HomeMy Public PortalAbout6028 AVON AVE_Plumbing__ (3) 76A887 -CEWB 17 12 64
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING 6028 Avon
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
COLEMAN W JENKINS SUPT DF BUILDING LOCALITY San Gabriel
FOR APPLICANT TO FILL IN NEAREST
ROSS ST Muscatel & Burghardt
NUMBER FIXTURE OR ITEM EACHIFEE OWNER John J. Burghardt
2 WATER CLOSET $125 #12 Holsted Circle
MAIL
BATH TUB 125 ADDRESS
CITY Alhambra TEL N
1 SHOWER 125 1
2 LAVATORY 125 2 50 CONTRACTORLamac Plumbing Co.
3INB 125
ADDRESS 051 W. Front St.
DISHWASHER 125 CITY Covina TEL N0339-24.79
LAUNDRY TUB 1 25 CONTRACTOR S 2 aO COUNTY ]
REGISTRATION NO
1 CLOTHES WASHER 125 1 25 DISTRI�c NO G ZO E P BY
1 WATER HEATER 1 50 1 50 177 , cL-,
GAS SYSTEM OUTLETS 150 INDUSTRIAL a
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 0 INSPECTION RECORD O
V
O
1�
V
W
_ d
N
Z
APPROVALS DATE INSP CT/ORR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
55 ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH/ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTE
FINAL
, VALIDATION ROBERT A WOOD
cJfJJ M O CASH SUPERVISING MECHANICAL ENG R
LAC07305t2 NOV 12 5 A 16.55-
r