HomeMy Public PortalAbout5104 DOREEN AVE_Plumbing__ 26 A 667 —'CE 017 7-69 TEMPLE CITY '
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING' AND SAFETY DIVISION ADDDRESS 5104 Doreen Street
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY Temple City
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER Mars all
WATER CLOSET 1.50 OO NAIL
BATH TUB 1.50 O ADDRESS
SHOWER 1.50 S^� CITY TEL. NO.
LAVATORY1.50 CONTRACTOR Owen Bros. Plumbing,Inc
SINK 1.50 ADDRESS 4265 NO: Baldwin Ave.
DISHWASHER 1.50 I CITY El Monte 91731 TEL No. 443-0078•
CLOTHES WASHER 1.50 LIC C
SATE
ESE NO. 231 741 E1 CLASS 36
SWIMMING POOL RECEPTOR 1.50
DISTRICT NO. GROUP ZONE P E O B
LAWN SPRINKLER SYSTEM 2.00
WATER HEATER 1.50 U INDUSTRIAL 1
WASTE APPROVAL
GAS SYSTEM S OUTLETS 1.50 l INSPECTION AE D u
OUTLETS OVER /
5 PER SYSTEM .30 v.F � Z
d
N
Z
Plan check fee 2.S o of above. See reverse.
PLUMBING PERMIT ISSUING FEE 3 2 00
TOTAL FEE O
_ APPROVALS DATE INSPECTOR'S SIG uru RE
Plan check applicant UNDER SLAB WORK '� �✓ ��
IN ame ROUGH PLUMBING44
Address GAS PIPING
GAS VENT
Grt}' Tel. No. HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
I HEREBY CERTIFY THAI I AM PROPERLY REGISTERED ANO/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIi.R..A OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE O CRI RESIDENTIAL PROPERTY. FINAL
BIGNATU RE JACK R. ALLEN, SUPERVISING CHANICAL ENG'R.
OF PERMITTEE "
.. . .-.. _. PERMIT VALIDATION K M.O. CASH
PLAN CHECK VALIDATION CH. M.o. CASH
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