HomeMy Public PortalAbout5332-5334-5836-5338 MCCULLOCH AVE_Plumbing__ 7GA667A(CYEt6170)-1'1/78. ' o
APPLICATION FOR,PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
NUM R FIXTURE OR ITEM ® FEE
ADDRESS 5332-34 Mc Culloch Ave
WATER CLOSET D LOCALITY Temple City
BATH TUB NEAREST
CROSS ST. 7
SHOWER OWNER LCharles L. Ac Nabb
MAIL
LAVATORY ADDRESS 61 S. Lalli Ave.
SINK 0 CITY Pasadena TEL.NO. 449-OX6
DISHWASHER CONTRACTOR Owen BI'�O$e Plumbingg Inc*
CLOTHES WASHER ADDRESS 4265 N. Baldwin Ave.
SWIMMING POOL RECEPTOR
' CITY L! Monte TEL.NO.. 8
LAWN SPRINKLER SYSTEM STATE LIC.
WATER HEATER LICENSE NO. 2 CLASS
GAS SYSTEM OUTLETS DISTRjCiL4O. GROUP J.FNE PRQOESSED BY
OUTLETS OVER QCJ
S PER SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD R�ECOORD�y
?/ 7 7(.11191 wJ!r/
V Al � r�uT -- 7- /v
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check applicant '
Name
APPROVALS ry DATE INSPECTQRS SIGNATURE
UNDER SLAB WORK
Address ROUGH PLUMBING
City Tel.No. GAS PIPING
1 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 HOT WATER HEATER
AND STATE LAWS REGULATING PLUMBING:
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES r
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE GAS TEST
LEGAL OWNER OF.AND INTEND TO RESIDEIN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED /
SIGNATURE a
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
4, 0. 3.Xttt3 1 u Y U.S U
es
76A667/VI¢E H17B).11/78 �
APPLICATION FOR PLUMBING PERMIT
r
BUILDING AND SAFETY DIVISION
R APPLICANT TO FILL IN IPRINT OR TYPE) BUILDING
5336 — 3g .MC Culloch .Ave.
TB7ATH
FIXTURE OR ITEM ® FEE
R CLOSET LOCALITY Temple City
TUB NEAREST
CROSS ST.
SHOWER OWNER Charles' L. N!c Nabb
MAIL
LAVATORY ADDRESS 61 S. Latae Ave.
SINK CITY Pasadena TEL.NO.
DISHWASHER CONTRACTOR Ogen BrOs. Plumbingg Inc.
CLOTHES WASHER 4265 N. Baldwin Ave.
ADDRESS
SWIMMING POOL RECEPTOR
CITY In Monte TEL.NO. L
8
LAWN SPRINKLER SYSTEM STATE LIC.
WATER HEATER
LICENSE NO. 231 CLASS
GAS SYSTEM OUTLETS DISTRICT NO. GROUP ZONE PR ED BY
OUTLETS OVER 15-108 1. r
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
Plan check fee '���!'� .�� �� �U�.�- '��r'�, �`'-i7- r'•.yE 1 �
PLUMBING PERMIT ISSUING FEE$ ��
TOTAL FEE f-12 zp
Plan check applicant
APPROVALS DATE INSPECTOR'S SIGNATURE
Name .
UNDER SLAB WORKa��'!�, ` r.';��
Address ROUGH PLUMBING
.�.�,.
City - Tel.No. GAS.PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THATTHE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES HOT WATER HEATER
AND STATE LAWS REGULATING PLUMBING'.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/UR 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
SIGNATURE
OF PERMITTEE QN-
FINAL
PLAN CHECK VALIDATION CK.. M.O. CASH PERMIT VALIDATION - C M.O. CASH
4 0 2 CEEB 1 u ' 7 0.5 0 a3