HomeMy Public PortalAbout6252 GOLDEN WEST AVE_Plumbing__ 7&kd6157 DM 17 11-50 APPLICATION FOR PE BM
-LAPARTKENT OFa ' SAFETY.
PLUMBING 2
COUNTY OFF LOS LOS ANGEL
f WILLIAM J. FOX, CHIEF ENOINExR
FOR APPLICANT TO FILL IN
PLLMOERGorpoREO[IVED LADY FOR DATE ISSUm
1 INSPE OnON
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CITY 00var TEL No. ADDR[DB
C O U NTY LOCAL I TY
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N[AR T.T.nE3D,fr . FEES ORGY
NUMu[m TYT[or FTXTu Ri on nIM FEE OWNER
MAIL
E 0.
WATER OLORET(TOILET) • 60 0 ADDRESS So= OR ZtMD iIabwa
BATH 7112 • 0.60 O1w TIL. No.
ZHOWER • 0.60 I H19REfY ACKNCWLEDO[ THAT 1 HAV[ READ THIN
LAVATORY (WASH MAIIN) • 0.60 APPLICATION AND MHO
TATIL THAT THE AIIVK 17 DORRE13T
AND ADR[[ TO COMPLY WITH ALL COUNTY ORIINANDXM
KITCHEN MINK @ 0.60 AND 9TATI LAWS REOULATINO FLUMMINO.
t 013M Y THAT I F0MMXRS THE ABOVE AL OS
[lA7 MYMTCu nUTiLZo • [LBOVAUD L
LAUNDRY TUN OR TRAY • 0.60 ANOILEN COUNTY LIC[H ppR 1 A!1 THE L[O
OF TH[ RERIDEN-rtAL P lY7 y D[iDRJK[D
NISNATURE OF
WATER HEATER • 0.60
PERM ITT[
GLOP MINK • 0.60 INSPECON R&ORD
FLOOR MINK • O.MO
FLOOR DRAIN • a6O
DIBHWAHHIR • C.6D
DRINKING FOUN:rAIN • 0.60
URINAL • 0.60 4r
HOUSE NEWER • 0.60 U_
MISDELLANIOU■ J
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0
APPROVALS
DATE IN0V4Caro P'■ NAML
ROUDH PLUMMINO
OAM PIPING
IIAB VENT
CK815POOL • 1= DEMBPCOL
B[PTIO TANKS SEPTIC TANK
DRAIN ( ) PIT ( ) • 1.00 HEWER
PERMIT 1.003 °ti TAT
UTILITY 00.NOTIFIED
TOTAL FEE 0 1 C�
J FINAL
78A887 (CE-817)-4/72
APPLICATION F. ; PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: ADDRESS 6252 GOLDEN WEST38C 1 & 2
HARVEY T. BRANDT, COUNTY EINO1NEItR LOCALITY
TEMPLE: CITY
FOR APPLICANT TO FILL IN (PRINT OR TYPEI NFAREST �k r
NUMBER FIXTURE OR ITEM 0 FEE C ROSS ST
WATER CLOSET 1.78 OWNER
MAIL
BATH TUB 1.75 ADDRESS 6252 GOL EN WEST
SHOWER PAN 1.75 CITY i TY TEmp LE QTEL NO.
LAVATORY 1,75 CONTRACTOR L.M. HAMM INC.
SINK 1.78 ADDRESS425 W.- MAIN ST
DISHWASHER 1.18 CITY ALHAMIBRA TEL N0282-21 1
CLOTHES WASHER 1.75 STATE LIC
C
SWIMMING POOL RECEPTOR 1.75 LICENSE NO. 1 CLASS -
DISTRICT NO. GROUP ZONE I CESSED BY
LAWN SPRINKLER SYSTEM 1..78 ��j
WATER HEATER 1.78 ��g�plq�O
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.78 INSPECTION RECORD
UTLET3 OVER SO
b PER SYSTEM
I
I
I
I
Plan Ghack fee S« Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE 5
APPROVALS DATE ING P[c-ro R'e GIOM ATU R[
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT
HOT WATER HEATER
I HERESY ACKNOWLEDGE THAT I HAVE READ TH1[ APPLICATION
AND STAT[ THAT THE ABOVE ID CORRECT AND AGREE TO COMPLY PLUMBING-FIXTURES
WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING GAS TEST
PLUM SING. -
I HERESY CERTIFY THAT I AM PROPERLY RE41STERKD AMD/OR UTILITY CO. NOTIFIED '
LICENSED AS RECUIRED BY L68 ANGELES COUNTY AND STAT[ OF
CALIFORNIA OR THAT I A LEGAL OWNER OF, AND INTEND TO
>,[SID[ IN THE ABOVE RI ED ES NTIAL PROPERTY. FINAL
SIONATU RE
OF PERMITT
PERMIT VALIDATIONcK. M.O. CASH
PLAN CHECK VA ATION CK. M.o. cr -
`Y;0 9 6 3 3 IAV 6 5 'D .7 5,
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7dA8e'7A(CM•I7IS)->I 1l7e ! •�
APPLICAT OR PL M B ING RM IT
Rma� M5PE CH
BUILDING MID SAFETY DTVLSION
FOR APPLICANT TO RLL IN(PRINT OR TYPE] BUILDING
NUMBER FIXTURE OR ITEM • FEE
WATER CLOSET L
NEAREST
BATH TUB CROS$
SHOWER OWNER
L
LAVATORY ADMAIS
SINK CITY TEL.
i y0
DiSI-IWASHER ctaWkRiU ! -
CLOTHES WASHER GRANDA i E.
swlMhuNG Pool RECEPTOR CTEMPLE CITY, CALF Fpk,
LAWN SPRI NKLER SYSTEM STATE LIC
WATER HEATER UCEW NO C1°SS
Pf
GAS
T�SYSTEM
� OUTLETS J 'QP /ZONE BY
5 PERI STEM INDUSTRIAL
WASTE
AL
INSPECTION RECORD
Plan check fee
PLUMBING PERMIT ISSUING FEE f
TOTAL FEE
Plan check appflcant
APPROVALS DATE Delr[cTou's swNATura
Name
UNDER SLAB WORK
Address ROUGH PLUMBING
city Tel.No. GAS PIPING
I HEREBY ACKMOWLEDQE THAT I HAVE READ 1HI5 APPLICATION AND STATE GAS VENT
THAT THE ABOVE LS CORRECTAND AGRU TO COMPLY WITH ALL COUNTY OfDIMMCLS
AND STATS LAWS REGULATING,PLUMBING,. HOT WATER HEATER
I HER!<BY COMFY THAT I AM PROPERLY REGISTERED AND/01R UQXZID AS PLUMBING FIXYURES
RIEOUD{LD BY LOS ANGELES COUNTY AND STATY OP CAUPORNIA ORTHAT I A.MTHE �- TEST
LEGAL OWNER DF,Alm INTYND TO RESIDE IN THE ABOVE DTSCRIEED RESDENT4I1-
PROPEITTY. z unLm co.NonAEa
SIGNATURE -�•�
rrTL R NAL 7' -Te
PLAN CH cryH,7 nF� G,�ERMSVALIDATION Cx. M.O. C"
.7 1177 7.50A�-o
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