HomeMy Public PortalAbout4843 KAUFFMAN AVE_Plumbing__ 76A667 (CE-817) - 1/75 TEMPLE
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CITY
,
APPLICATION FOR
PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER Lot #6 Tract #31181
BUILDING AND SAFETY DIVISION -
MAKE'CHECKS PAYABLE TO: BUILDING
4843hKaufman Ave.
HARVEY T. BRANDT, COUNTY ENGINEER
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FOR APPLICANT TO FILL IN (PRINT OR TY PEI NEAREST
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NUMBER FIXTURE OR ITEM @ FEE CROSS ST.
00 OWNER J. B. Weber Development
WATER CLOSET MAIL
BATH TUB F.00 -6100 ADDRESS 5926 Temple City Blvd.
SHOWER 00 CITY Temple City TEL. NO.444-0971
LAVATORY .00 12 00 CONTRACTOR�+ OValle ' Plumbing Co.
1 SINK 00 ADDRESS 442 W. Fleetwood Place
1 DISHWASHER .00 3100 CITY ndora TEL. NO. 12
93
1 CLOTHES WASHER .00 3100 STATE LIC
SWIMMING POOL RECEPTOR .00 '1 4
LICENSE NO. 20931 CLASSC36;SC42/2 v
DISTRICT NO.GROUP ZONE CESSED BY
LAWN SPRINKLER SYSTEM .00
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WATER HEATER .003 00 INDUSTRIAL
WASTE APPROVAL
1 GAS SYSTEM OUTLETS .00 3 OO INSPECTION RECORD
OUTLETS OVER CD
5 PER SYSTEM •30 v
11 Floor Drain 3.00
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Plan Check fee See Reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE 49.50
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK }7K � .
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. GAS TEST
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
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 D SCRIBED RESIDENTIAL PROPERTY, FINAL
SI GNATU RE
OF PERMITT EE \J•
PERMIT VALIDATION CK. M,O: CASH
PLAN CHECK VALIDATION CK. M.O. CASH