HomeMy Public PortalAbout5417 MCCULLOCH AVE_Plumbing__ � [ e
78A887-C EIl817 5/69
APPLICATION FOR PLUMBING PERMIT �-
COUNTY OF LOS ANGELES
DEPARTNENT OF COUNTY.ENGINEER
BUILDING AND SAFETY DIVISION I
D C oo/ 0�
JOHN A.LAMBIE. COUNTY ENGINEER
OSS
WILLIAM A.JENSEN,SUPT OF BUILDING
FOR APPLICANT TO FILL IN `
NUMBER FIXTURE OR ITEM EACH FEE OWNER + 0
WATER CLOSET 51:25 MAIL, rroC V�
BATH TUB1.25 ADDRESS
SHOWER 1.25 s- ,CITY r� TEL..NO: 6
LAVATORY 1 CONTRAC OR
SINS 1.25 ADDRESS
DISHWASHER 1.25 CITY TEL. NO.
LAUNDRY TUB 1.25 CONTRACTOR'S . STATE p
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PROCESSED BY
WATER HEATER
GAS SYSTEM—=?—OUTLETS ,-1.50 INDUSTRIAL a
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .90 V
INSPECTION RECORD'
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2 -
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APPROVALS �� DATE Y INSgECTOR'S�SiGNyE„
PERMIT $ 2 0.0 UNDER SLAB WORK
ROUGH PLUMBING /
TOTAL FEE GAS-PIPING (%
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATIO GAS VENT
AND STATE THAT THE ABOVE Ili CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE -LAWS REGULATING
PLUMBING. HOT WATER HEATER .�
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES: _
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST ' O ' �D =3fCALIFORNIA OR THAT I AM.THE LEGAL OWNER OF,AND INTEND TO (i+�f
RESIDE IN,THE ABOVE DESCRIBED-RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE .j
OF PERMITTEE
FINAL /_T �{
VALIDATI ROBERT A.WOOD
CK. M.o. cnsH- SUPERVISING MECHANICAL'ENG'R
1015` AL 18 , 5 D 9.75r
8540 '
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DOS-177 f0-SS APPLICATION .FOR PLUMBING PERMIT 1
DB
DIVISION OF BUILDING AND .SAFETY
Deportment of County Engineer
County of Los Angeles BUILDING
JOHN A.LAMBIE, COUNTY ENGINEER ADDRESS 5417 MI-cCu
Jlloch
CASSATT D.GRIFFIN,SUPT OF 13UILDING LOCALITY Temple City
FOR APPLICANT TO FILL IN I NEAREST
CROSS T. LE►j.11AS Dr
OWNER A. E. Koenig DISTRICT NO. GROUP ZONE RE DY FOR INSPECTION'
MAIL j;
ADDRESS Same ff'-/ W
CITY TeWle CityTEL.NO. WASUTE APPROVAL I
PLUMBER GENERAL.INSTALLATION CO. INSPECTION RECORD
ADDRESS 6558 West Blvd,
CITY L.A. 43 TEL.NO. PLeasant 3-254
LICENSE NO. 787 C-36 131839
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 $
BATH TUB @ $1.00
SHOWER @ $1.00
LAVATORY (WASH BASIN) @ $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
1 WATERsor-TEm nn
APPROVALS
DATE INSPECTORS SIGNATURE
UNDER SLAB WORK
PERMIT $ 00 ROUGH PLUMBING -2-A
GAS PIPING
TOTAL FEE 00 GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 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 I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER. OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL LPVTyA
SIGNATURE (JI(!
OF PERMITTEE FINAL r3�a-1.e �! L
IOHN A.LAMBIE,COUNTY ENGINEER ALIDATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR
CK. M.0. CASH
7.-9 5 0 NIA[t 18 5 A 3.0 0