HomeMy Public PortalAbout5826 MYDA AVE_Plumbing__ 76A667- CE817 5/70 Ready for ' . spectiop
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGIIMER-
BUILDING AND SAFETY DIVISION FNEAREST
ac Q
JOHN A.LAMBIE, COUNTY ENGINEER SS_ 826 NO. da Ave.
COLEMAN W:JENKINS. SUPT. OF BUILDING I'TT Tim a City
FOR APPLICANT TO FILL IN(PR NT OR TYPE) .
NUMBER FIXTUREOR ITEM EACH1 FEE
owNea Kimble
WATER CLOSET 1.50 Mrs. 7I� Ave.ATHTUB 1.50 DSS 826 NoM da li
SHOWER 1.50 CTTY Temple City TEL. NO. 286-6494
LAVATORY 1.50 .' CONTRACTOR. Duce Plumbing & Heating
SINK 1.50 ADDRESS 3232 N. khn Gabriel Blvd.
DISHWASHER 1.50 ' CITYRosemead a�I p TEL' NO- 22004
231-
CLOTHES WASHER 1.50 STATE —LICENSE NO. 104978 CLASsG-3.6 20
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP E PROC SED Y
LAWN SPRINKLER SYSTEM 2.00 'U
WATER HEATER 1.50 1 175 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD
OUTLETS OVER
5 PER SYSTEM •30
C/f
z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE..8 3 00
TOTAL FEE - 4 75
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
. City - Tel. No. GAS VENT -
I HHOT WATER HEATER
HEREBY ACKNOWLEDGE THAT '1 HAVE READ THIS APPLICATION -
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL' COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
LICENSEE AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN,THE1 B�OVE CES RIBED RESIDENTIAL PROP FINAL �}
V .
SIGNATURE
OF PERMITTEE .TACK R. ALLEN SUPE VISI CHANICAL ENG'R.
PERMIT VALIDATION CK. M.O. CASH.
PLAN CHECK VALIDATI . CK. M.O. CASH
'.
36 0 573 OCT 15 5 4-.1754
BA667-CE817 12159.
APPLICATION FO PLUM IVIG PERMIT �
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINM
BUILDIl GLAND SAFETY VISION "U==D
s'I
JOHN MBIE. COUNTY NGINEER
WILLIAM A.JENSEN,Su IT OF BUILDING LOCALITY
FOR APPLICANT TO FILL ni . NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM /
OWNER
WATER CLOSET MAIL
o�
DATE TUB ADDRESS
CITY NO.
SHOWER
CONTRACTOR
LAVATORY -
SIM ADDRESS
DISSWASRER CITY TEL. N0,00 , 7, 6�
CONTRA 'S w STATE p-
LAUNDRY TUB REGISTRATION NO. /a�I✓ COUNTY ❑.
CLOTBES WASHER DWRRInnCT NO. 1aBOUP ZONE PR ESSED BY
WATER REATER . U liz/
GASPISTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
O
U
10.
7 D�4yA/rte rl
/ W O8 PER
$
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE � ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANDIOR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES TY AND STATE OF GAS TEST
CALIFORNIA OR THAT I�PR.
M.�N'
GAL N OF THE ROVE
DESCRIBED BESIDE TIALOUTILITY CO.NOTIFIED
c
SIGNATURE
OF PERMI7TE
FINAL !1�
�■ ALIDATION ROBERT A.WOOD.
ex. B.0. CUR SUPERVISING MECHANICAL ENG'R
3 6 1 3 JUL 11. 5 D 3.0 0
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