HomeMy Public PortalAbout10680 KEY WEST ST_Plumbing__ 7fiA667'SS,E-817)-B-71 1-;e- �/
1 APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FADDRESS
BUILDING AND SAFETY DIVISION 10680 Ke est
Tnmple City
FOR APPLICANT TO FILL IN (PRINT OR TYPE)
CROSS ST. f ^ dlvr—.
NUMBER FIXTURE.OR ITEM @ FEE .
WATER CLOSET 1.75
3 G OWNER John Sell
MAIL
BATH TUB 1 75
ADDRESS 2023 Bella Vista Drive
SHOWER 1 .75 CITY ArcadiaTEL. NO.
LAVATORY 175 CONTRACTOR
SINK 1 75 7ADDRESS 4265 North Baldwin Ave.
DISHWASHER 1 75CITY El Monte TEL. N0. "3-0078
CLOTHES WASHER 1 75 STATE LIC
SWIMMING POOL RECEPTOR 1 75
LICENSE NO. 231 1 CLASS c36
DISTRICT NO. GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 1 75 O
WATER HEATER 1 75 �i INDUSTRIAL
WASTE APPROVAL
/ GAS SYSTEM OUTLETS 1 75 INSPECTION RECORD
OUTLETS OVER 30 g,
5 PER SYSTEM
MA
Vl
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Plan check fee See reverse.
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE a,Z o2 s
APPROVALS 4ATPECTOIR'_,9SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING -
City Tel. No. GAS VENT 1
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 ,
GAS TEST
PLUMBING.
I HEREBY 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 C ED RESIDENTIAL PROPERTY. FINAL
SIGNATUREcLrcne
-
OF PERMITTEE
PERMIT VALIDATION cK M.O. CASH
PLAN CHECK VALIDATION CK.. M.O. CASH-
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