HomeMy Public PortalAbout5823 KAUFFMAN AVE_Plumbing__ 76A667 (CE-817)-4/72 x City"6f'-Temple City '
APPLICATION •FOR,PLUMBUNG!:PERMIT
COUNTY OF LOS ANGELES ' '22136
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING 5823 ,N. Kauffman, Avenue
ADDRESS
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY Temple City,
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST OS Tunas
CROSS ST.
NUMBER FIXTURE OR ITEM @ FEE_ •I - -•
OWNER
WATER CLOSET 1.75
MAIL Same
BATH TUB 1.75 'ADDRESS
SHOWER 1.75 CITY Temple -Cl y• TEL. NO•. -
LAVATORY 1.75 CONTRACTOR
SINK 1.75 ADDRESS 6558 WEST BLVD.
DISHWASHER 1.75 CITY Los An deles ' %',TEU. NO. - A 3-2541
CLOTHES WASHER 1.75 STATE ` -LIC
LICENSE NO. C 36,151839 CLASS
SWIMMING POOL RECEPTOR 1.75
DISTRICT NO. GROUP - E OCESSED BY
LAWN SPRINKLER SYSTEM '1.75 _
1 WATER HEATER 1.75 75 INDUSTRIAL
WASTE APPROVAL 0-
GAS SYSTEM OUTLETS' 1.75 INSPECTION RECORD COD
OUTLETS OVER
5'PER SYSTEM 90 'Ready for Inspedion NOW CD
WATER SOFTENER a
co
Plan check fee See Reverse-
PLUMBING PERMIT ISSUING FEE S. - 3, 00-,
TOTAL FEE 4-751
75
APPROVALS DATE: INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING'
Address GAS PIPING
C'Ity
"GAS VENT
HOT WATER HEATER �A) O)7�
I 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 IAM PROPERLY REGISTERED AND/OR UTILITY-CO NOTIFIED '
LICENSED AS REQUIRED BY •Lo ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND,TO
RESDEANTHE ABOVE DESCRIBED RESIDE P OPER 7v 9v �')l
Gj/yam FINAL e., r�Q�ip-77 '`.9' �,�Y�'�i
SIGNATURE • f r _
OF PERMITTEE - -
PERMIT VALIDATION CK. M.0. CASH
PLAN CHECK VALIDATION CK. M.O. - CASH' ;y
...4 -7.5 ®�a
- - -