HomeMy Public PortalAbout5637 GOLDEN WEST AVE_Plumbing__ DEPARTMENT OF COUNTY ENGINEER PLUMBING
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS
FOR APPLICANT TO FILL IN LOCALITY
BUILDING NEAREST
ADDRESS �� CROSS ST
DISTRICT NO. GROUP ZDNE —PERMIT N0
LOCALITY � _ •
NEAREST _ D /i RECEIVED BY Ready for Inspection D/�ATE ISSUED a
CROSS ST. �_.bwC_ /LYS G(/1^L_ t / 6- "� , �J
OWNER `ILO�.V" •6•.
MAIL INDUSTRIAL
ADDRESS WASTE APPROVAL
CITY TE0
INSPECTION RECORD
®®'AF UAL.N .//�j
PLUMBER le/�sCA . 4,%, U�6P�yulLtsw� /r^2� 1 S
ADDRESS ) /,?y
CITY TEL.NO.jf7--y-q049 Alf �I/ rl-1fl ArJX7".
STATE
LICENSE NO �s� 4 7 O
/► �/ COUNTY
_ J
PERMIT FEES va
. z
Nl..M6ER TYPE OF FIXTURE OR ITEM FEE ur
!2:!'WATER CLOSET(TOILET) @ 0.80 3 D' O
BATHTUB @ 080
SHOWER @ 0.80 d
LAVATORY (WASH BASIN) @ 0.80 O
KITCHEN SINK @ 0 80
LAUNDRY TUB OR TRAY, @ 0 80
SLOP SINK @ 0 80
FLOORSINK @ 080
FLOOR DRAIN @ 080
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 080
URINAL @ 080
GAS SYSTEM..._f------OUTLETS @ 1.00 D
WATER HEATER @ 1.00 O
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ I OO ROUGH PLUMBING
TOTAL FEE d GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI_` GAS VENT / y�
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS /
REGULATING PLUMBING PLUMBING.FIXTUR SS K Y
STERED
AND/OR LICENSED CERTIFY
AS R QUIREDHEREBY THAT IABY LOS PROPEANGE LY RES(COUNTY GAS TESI, Iy rJ / I
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN=
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
IGNAT URE
SOF —.10
FINAL
76A667 DBS 17 1/53
78A887 (CE-817) - 1/75 /' 7- 01
�iM�I` / • /
APPLICATION FOR PLUMBING PERMIT [1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO MROAA
HARVEY T. BRANDT, COUNTY ENGINEERFOR APPLICANT TO FILL IN (PRINT OR TYPE)NUMBER FIXTURE OR ITEM p FEEWATER CLOSET 200
MAIL
BATH TUB 200 ADDRESS
SHOWER 200 CITY TEL. NO.
LAVATORY 200 CONTRA
SINK 200 ADDRES L. GRAND .
DISHWASHER' 200C ITY TEMPLE CITY, C*UFti (j
CLOTHES WASHER, 200 STATE //Q�r1 CLIC
LASS
SWIMMING POOL RECEPTOR 2.00 LICENSE NO1 41 UU u
DISTWTT NO GROUP /ZONE PR CESS I,
LAWN SPRINKLER SYSTEM 2 00
WATER HEATER 2fyg o INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 200 INSPECTION RECORD 0
OUTLETS OVER 90 v
5 PER SYSTEM
d'
O
F--
C.�
W
a
N
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEES 0
TOTAL FEE _
APPROVALS DATE IN9 PECTOR 9 SIGNATURE
LRES�DE
check applicant UNDER SLAB WORK
ROUGH PLUMBING
ss GAS PIPING
Tel NO. GAS VENT
HOT WATER HEATER
EREBY ACKNOWLEDGE THAT I HAVE READ •THIS APPLICATION
TATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
ING. ,
EREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
ED. AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
RNIA OR THAT I AM THE LEGAL O NER OF, AND INTEND TO
IN THE ABOVE DE IB RESI E IAL PROPERTY. FINALATUREPERMITTEE
PERMIT VALIDATION CK_ M.0. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
READU F®K FINAL � ASFE:1 (o �)�a� 9 5 7.50 � s
( �C�'