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APPLICATION FOR PLUMBING, PERMIT
COUNTY OF LOS ANGELES -BUILDING AND SAFETY
FOR APPLICANT TO FILL IN IPRINT OR TYPE) BUILDING
NUMBER FIXTURE OR REM O FEE ADDRESS
WATER CLOSET LOCALITY
NEAREST
BATHTUB CROSS ST
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY TEL NO
DISHWASHER CCNJTRACTO
CLOTHES WASHER ADDRESS
SWIMMING POOL RECEPTOR '
CITY TEL
LAWN SPRINKLER SYSTEM STATE 2..
WATER HEATER LICENSE NO CLASS C-r
pGAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE
5 PER SYSIEMR UNDER SLAB WORK
ROUGH PLUMBING y
GAS PIPING O
GAS VENT V
n
HOT WATER HEATER O
PLUMBING FIXTUR
GAS TEST b
Plan check fee UTILITY CO NOTIFIED _
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL J
Plan check oppl,cant PLAN CHECK VALIDATION
Nome
Address
City Tel No
I NEWBY ACKNOWLEDGE THAT I HAVE READ TRIS APP TION AND STATE /,
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ;P,74 2 3 A
AND STATE uwS REGULATING KUNMING PERMIT VALIDATION
I HEREBY CERTVY THAT I AY PROPERLY REGISTERED AND/OR LICENSED AS I # a •'• a 9'5 '
REQUIRED BY LOS ANGELES CW NTN AND STATE OF CALIFORNIA OR THAT I AN THE '
LEGAL OWNER OF AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL I @,*
^LL 0 O
PROPERTY
SIGNATURE as • a O O 2i
OFPERMITTE
DISTAL NO �` D BY •I a 2 5Y-7 9
INDUSTRIAL
WASTE APPROVAL ,
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APPLICATION FOR PLUMBING RMIT
COUNTY OF LOS ANGELES
DEPARTMENT
AOOF�SCO TA��ENGIIVEE[i aBELDENa
BJIIA�AM 91 E. OUNTY CN1O6[OR� ADDRESS `!`Y10� dUil�1.UI LL1,
ST
WILLIAM A JENSEN SUPT of BUILDING LaCA1(TT
FOR APPLICANT TO FILL-IN CROSS T
NUMBER FIXTURE OR ITEM EACH P[ owm! + �+
WATER CLOSET $Iss SO KAM
/ BATH TBS 125 DRM /jamp-
SHOWER I Ty 1 . t CITY TEL. no
LAVATORY 1 ss 3 /,S CONTRACTOR 6DaAkel
/ RHR 123
/ DISHWASI�H ADDRESS 14617
Iss QTY63a �JwLn (A-LAh
TEL No F.d.-81127$)
/ LAUNDRY TDB 125 {
CONTRACTOR
NO 197747 COUtT ❑
CLOTHES WASHER 143 DISTRICT NO I GROUP I Z E ! SV
WATER HEATER 130
-GAS SYSTEM OUTLETS 1 30 INDUSTRIAL a
WASTE APPROVAL
OUTLETS OVER 3 PER SYSTEM .00 INSPECTION SECORD O
W
l •C712 Z
AI
1 r —
3. —
AP ATE/ INEF[CTOR E baNw
PERMITI2 OO UNDER�1• WORK /
ROUGH PLUMBING '
TOTAL FE
GAS PIPING
1 NSTATT HAT TH ABO 1. 1 CORRECT
REAu MPLY GAS VENT
AMD RAT[ TNAT THE RDIMA Ie CORRECT AGR COMING
PLUNGIALL NG couHTY owDlHwwcu AND ETouLAnM° HOT WATER HEATERmFG THAT 1 AM IIIOIIwO AND/OR PLUMBING FI%TURESNEEDA[ REQUIRED er LO[ AHa[L[. STAT[ OF GAS TEST
CALIFORNIA OR THAT I AM THE L[ ALOWI D TORIDE IN THE AwVff/�E/JIe[D UTILITY CO NOTIFIED
SIGNATURE /� AV
OF PERMI fi
FINAL i
0ALIDATION ROBERT A WOOD
M O CASH SUPERVISING MECHANICAL ENG R
[AGO 8'9 3 8Z2 JAM 19; 5 D 15.75- 4
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COUNTY OF LOS ANGELES TEMPLE CITY i! 0508 PLL14BING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0101310005
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 i
PHONE (626) 285-0488 EXT
LEGAL ID FEES PAID BUILDING ADDRESS
TR 11218 LT 1 BL B 5466 SULTANA AV
FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803054
ASSESSOR INFORMATT5"098ER NEAREST CROSS STREET- BROADWAY
5388-002-025 01 PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY
51 LOW PRS GAS 5 OUTLET 1 00 SYS 16 20
TENANT TOTAL FEES 43 95 ISSUED ON PROCESSED BY PLAN BY EXPIRES ON
' 01/31/01 UT 07/30/01
OWNER —rfr No FINAL DATE FINAL,9Y4-j.., CODE
CHOU FU C,YUAN Y - 1
5466 SULTANA AV ( 2'�-0
TEMP 917803054 USMMUN U
INSTALL NEW MAIN GAS LINE
APPLICANT
NO
DZEN-KUD PAN (626) 284-5721-
1604 S MONTEREY ST SPECIAL CONDITIONS
ALHAMBRA, CA
CONTRACT OR TEL NOPAM �Oy PNGELES Cp��TyAPPROVALS DATE INSPECTOR SIGNATUR
DZEN-KUO (626) 284-5721-
1604 S MONTEREY STREET LIC NO UNDEP SLAB WORK
ALHAMBRA, CA 91801 518456/C36
WATEP SERVICE
PLASTIC Y/N METAL Y/N
ARCHITECT OR ENGINEER ILL NU
LIC NGAS PIPING
O 11111 t1
WORMS)NORMS
FEW NG FIXTURES
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GAS Tt5l
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ervice ThGRAY WATER SYSTEM
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REPORT ID DPR263 ROUTE TO BS0508
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