HomeMy Public PortalAbout6031 GOLDEN WEST AVE_Plumbing__ 76A667A
CE 817(REV 6/78) - •'
tS i.
APPLICATION IFOR F• UMBING PERMIT
COUNTY OF LOS ANGELES �` BUILDING AND SAFETY '
FOR APPLICANT TO FILL IN IPRINT OR TYPE). •_ BUILDING
N6031 Golden •West
ADDRESS
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET 7� LOCALITY Temple Cit
U NEAREST '
BATH TUB CROSS ST
of
SHOWER OWNER Nick• Gomez
MAIL
LAVATORY ADDRESS 11915 Eberle Street
SINK 'CITY Cerritos TEL No 924-4580
DISHWASHER CONTRACTOR
Owen- Bros. Plumbing ,Inc.
CLOTHES WASHER ADDRESS'
4265 N. Baldwin Ave.
SWIMMING POOL RECEPTOR
LAWN SPRINKLER SYSTEM CST
ITY El Monte TEL NO 443-0078
WATER HEATER 7 LIC NSE NO 231 741 TATE - LIC
SS , C36-20
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR S SIGNATURE
'OUTLETS OVER UNDER SLAB WORK f' ,J
5 PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT
R!
HOT WATER HEATER
PLUMBING FIXTURES 9
GAS TEST / 1111!!ll�A
Plan check fee UTILITYCO NOTIFIED
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE FINAL ? 'g
PLAN
CCH�ECK�VALIDATION
Plan check applicant ��C.�iG�M-tip '
Name 7'6 4.6 A
Address
6-716 67- # Oo,OODS
City Tel-No 2 o 4 9,0 0
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE '
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES O O -49.0 O u
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS 10'7 ! 7
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE '
LEGAL OWNER OFD INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL f/ �j���•}.- i )���y�s, ��` �,�' y�
PROPERTY
SIGNATURE
OF PERMITTEE +� ^,
6-uT-
DISTRICT NO 06CESSED BY
INDUSTRIAL -
WASTE APPROVAL