HomeMy Public PortalAbout4833 KAUFFMAN AVE_Plumbing__ -76A667 (CE-617) - 1/75 TELE CITY
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES ' 'fl
DEPARTMENT OF COUNTY ENGINEER Lot #5 Tract #31181
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: ADIDRESS 4833 Kaufman Ave.
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
ty
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST '
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE -
OWNER J B Weber Develo ent
'Z WATER CLOSET 00 6 O0 MAIL
1 BATH TUB .00 3 OO ADDRESS 26 Temple City Blvd.
1 SHOWER .00 3.00 CITY Tem le Cit TEL. NO, 444-0971
1
2 LAVATORY .00 6 OO CONTRACTOR Valle P.J:umbi Co.
1 SINK .00 100 ADDRESS 442 W. Fleetwood Place
1 DISHWASHER .00 3.00 CITY Glendora , TEL. NO. 335'-1293
' CLOTHES WASHER .00 3.100 STATE LIC F�
LICENSE NO. 209431 CLASSC36�SC`FZ/2 a
SWIMMING POOL RECEPTOR 00
DISTRICT NO.GROUP ZONE CESSED BY
LAWN SPRINKLER SYSTEM ,00 15, U, ,/�.,/
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1 WATER HEATER 00 3 00 INDUSTRIAL-
. WASTE APPROVAL CD
GAS SYSTEM OUTLETS 00 INSPECTION RECORD V
OUTLETS OVER
5 PER SYSTEM .30 p
W
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Plan Check fee See Reverse
PLUMBING PERMIT ISSUING FEE S
TOTAL FEE 37-50
APPROVALS DATE INS PECITOR'S SIGNATURE
Plan Check applicant UNDER SLAB WORK
Name' ROUGH PLUMBING
Address
GAS'PIPING
City Tel. No. GAS VENT `
HOT WATER HEATER
1 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
LICENSED AS REQUIRED BY LOS ANGELES COUNTY SAND STATE OF _
CALIFORNIA OR'THAT I AM THE LEGAL OWNER OF, AND INTEND TO ,r
RESIDE IN THE
_ABO_VE RIBED RESIDENTIAL PROPERTY.
FINALD"7�
SIGNATURE ,
OF PERM,TTEE
PERMIT VALIDATION 1. M,O: CASH
PLAN CHECK VALIDATION CK. M.O. CASH �`