HomeMy Public PortalAbout4840 HALLOWELL AVE_Plumbing__ 76A667-CES17 12/59 TEMPLE CITY'
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER �j / �+
BUILDING AND SAFETY DIVISION BUILDING
ADDRESSJ� y �l/1
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY C/
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. 41 6
NUMBER FIXTURE OR ITEM
OWNER 4
WATER CLOSET MAIL / +,
ADDRESS ate.
BATH TUB
CITYf.l TEL. NO. '
SHOWER
CONTRACTOR
LAVATORY
SINK ADDRESS
DISHWASHER CITY TEL. NO.
CONTRACTOR'S STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY
CLOTHES WASHER DISTRIC�TgNO GROUPZONE SSED BY
WATER HEATER � 4' I e,(
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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@ $1.00 PER ITEM
OR FIXTURE APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ I 2 100 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 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 H -ABOVE
DESCRIBED RESIDENTIAL PROPERTY. ^ r UTILITY CO.NOTIFIED
SIGNATURE /
OF PERMITTE FINAL
oi�VAIJDATION
ROBERT A. WOOD.
Y.O. CASH SUPERVISING MECHANICAL ENG'R
7736 FEB ? 5 D 6.0 0 �4
76A667-CEfi 817 6-66
N J�
• APPLICATION FOR PLUMBI r(e�ERMO
COUNTY OF LOS ANGELES ,
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
COLEMAN W JENKINS. SUPT OF BUILDING LOCALITY --T�
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET $1.25 MAIL /
BATH TUB 1.25 ADDRESS
SHOWER 1.251 CITY TEL. NO.
LAVATORY 1.25 CONTRACTORzo
SINE 1.25 ADDRESS
DISHWASHER 1.25 CITY TEL. 110�..53,
LAUNDRY TUB 1.25 LICENSE NO Of CLASS
CLOTHES WASHER 1.25 DISTRICT NO. GBQUP Z E PRO ESSED BY
WATER HEATER 1.50zw-
GAS SYSTEM OUTLETS 1'50 INDUSTRIAL 0}..
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM •90 INSPECTION RECORD V
o
W
d
to
Z
�7
APPROVALS Qi DATE I SPEC R'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
l
ROUGH PLUMBING
TOTAL FEE GAS PIPING
IH
ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL 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,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. U7Y CO. NOTI IED r�
SIGNATURE , rft-r
OF PERMITTEE J
FINAL
AUDATION • �V
CK. M O CASH
__ LAUO 0 3 6 1 MAR 10 5 0 5.Q 0