HomeMy Public PortalAbout5422 MCCULLOCH AVE_Plumbing__ 76A667 (CE-817)- 5/73
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ,5 ��
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDING
HARVEY T. BRANDY, COUNTY ENGINEER ADDRESS McCulloch At'e�
LOCALITY Temple City
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.. L1Ve Oak
NUMBER FIXTURE OR ITEM (a FEE -
WATER CLOSET 1,75 -7 &-DOWNER Foothill Service Corp.
MAIL
BATHTUB 1.75 � ab
ADDRESS 2215 & Lake Ave®
SHOWER 1,75 CITY Altadena TEL. No. 798 9109
LAVATORY 1,75 7 ov CONTRACTOR e1SdO f PlumbingCo.; T'n
SINK 1.75 3 ADDRESS 2119 Subtropic Dr,
DISHWASHER 1.75 3 CITY La Habra TEL. NO. 697 1349
CLOTHES WASHER 1.75 274231
STATE LIC C®36
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.75
TRICl NO. GP IZONE1 PR CESSED BY
LAWN SPRINKLER SYSTEM 1.75
WATER HEATER 1,75 INDUSTRIAL
g WASTE APPROVAL '
GAS SYSTEM OUTLETS 1.75 • J INSPECTION RECORD v
OUTLETS OVER p
5 PER SYSTEM -30 7�
0,,-I—zr!2 sa-n !tel C J -- D.f,� IVC 0 v1sx?. a
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE 13 2 120
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK -7.P'71A OX ref r
Name ROUGH PLUMBING „a r
Address GAS PIPING
City Tel. No. GAS VENT L�
HOT WATER HEATER ,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES cj�I/r
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING p
PLUMBING. GAS TEST ,, -vii
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CAMFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL rjWERTY. ^ FINAL
SIGNATURE i
OF PERMITTEE
PERMIT VALIDATION ,;exti M,O . CASH
PLAN CHECK VALIDATION CK. .0. CASH (�f/
`/ 1 0 7 V'!MAY 22 5 0 3 8.9 0 098