HomeMy Public PortalAbout4809 KAUFFMAN AVE_Plumbing__ 76A667 (CE-817) - 175 '
APPLICATI64'�'6ff'kUMPING PERMIT ,
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER Lot #1 Tract_ #31181
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE BUILDING
BUILDING
• ADDRESS '-FOO KaLlfTI1r9.T1. Ave.
HARVEY T. BRANDT, COUNTY ENGINEER
LOCALITY' .
FOR APPLICANTTO FILL IN (PRINT OR TYPE) NEAOREST
� SS�ST.
NUMBER FIXTURE OR ITEM @ FEE CR
— 0WNER
.00 Weber De e e t
MAIL
'L WATER CLOSET 6
ADDRESS 5926_Teri! le,-, it Blvd.
J 1 BATH TUB 00
3100
1't'4
1 SHOWER... .00 OO C ITYT2 le CiZ TEL: NO.4.` -O` .1
CONTRACTOR
2 LAVATORY. too 6100 Valle Pltmlbing, Co.
. SINK' .00 ADDRESS
1 00 �>+2 W. Fleetwood Place
DISHWASHER 00 3' OO CITY TEL. NO.
dlendora 335-12q3
CLOTHES WASHER 00 00STATE LIC
LICENSE NO 209431 CLASSC •.SC42 2
SWIMMING POOL RECEPTOR. 00
DISTRICT NO.GROUP ZONE' ESS ED BY
LAWN SPRINKLER SYSTEM ,00 11 G
WATER HEATER .00 3 OO INDUSTRIAL I
WASTE APPROVAL a
1 GAS.SYSTEM' OUTLETS .00 3 OO INSPECTION-RECORD- V I
,OUTLETS OVER
5 PER SYSTEM .30 = O'
W
Z.
Plan Check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE 1 37150APPROVALS DATE - IN PE C'T_O R'S'SIGNATU RE
Plan Check applicant UNDER SLAB WORK .
Name ROUGH PLUMBING
` AddresS. - GAS PIPING - - •v. --//.L'
City Tel. No. GAS VENT
HOT WATER HEATER
P HEREBY ACKNOWLEDGE THAT I`HAVE READ THIS APPLICATION.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
a LICENSED.AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ,
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE ESCRI'BED RESIDENTIAL PROPERTY. FINAL `(f —y{6
SIGNATURE -
OF PERMITTEE NIP "
r PERMIT VALIDATION CK. M,O: CASH
PLAN CHECK VALIDATION CK. M.O. CASH
Z5':39 ..4 .