HomeMy Public PortalAbout6221 GOLDEN WEST AVE_Plumbing__ 7VA667-CE#017 5-61
APPLICATION FOR PLUMBING. PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION fU
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JOHN A. LAMBIE. COUNTY ENGINEER /�
WILLIAM A. JENSEN, SUPT OF BUILDING
FOR APPLICANT TO FILL IN 0 s Cl
T.
NUMBER FIXTURE OR ITEM OWNER -
WATER CLOSET buuL
ADDRESS
BATH TUB
CITY TEL. NO.'
" SHOWER
CONTRACTOR
LAVATORY
_ADDRESS Z
SINS
DISHWASHER CITY TEL. NO.
CONTRACTOR'S STATE
LAUMEY TUg . REGISTRATION NO. COUNTY
'
WATER
CLOTHES
I�AW� ,DISTRICT ISO. GROUP E SEED BY -
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GAS SYSTEM INDUSTRIAL V
WASTE APPROVAL
INSPECTION RECORD 0
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W
O.
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$1.00 PER ITEM C
OR FIXTURE $ r D APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ ' 2100 UNDER SLAB WORK
TOTAL FEEROUGH PLUMBING
GAS PIPING
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION '
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL,PROPERTY. UTILITY CO NOTIFIED p
SIGNATURE
FINAL
OF PERMITTE 1 l i f 1141.R6'r'
AL0. N ROBERT A. WOOD
M.O. —
�/SCK. M. CASH SUPERVISING�MECHANICAL ENG'R ,
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/ 76A667 (CE-817)-4/72 �(/ � `� /c,.,^/�//_ /Tv
APPLICATION FOR/`'PLGU M BING PERMIT
LOS
COUNTY OF O ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION /
MAKE CHECKS PAYABLE TO BUILDING.
ADDRESS'
HARVEY T. BRANDT, COUNTY ENGINEER ,
LOCALITY i Em 16
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST J
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET 1.75 OWNER
MAIL
BATH TUB 1.75 ADDRESS ra
SHOWER 1,75 CITY TEL NO0' ✓-/-/Qf
LAVATORY 1.75 CONTRACTOR /,n d l�-
SINK 1.75 ADDRESS`j)63_
DISHWASHER 1.75 CITY T�n Ic Ir TEL NO
CLOTHES WASHER 1.75 STATE If *� � LIC
SWIMMING POOL RECEPTOR 1.75 LICENSE NOJI� CLASS
DISTRICT NO GROUPZONE FROCESSED BY
LAWN SPRINKLER SYSTEM 1.75 �® "7T —I
WATER HEATER 1.75 �� INDUSTRIAL /
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD V
OUTLETS OVER
5 PER SYSTEM .30 O
CD
V
• W
O..
N
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE r
APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel NO GAS VENT
I 7y�f
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REOU IRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. y+
FINAL
SIGNATURE �-J((((jd�����T /a
OF PERMITTEE ..JXXCJJJ I]3.XJ'
PERMIT VALIDATION cK M.o CASH
PLAN CHECK VALIDATION CK M 0 CASH
3 7r'-4%► 8 5 D 4.7 5
,76A667-CE817 12/59 `
APPLICATION LORI �J PL. BIND PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT'OF COUNTY ENGINEER
BUILDING AND r gTY IVISION BUILDING
JOHN A. LAMBI , COUNTY NGINEER ADDRESS 6221 Golden West
WILLIAM A. JENSEN, SUPT OF BUILDING
- LOCALITY Temple Cit
FOR APPLICANT TO FILL IN NEAREST tendon Ave.
CROSS ST.
NUMBER FIXTURE OR ITEM OWNER o Ca oraso
WATER CLOSETMAIL
1 BATH,TUB ADDRESS 2727 Vanderhoff Dr.
1 sxowER
CITY West Covina TFT-- No. ED- 20 86
2 LAVATORY CONTRACTOR Owen Bros. Plumbing
1 SINK ADDRESS 525 No Baldwin Ave.
DISHWASHER CITY El Monte TEL. No. GI- 37644
CONTRACTOR'S197184 STATE
LAUNDRY TUB REGISTRATION NO. COUNTY ❑
1 CLOTHES WASHER DISTRICT N GROUP Z NE P CESSED BY
1 WATER HEATER '-5 , 6 I
1 GAS SYSTEM INDUSTRIAL
WASTE.APPROVAL
INSPECTION RECORD
a
� V1
a $1.00 PER ITEM
10, OR FIXTURE $ 10000 APPROVALS / DATE r INSPECTOR'S SIGNATURE
PERMIT 2 00 UNDER SLAB WORK!
T `ROUGH.PLUMBING
TOTAL FEE 12 ��
GAS PIPING I "
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION J
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER e
P
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED A3 REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST 9+4F �•0 f e2:
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. „ k a
UTILITY CO.NOTI ED / I ��
SIGNATURE �� 1/ ���� A A•)•�
OF PERMITTEE r��fff^^^ FINAL I /p _ � "f
OF VALIDATION (ROBERT A.f D.
cK. H.0. CAS. SUPERVISING MECHANICAL ENG'R
UT
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