HomeMy Public PortalAbout6037 KAUFFMAN AVE_Plumbing__ 76A887 APPLICATION FOR PLUMBING PERMIT 1
DBS-17 10.55
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles BUILDING `
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS - Yy� %•'Y "�- .w_ -
CASSATT D. GRIFFIN SUPT OF BUILDING -
LOCALITY
FOR APPLICANT TO FILL IN I
CROSS ST.
T.
OWNER •o
' di '��' DISTRICT NO. GROUP Z N I READY FOR INSPECTION
MAIL
VOLte
ADDR SyyfS � " _*y,'71F I
INDUSTRIAL
CITY r TEL. -O. WASTE APPROVAL
PLUMB INSPECTION RECORD
ADDRESS toz/'
CITY `
7-15
LICENSE /'a F
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 $
BATH TUB @ $1.00
SHOWER @ $1.00
LAVATORY (WASHBASIN) @ $1.00
KITCHEN SINK @ $1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPECTORS SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE
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
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES -
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST "-
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I e THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED ---------------
DESCRIBED RESIDENTIAL ROP /�' f
SIGNATURE j,J,i3i1 �"2114
//Ji1��s�
OF PERMITTEE "r,/iL LT�,I�L/,c. FINAL
JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR
CK. Y.0. CASH"
0 9 5 1- Am 5 3
TOO O n
76A667A ICE 6178)- 11/76 - -
APPLICATION F®R•PLUM B ING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
DRESS ' 6037 No Kauffman
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET LOCALITY Temple _ Cit -
BATH TUB CROSS ST ' Woodruff
SHOWER OWNER Gutkin Helen
LAVATORY MAIL
ADDRESS as above
-SINK CITY TEL NO 285-5989
DISHWASHER CONTRACTOR w F -
CLOTHES WASHER
ADDRESS 9127ei ve
SWIMMING POOL RECEPTOR Las Tunas Dr '
CITY Temple City TEL-NO 286-9293
LAWN SPRINKLER SYSTEM ST ATE LIC
WATER HEATER replace
(�) LICENSE NO O CLASS C-36
GAS SYSTEM OUTLETS DISTRICT NO GROUP ZONE PROCESSED BY
OUTLETS OVER %O
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL O
INSPECTION RECORD V
ad
O
Lu
Plan check fee —
PLUMBING PERMIT ISSUING FEE$ C�
TOTAL FEE --o
V �
Plan check applicant
APPROVALS DATE INSPECTOR'S SIGNATURE
Name
UNDER SLAB WORK
Address ROUGH.PLUMBING
City Tel No GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT ,
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING, HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING*FIXTURES
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST, '
LEGAL OWNER OF,AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL -
PROPERTY UTILITY CO.NOTIFIED
/l
SIGNATURE /' 1,52
�
OFPERMI 7-; •G/�'�"�,p
PLAN CHECK VALIDATION CK M o. CASH PERMIT VALIDATION U r
7 9 7. ._ 5 %. a � es
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