HomeMy Public PortalAbout5118 GOLDEN WEST AVE_Plumbing__ 76A667-CE8173-59Temple City
APPLICATI BING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION 7BUILDINGJOHN A. LAMBIE, County Enq'neer 1?8 Goldenwest
CASSATT D. GRIFFIN, Supt of Building Tem?le City
FOR APPLICANT TO FILL IN
CROSS ST.
NUMBER FIXTURE OR ITEM OWNER Don Rogers
2 WATER CLOSET MAIL
1 BATH TUB ADDRESS 9222 De$delina
SHOWER CITY Rosemead TEL NO.
1_
CONTRACTOR valley Plumbing Co,
3 LAVATORY
1 SINS ADDRESS 442—FFleetwood, Pi .
DISHWASHER
CITY Glendora TEL. NO. Ed 5-1'-
CONTRACTOR'S
--1'
CONTRACTOR'S 160847 STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY ❑
1 CLOTHES WASHER DITII,CT GROUP ZONE P OCESSED BY
1
WATER HEATER 6 ,�
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
a
0 $1.00 PER ITEM `
ll OR FIXTURE APPROVALS DATE INS CTOR'S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
4 G r
TOTAL FEE 13 ROUGH PLUMBING
GAS PIPING
AHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT _
D STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER `
[ HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE _
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE '� - /
OF PERMITT �-
OF �\TAUDATION ROBERT A. WOOD,
CK. M.o. CASH SUPERVISING MECHANICAL ENG'R
LCA z)8 5 7 3 4 5 0 1 3.0 0
78A887 WE-817)-4/72
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION CBUILDING/ /x�/�J_/e
MAKE CHECKS PAYABLE TO: W!r
HARVEY T. BRANDY, OUNTY LrNOINEER ADDRESS CLOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAR
CROSS SESTT.
NUMBER � FIXTURE OR ITEM • FEE
WATER CLOSET 1.75 OWNER
MAIL
BATH TUB 1.75 ADDRESS l 5
SHOWER 1,75 CITY TEL. NO -15 q3
LAVATORY 1.75 CONTRACTOR
SINK 1.73 ADDRESS ve
DISHWASHER 1.75 CITY`--1e Ili/(yTEL N0,;?, $�
CLOTHES WASHER 1.75 STATE LIC /r ��
LICENSE NO. CLASS l� .V
SWIMMING POOL RECEPTOR 1.76
D I�TAIO. GROUPI ZDNE QgESSED BY
LAWN SPRINKLER SYSTEM 1.75 �ff//////(`((�J�{{
Al
WATER HEATER 1.75 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.76 INSPECTION RECORD 8
OUTLETS OVER 30
5 PER SYSTEM 7- LJrIJ� /L/Q
� W
Plan check fee S•• Reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Addres, GAS PIPING
City Tel. No. GAS VENT
HOT WATER HEATER
1 HEREBY ACKNOWLEDSE THAT I HAVE READ THIS APPLICATION
AND BTATE THAT THE ABOVE 12 CORRECT AND ASRE[ TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY 0RDINAN CED AND STAT[ LAW( R[SULATINS
PLUMBI NS. GAS TEST
I HEREBY CERTIFY THAT I " PROPERLY REGISTERED AMD/OR UTILITY CO.NOTIFIED
LICENSED Al REOUI RED BY LOB ANGELES COUNTY AND STATE OF
CALIFORNIA OR THA2TH'.7.LEGAL OWN OF, AND INTEND TO
RESIDE III THE ABOVBR[fID[NT PROPERTY. J FINAL �77-7
5_
SI CY NATU RE
OF PERMITTE
PERMIT VALIDATION CK. M.0. CASH
PLAN CHECK VALIDATION CK. M.0. CABH
3.1 3 MAY 16 b B 7-5C)