HomeMy Public PortalAbout10936 DANBURY ST_Plumbing__ 76A667-CESI7359
APPLICATION FOR PLUMBING PERMIT �]
COUNTY OF LOS ANGELES -
DEPARTMENT OF COUNTY ENGINEER ' -
BUILDING AND SAFETY DII�V�ISION RmLDING
CASSAIII�IA. IE
'1TGAIFFTN, Supe gE Bwldiag ADDRESS 10936 E. +Oanbury
LOCAL= Temple Cit
FOR APPL[CANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
WATER CLOSET MAIL La rk v d Const.
MAIL
1 BATH TUB ADDRESS
1 CITY TEL. NO.
SHOWER
2 LAVATORY CONTRACTOR Richard Cavanauah P u
1 STNS ADDRESS 13354 Central Ave
DISHWASHER CITY Chino TEL NO. NA 84721
CONTRACTOR'S STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY
' CLOTHES WASHER DISTRIIC�STNNO. � GRO/UP ZONE PROCESSED BY
1 WATER HEATER ; �0 .1- I I _
GAS SYSTEM " INDUSTRIAL
WASTE APPROVAL
INSPECTION/RECORD /
a 51.00 PER ]TEM
10 OR FIXTURE $ 10. 00 APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 200 UNDER SLAB WORK `,/-I 'Lc
TOTALFEE ]-'Z bO ROUGH PLUMBING 'fes /'Y-ca
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION - J
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER i
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LDSRG']<LES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM S LEGAL OWNER IF THE ABOVE
DESCRIBED RESIDENTIAL PROP - Y. t UTILITY CO. NOTIFIED Y
SIGNATURE
OF PERMITTEF��
FINAL I If
®� -q--{/1 St.OATION ROBERT A. WOOD,
CK. R.O, Op9X SUPERVISING MECHANICAL ENG'R
{jtC07 8 3 62 MAR 16 5 A 1 2�.0 0
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76A667 ICE-BVI - 1/75
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APPLICA ON F PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISIOND NO
c
MAKE CHECKS PAYABLE TO: [R1DD"C"DL"FFSS10 6 DANBURYHARVEY T. BRANDT, COUNTY ENGINEER LITY TEMPLE CITY
- \
FOR APPLICANT TO FILL IN (PRINT OR TYPE] NEAREST
CROSS STyzt
NUMBER FIXTURE OR ITEM a FEE
OWNER
KEN GOLDBERY
WATER CLOSET 2.00
MAIL c T��
BATH TUB 2.00 ADDRESS 10936 DANBURY
SHOWER 2.00 GITYTEMPLE CITY TEL. NO. 448—r)1.15
LAVATORY 2.00 CONTRACTOR AQUATIC POOLS
SINK 2.00 ADDRESS 101 E. HUNTINGTONDRIVE
DISHWASHER 2.00 CITY ARCADIA TEL. NO. _
CLOTHES WASHER 2.00 5 CENSE NO. 315620 CLIC
LASS C-53
SWIMMING POOL RECEPTOR 2.00 - - -
DIST$ICT N GR U ZONE PR ES ED V
LAWN SPRINKLER SYSTEM 2.00 � d' _/-' .Ul� N c
2.00 WASTETAPPROVAL
a
GAS SYSTEM OUTLETS 2.00 INSPECTION RECORD U
OUTLETS OVER /
5 PER SYSTEM .30 p O
r U
W
N
Z
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE S
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan Check applicant UNDER SLAB WORK
Name ROUGH PLUMBING _
Address GAS PIPING
City Tel. No. GAS VENT
HOT WATER HEATER
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES —I
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST 'Ie'-17-'77 't
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR UTILITY CO. NOTIFIED
LICENSED AS REOU I RED BY LOS ANGELES COUNTY AND STATE OF
CALI FOq NIA OR THAT I AM THEL OWNER OF• AND D TO,
RESIDE IN THE ABOVE DESCRIBED E I Try FINAL
SIGNATURE
OF PERMITTEE •�'� �• "
- ._. ---- - .. PERMIT VALIDATION \ M,O: CASH
PLAN CHECK VAL16ATION CK. M.O. CASH
2 7 7�IMAY 13 5 B 1 35 0 ,&5a
O > Q