HomeMy Public PortalAbout10422 LIVE OAK AVE_Plumbing__ 76A66-/A(GE 8178)-
Q 1111/776
AL8CATOON FOR PLUMBING PERMIT
BUILDIN AND SAFETY DIVISIO�—
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS 10422 E. Live Oak
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET LOCALITY ARCADIA
NEAREST
BATH TUB CROSS ST Holly
SHOWER OWNER CLAU
LAVATORY MAIL
ADDRESS 10422 E. LIVE 'OAK
SINK CITY ARCADIA TEL NO 447-3486
' DISHWASHER CONTRACTOR Aquatic Pools
CLOTHES WASHER
ADDRESa01 Eo Huntington Dr.
SWIMMING POOL RECEPTOR 4.6-4661
CITY Arcadia TEL NO
LAWN SPRINKLER SYSTEM
STATE LIC
WATER HEATER LICENSE NO 311ilS20 CLASS C 53
GAS SYSTEM OUTLETS - DISTRICT NO GRO P ZONE
AL P CESS Y
OUTLETS OVER ` _�
5 PER SYSTEM n INDUS
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WASTE APPROVAL O
INSPECTION RECORD V
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y
z
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
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 7H15 APPLICATION AND STATE GAS VENT V
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 1 AM THE GAS TEST
LEGAL OWNER OF AND INTEND TO yfDE IN THE ABOVE DESCRIBED IDENTIAL
PROPERTY /,�j UTILITY CO NOTIFIED
SIGNATURE C�
OFPERMIT'TEE FINAL Q
PLAN CHECK V.QLI ;TjON_" -I�'ar�1cic I ren°D cns l PERMIT VALIDATION M Q CASH
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Cy ';.r�,r->s �j� 5 9 6'r-'OCT I S 5 D 1 3.5 G
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,76A667-CE817 12/59 TEMPLE CITY
APPLICATION FORPLUMBING UMBING PERMIT �
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND 5&FETY �IVISION BUILDING
JOHN A. _A E. OUNTY NGINEER ADDRESS D "!�� l!rte C/A
WILLIAM A JENSEN, SUF'T of BUILDING
LOCALITY E �!T
FOR APPLICANT TO FILL IN NEAREST /
CROSS ST. /4
NUMBER FIXTURE OR ITEM
OWNER QS C Q
WATER CLOSET Agpin
BATH TUB ADDRESS
SHOWER CITY TEL. NO.
LAVATORY CONTRACTOR E tZ ?O5
SINS ADDRESS < 0j"W45
WE
DISHWASHER CITY TEL. NO.
CO CTOR'S / STATE ($
LAUNDRY TUB REGISTRATION NO. COUNTY ❑
CLOTHES WASHER DISTRICT NO. GROUP I ZONE I P SSED BY
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD , y
P.
i O
/ W
a
Q $1.00 PER ITEM
OR FIXTURE $ / APP OV ' DATE INSPECTO 'S SIGNATURE
PERMIT $ 2100 UNDER SI4B WORK
TOTAL FEE / ROUGH PLUMBING
'
/ GAS PIPING
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION '
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL°COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES G
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE W r/ �
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE / /
OF PERMITTEE �q
FINAL d—
OF VALIDATION ROBERT A. WOOD,
CK. M.0. CASH SUPERVISING MECHANICAL ENG'R
D 12
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