GAB VENT
CESSPOOL 100 CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN ( I PIT ( I 0 1 00 1 1 SEWER
PERMIT 1 OO GAS TEST
UTILITY CO NOTIFI HD
TOTAL FEE E
FINAL
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vowel TF wa m APPLICATION FOR PERMI!
DEPARTMENT OF BUILDING AND SAFETY PLUMBING
COUNTY OF LOS ANGELES
WILLIAM J FOX, CHIEF ENaINHER
FOR APPLICANT TO FILL IN DISTRI^� O GROUP ZONE PERMITNO
6 ` 006
PLUMBER R IVES BY EADY FOR OATH ISHU ED
FIRST INSPECTION
ADDRESS I
J BUILDING
CITY����/�/11f��j� TEL NO ADDRESS
COUNTY LOCALITY
LICENSE NO EXPIRES ��
NEAREST
PERb= FEES CROSS ST
1
NUM"M TYM OF M"URt OR IT[M PEE OWNER /q
MAIL
WATER CLAS (TOILET) O SO S ADORHSB �
V
BATH TUB O 80 CITY �/�� T TEL NO
SHOWER O BO 1 HEREBY ACKNOWE H THAT I HAVE READ THIS
LAVATORY WASH BASIN) O EO APPLICATION AND STATHAT THE ABOVE IB CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK a O SO STATE LAWS REGULATING PLUMBING
1 CERTIFY THAT I POSSESS THE ABO%E VALID LOS
LAUNDRY TUB OR TRAY O SO ANGELES COUNTY LICENSE OR I AM THE LNGGAL OWNER
OFTHE
PERRESIDENTIAL NTIAL
GAS BYBTQM_OUTLHTB O BOI SIGNATURE OF ��ROPERT�YOL�•/ LIG/4§�LJ
VQ
WATER HATER @ OSOI
SLOPSINK 0 O SO I INSPECTION RECORD
FLOOR SINK a O SOI
FLOOR DRAIN O BO
DISHWASHER 0 O SO
DRINKING FOUNTAIN O BO 1
URINAL a O SO J
HOUSHSEWER 0501
Z
MISCELLANEOUS (�
a
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I
I
APPROVALS
DATE IN[PQCTOR{ NAME
ROUGH PLUMBING
GAS PIPING
OAS VENT
CESSPOOL 1 001 CESSPOOL
SEPTIC TANK SEPTIC TANK
DRAIN I I PIT 1 1 ® 1 00 86YJER 3-1b
PERMIT 1 00 GAS TEST
UTILITY CO NOTIFIED
TOTAL FEF
FINAL 3/-11
COUNTS OF LOS "GEL" TEMPLE CITY 10508 PLUMBING PERMIT
DEPARTMENT OF PUBLIC WORIB 9701 LAS TUNAS PL 0506 0507790003
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (676) 385-0488 HIT
LEGAL ID FEES PAID BUILDING ADDRESS
ON PILE 5051 SULTANA AV
FEE DESCRIPTION QUANTITY UOM AMOUNT TET CA 917803046
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET
5388-070-018 01 PERMIT ISSUANCE PRS 77 75 THOMAS PAGE 596 GRID HS LOCALITY TEMPLE CITY, C
03 BACKWATER VALVES) 1 00 VAL 46 95
TENANT 05 BACRPI.OM DEVICE(a) 1 00 DEV 16 70 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
07 RATRTUBS/SHOIWENS + 00 FII 64 80 07/79/05 JX 01/25/06
11 CLOTHESMASHER(S) 1 00 FII 16 70
OWNER TEL NO 75 LAVATORIES/SINKS 4 00 FIX6{ BO FINAL D;,p,gM BY CODE
BAN, JENNIFER (676) 785-7795- 45 WATER CLOSET/URINAL 4 00 PIX 6{ 80
5051 SULTANA AVE 51 LOW PRE GAB 5 OUTLET 1 00 SYS 16 70
TEMPLE CITY CA 91780 TOTAL FEES 317 70 DESCRI
PLUMBING FOR ADDITION AND REMODEL
APPLICANT I" NO
SAME AS OWNER -
SPECIAL CONDITIONS
CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC NO ORDER SLAB WORK ! /
y
NATER S&RVICH
PLA6TIC YIN METAL YIN
ARCHITECT OR ENGIIiEeR TEL NO
- ROUGH PLUMBING
LIC NO
GAS PIPING
GAS VENT
HOT MATER HEATER
PLUMBING FIXTURES
LAWN SPRINKLERS
GAS TEST
UTILITY COMPANY NOTIFIED
CWV T lT
GRAY WATER SYSTEM
REPORT ID DPR763 ROUTS TO BS0508