HomeMy Public PortalAbout6103 HART AVE_Plumbing__ 76A667C (CE-8'17B) -9/75
'APPLICATION. FOR:PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
cFOR APPLICANT TO FILL IN (PRINT OR TY PEI BUILDING
DRESS 6103 No Hart Ave,
NUMBER FIXTURE OR ITEM @ FEE rfs
WATER CLOSET 'V ,• n J'� LOCALITY le1Sp�-e City
v v NEAREST
BATH TUB - CROSS ST.
SHOWER OWNER Rosemead Construction
MAIL
LAVATORY h ADDRESS 527'S- 'Atlantic .
SINK CITY �Iontere Park TEL. NO. 1
DISHWASHER CONTRACTOR
Owen Broso Plumbing
CLOTHES WASHER ADDRESS 4265 No Baldw6n Aveo
SWIMMING POOL RECEPTOR
CITY El Monte TEL. NO. 443-0078
LAWN SPRINKLER SYSTEM STATE
WATER HEATER LICENSE NO. 231 41 CLASS C36-20
DISTRICT NO. GROUP' ZONE CESS BY CD
GAS SYSTEM OUTLETS •� .•- V
OUTLETS OVER •i�/� IBJ
5 PER SYSTEM V
INDUSTRIAL ,
WASTE APPROVAL W
INSPECTION RECORD - Cn
Z
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
Plan check applicant ,,, al
Name APPRQUAL'5S— DATE INSPE_TOR'S SIGNATURE
UNDER'r&trkB•WORK fJ%ZD-7�', l
Address
ROUGH PLUMBING �' ✓� u
City Tel. No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAW5 REGULATING HOT WATER HEATER
PLUM Bi NG.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY NO STATE OF - _GAS TEST
CALIFORNIA OR THAT I THE L OWN OF INTEND TO
RESIDE IN THE ABOVE $CR E IDENTIA R R Y. UTILITY CO. NOTIFIED
SIGNATURE nM
OF PERMITTE �✓d� - _ FINAL
' PIAN C� �Ct AL DAT 0 SCK. M.O. CASH PERMIT VALIDATION CK. M,O.' CASH
POLICYHOLDER: TSE e,1,110 e4s-,ALrj 4 7 34"-f-ICT 13 034--f-ICl 6.5
POLICY NUMBER: G14-6 cj os j6 > � L
7eA667A- '
CE 817(REV.6/7,8)
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN.(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM 'FEE ADDRESS 6103 On 4ta-vt.-;LOCALITY
le
WATER CLOSET
NEAREST
BATH TUB CROSS ST. A
SHOWER . OWNERFA
LAVATORY MAIL
ADDRESS
1
SINK CITY TEL.NO.
DISHWASHER CONTRACTO SO,,,,
CLOTHES WASHER ADDRESSPeA'
e SWIMMING POOL RECEPTOR ,r
CITY TEL.NO.
LAWN SPRINKLER SYSTEM
STATE �f" LIAKI,q
CLASS
WATER HEATER LICENSE NO.
J GAS SYSTEM OUTLETS APPROVALS DATE' INSPECTOR'S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
5 PER SYSTEM ROUGH PLUMBING /
GAS PIPING
0
GAS VENT
HOT WATER HEATER
PLUMBING FI TURES
GAS TEST
Plan check fee T LITY CO.NOTIFIED g
PLUMBING PERMIT ISSUING FEE$ TPI� ! o
TOTAL FEE FINAL
Plan check applicant PLAN CHECK VAI IDATIONr C�
Name ��
,. Address aff s
City Tel.No.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE n
THATTHE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES _ c�'� . PI
AND STATE LAWS REGULATING PLUMBING. PERMIT VALIDATION
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS to O O O'O
r
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE
LEGAL OWNER OF.AND INTEND TO RESIDE IN THE A VE DESCRIBED RESIDENTIAL 4 2 C O 0 0
PROPERTY. `•
SIGNATURE
OFPERMITTEE
DISTRICT NO. T CESSED BY 0 4 2 1
INDUSTRIAL
WASTE APPROVAL