HomeMy Public PortalAbout4818 KAUFFMAN AVE_Plumbing__ 76A667 (CE-817) - 1/75 TEMPLE C=-
APPLICATION
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER Lot #10 Tract #31181
BUILDING AND SAFETY DIVISION
ADDRESS 4818 KaUfman Ave- .
• MAKE CHECKS PAYABLE TO: BUILDING ` '
HARVEY T. BRANDT, COUNTY ENGINEER
LOCALITY _ T m le Cit
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER' FIXTURE OR ITEM @ FEE
.00 OWNER J B Weber Dkeloloment
WATER CLOSET MAIL
1. BATH TUB .00 QQ ADDRESS 9926 Temple. City Blvd,
1 SHOWER .00 3.00
CITY Temple City TEL. NO. 444-Q 1
LAVATORY .00 00 CONTRACTOR '
Valley Plumbing
1 SINK .00 3400 ADDRESS 442 W. Fleetwood Place
1 DISHWASHER .00 QQ CITY Glendora TEL. NO. 335-1293
1 CLOTHES WASHER .00 QQ STATE - LIC
SWIMMING POOL RECEPTOR .00 LICENSE NO. 209431 CLASSIC •3042 2
DISTRICT NO.GROUP ZONE OCESSED BY
LAWN SPRINKLER SYSTEM ,pp
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$1 WATER HEATER .00 3,00 INDUSTRIAL -
WASTE APPROVAL
GAS SYSTEM OUTLETS 00 INSPECTION RECORD
OUTLETS OVER .O U
5 PER SYSTEM .30,
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
.TOTAL FEE 37 li50
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
r
Name ROUGH PLUMBING
AddreSS. GAS PIPING
GAS VENT
City Tel. NO.
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT..1HAVE READ .THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH
ALL COUNTY ORDINANCES AND STATE LAWS REGULATING iq
PLUMBING.. GAS TEST 7iP. I t
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED f
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 ES CRIBED RESIDENTIAL PROPERTY. _ FINAL
SIGNATU RE
OF PERMI TT EE -
PERMIT VALIDATIONcK. M,OI CASH
PLAN CHECK VALIDATION CK. M.O. CASH ,,;,
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