HomeMy Public PortalAbout6380 ENCINITA AVE_Plumbing__ 76AG60A IcQJ B19B1 11/76
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„ APPLICATION FOR PLUMBING PERMIT
BUIL IN AND SAFETY DIV N
FOR APPLICANT TO FILL IN I PRINT OR TYPE I BUILDING
NUMBER FIXTURE OR ITEM ® FEE ADDRESS
6380 N_ FnCinitA Avp-
WATER CLOSET LOCALITY Tprnp1p City I irPnqP 'A� -
NEAREST
BATH TUB CROSS ST. Olive
SHOWER OWNER Mr, and Mrs M Barton
LAVATORY
ADDRESS 6380 N. Enc i n i to Ave.
SINK CITY Temple City TEL NO. 287-4253
DISHWASHER CONTRACTOR E. L. Payne
CLOTHES WASHER
ADDRESS 1.66 W. Live Oak
SWIMMING POOL RECEPTOR
CITY Arcadia TEL.NO. 446-6118
LAWN SPRINKLER SYSTEM
STATE LIC.
WATER HEATER LICENSE NO. 120228 CLASS C-20
1 GASSYSTEM 1 OUTLETS 00 DISTPIC 1.L/ SiQQUP3 7,0pIE PR SSFA BY
OUTLETS OVER �`�� (k1�A' SCJ/
5 PER SYSTEM INDUSTRIAL d
WASTE APPROVAL O
INSPECTION RECORD V
OC
0
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WI
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Plan check fee
PLUMBING PERMIT ISSUING FEE$ 7 00
TOTAL FEE 1 0 00
Plan check applicant
APPROVALS DATE INSPECTOR'5 SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
City TBI.No. GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
I HEREBY CEflTIFY THAT I AM PROPERLY REGISTERED ANO/OR LIC NSED AS PLUMBING FIXTURES /
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR I AM THE - GAS TEST Q �`
LEGAL OWNER OF.AND INTE5WW RESIDE IN THE ABOVE DESCRIB ESIDENTIAL /
PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OFF ITTEE _
PLAN V DATPOPI M.o. CASH PERMIT VALIDATION r cK. M.O. CASH
I • .:Y HOLDERR.R,,c f5e'�9 0 3 JUN 12 5 0 "1. 0.0 U A=
POLICY NUMBER: 3ja776 07 7.), ®'