HomeMy Public PortalAbout5105 GLICKMAN AVE_Plumbing__ 76A667-CE817-8-58 Job 587
j APPLICATION FOR PLU�V(BING PMIT 1
COUNTY OF LOS ANGELES L I C•K
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, CountF Engineer
CASSATT D. GRIFFIN, Sup t of Building
LOCALITY Temple Cit
FOR APPLICANT TO FILL IN CROS SST. Ba ldVrin Ave.
NUMBER FIXTURE OR ITEM
OWNER Adstad
2 WATER CLOSET j MAIL
1 BATH TUB Z ADDRESS
SHOWER CITY TEL. NO.
2 LAVATORY ?- CONTRACTOR Fie lve de re Plumbing C O.
l SINK ADDRESS 11900 E. Garvey Blvd.
DISHWASHER CITY El Monte TEL. NO. Gi 89836
CONTRACTOR'S STATE ❑
LAUNDRY TUB REGISTRATION NO. 179568 COUNTY El
1 CLOTHES WASHER / DISTRICT NO. GROUP ZONE P OCESSED BY
1 WATER HEATER
1 GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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APPROVALSCcb
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OR FIER ITEM XTiJi� $ DATE INSPECTOR'S SIGNATURE
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UNDER LAB WORK
PERMIT $ 2100 ROUGH PLUMBING
TOTAL FEE 1-11 100 GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES 'r/
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATUREFINAL
OF PERMITTE
ROBERT A.WOOD.
®F VALIDATION SUPERVISING MECHANICAL ENG'R
CK. H.O. CASH
rn8066 0V24 5 A 11 .00 '
76A667 - CE817 5/70
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES u
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION BUILDING
j
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALIT�� C
FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER- , LC
WATER CLOSET 1.50
MAIL
BATH TUB 1.50 ADDRES
CI TEL. NO LES G
SHOWER 1.50 ,r _ -
LAVATORY 1.50 CONTRACT
SINK 1.50 ADDRESS
DISHWASHER 1.50 CI 1 TEL. NO.
CLOTHES WASHER 1.50 STATE LIC
LICENSE NOM/ CLASS
SWIMMING POOL RECEPTOR 1.50
DISTRICT NO. GROUP ZQN ll P OCESSED BY
LAWN SPRINKLER SYSTEM 2.00 G &'-vV
WATER HEATER I• WASTE INDUSTRIAL
/ ®'
GAS SYSTEMOUTLETS 1.50 INSPECTION RECORD u
OUTLETS OVER .30
5 PER SYSTEM
O
Lu
W
D..
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Plan check fee 257. of above. See reverse.
PLUMBING PERMIT ISSUING FEE . 0
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name j ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel. NO. HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO 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 THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTI L PROPERTY. FINAL /'
SIGNATURE JACK R. ALLEN, SUPERVISI HANI CAL ENG'R.
OF PERMITTEE
PERMIT VALIDATION CK. M.O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH