HomeMy Public PortalAbout9646 LEMON AVE_Plumbing__ .76AG7P,4---I Te) -a/» '
ria APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN IPRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM @ FEE ADDRESS 9646 E. Lemon Ave
WATER CLOSET U / O LOCALITY Temple City
(O NEAREST •
BATH TUB CROSS ST
SHOWER OWNER Rosemead Cnnstr�ctinn
LAVATORYAIL
Do ADDRESS 1816 . San Gabriel Blvd.
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SINK CITY an Gabriel TEL N0573-411
DISHWASHER CONTRACTOR Owen Bros. Plumbing,, Inc.
CLOTHES WASHER
ADDRESS 4265 N. Baldwin Ave.
SWIMMING POOL RECEPTOR
CITY El Monte TEL NO 443-0078
LAWN SPRINKLER SYSTEM
STATE LIC
WATER HEATER LICENSE NO CLASS
GAS SYSTEM OUTLETS 00
DISTRICT NO GROUP ZONE OC ED BY
OUTLETS OVER •�� CD
5 PER SYSTEM INDUSTRIAL 17 V
WASTE APPROVAL cz
INSPECTION RECORD
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Plan check fee "��.•'� ��® `� � `
PLUMBING PERMIT ISSUING FEE'$' '—
TOTAL FEE0
Plan check applicant11,5�7V7—
Name APPROVALS DATE INSPEC,T,OR S SIGNATURE
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
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REOUIR ED 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 UTILITYCO NOTIFIED
SIGNATURE OD ,
OF PERMITTEE FINAL W-Z4
PLAN CHECK VALIDATION CK M o 014H o 0 00 PQRMIT VALIDATION '( K/ Mo , CASH \
O o 0 0 `/
,� ,� , 0 o.
1 S--) SD 0 N
�7 CD p 0 J
00, Q CD CJl
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