HomeMy Public PortalAbout4533 ELLIS LN_Plumbing__ 76AG67A (CE 017B) -4/77
Q APPLICATO®N FOR PLUMBONG PER OT
BUILDING AND SAFETY DIVISIO
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM ® FEE ADDRESS 4533 Mis Lane
WATER CLOSET V C9 LOCALITY mple City
BATH TUBv A C)^ NEAREST
(� CROSS ST
SHOWER OWNER Murray L&-9d & Dev,
LAVATORY O DMAIL
ADDRESS 3606 No Rio Hondo Ave,
SINK CITY Rosemead TEL.NO. 443-1579
DISHWASHER 'p� C9 CONTRACTOR
Owen Bros, Plumbing9 Inco
CLOTHES WASHER 3 06
ADDRESS 4265 No-Baldwi.n Ave,
SWIMMING POOL RECEPTOR
CITY El Monte TEL.NO. 443--0078
O
LAWN SPRINKLER SYSTEM STATE LIC.
® WATER HEATER � O�
LICENSE NO. 231 741 CLASS C36-20
GAS SYSTEM OUTLETS G o o DISTRICT NO.J� OUP Z E PRO SSED B
OUTLETS OVER �` 0 ! O
5 PER SYSTEM INDUSTRIAL V
WASTE APPROVAL I=
INSPECTION RECORD �
`y-y-fig �/✓ L�G 72) I'V11'? `t�L�ST14FrL_
12-JZ-7F C4uEt gasp- cE� ;t ►v
Plan check fee
PLUMBING PERMIT ISSUING FEE$ L;!
TOTAL FEE 0V
Plan check applicant'.
APPROVALS DATEINSP CTOF'S SIGNATURE
Nome _
UNDER SLAB WORK 11-2-7-6
Address ROUGH PLUMBING
City Tel. No. GAS PIPING 1 l'
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT w
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES I T
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES b'JV
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST
LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE FINAL '� k,a
PLAN CHECK LIDsATICHV�� P I �Mp ® ABH PERMIT VALIDATION U Oo 6 CKO
VA . M.0. CASH
1 9a 9D 0 �7
�l CD O o
Ia40LICY HOLDER: 00 o o Cn :r-
CH
POLICY NUMBER.-,,