HomeMy Public PortalAbout4825 KAUFFMAN AVE_Plumbing__ 76A667A (CE 6176) -477
/a(P L OCA ° TOOIN FOR PL UM o Ol► G FIE GSM OT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM@ FEE ADDRESS
WATER CLOSET LOCALITY o
BATHTUB NEAREST
CROSS ST.
SHOWER OWNERMAIL
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LAVATORY ADDRESS Z�
SINK CITY ��� TEL.NO.Z
DISHWASHER CONTRACTOR
CLOTHES WASHER
ADDRESS � v
SWIMMING POOL RECEPTOR
CITY TEL.NO. Z
LAWN SPRINKLER SYSTEM
STATE je /07 LIC.
WATER HEATER LICENSE NO. (l CLASS
GAS SYSTEM OUTLETS DISTRICT NO. UP ZONE �PRI�CESSE
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d 1\Ja/
OUTLETS OVER ,o" �� CD
S PER SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD Co
U'
W
CL.
N
Z
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTALFEE r
Plan check ap licant
APPROVALS DATE INSPECTOR'S SIGNATURE
Name
UNDER SLAB WORK
Address �(.� ROUGH PLUMBING
City Tel.No. Z��L26 GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE- GAS VENT
THATTHE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES 9
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST
LEGAL OWNER 0 AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERM ITT EE FINAL jl ",A /
Y /v
PLANICHECiFWAZA-Tj,ObI C:OMPENSATION PERMIT VALIDATION Y " CK. M.O. CASH
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POLICY HOLDER"/&
.POLICY NUMBER: ��� �'�d T vz:p
76A667 (CE-817(,.- 1/75
TEMPLE CITY
f APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER Lot #4 Tract #31181
BUILDING AND SAFETY DIVISION
MLDIV
AKE CHECKS PAYABLE.TO: ADDRESS 482 Kaufman Ave.
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST. Li(rZ/`�Li
NUMBER FIXTURE OR ITEM @ FEE
00 6 O OWNER
WATER J B Weber Develo ent
CLOSET MAIL
BATH TUB F.00 3 00 ADDRESS 5926 Temple City Blvd.,
1 SHOWER .00 3,00 CITY -Tem le Cit TEL. NO.444-0971
2 LAVATORY .00 6 OO CONTRACTOR-Valley Plmbing CO.
1 SINK .00 3,00 ADDRESS 442 W. Fleetwood Place
s DISHWASHER .00 3.00 CITY Glendora TEL. NO.335-1293
1 CLOTHES WASHER .00 3100 STATE1, LIC
SWIMMING POOL RECEPTOR 1'
LICENSE NO. 209431 CLASSCi36'ysc42/2
.00
DISTRICT NO.GROUP ZONE CES ED Y
LAWN SPRINKLER SYSTEM .00
1 WATER HEATER .00 3100 INDUSTRIAL
WASTE APPROVAL
1 GAS SYSTEM OUTLETS1.00 >-3 00 INSPECTION RECORD aO
OUTLETS OVER 90 U
5 PER SYSTEM
CD
F-
U
W
CL
C/J
Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE 37 ,50
APPROVALS DATE INS PE OTO R'S SIGNATURE
Plan check applicant UNDER SLAB WORK - =3
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT
I HEREBY'ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION HOT WATER HEATER
`. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. IGAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED I
LICENSED AS REOUI RED 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
SIGNATU RE �` V�w
OF PERMITTEE �V�-2..
- :•; . PERMIT VALIDATION cK,.' M.0; CASH
PLAN CHECK VALIDATION CK. M.0. CASH3
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