HomeMy Public PortalAbout4937 PERSIMMON AVE_Plumbing__ 76A667 (CE-817)- 5/73
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
MAKE CHECKS PAYABLE TO: ADDRESS 4 Persimmon Ave.
HARVEY T. BRANDY, COUNTY ENGINEER LOCALITY Temple City
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST. El Monte Ave . Lo«�� Z
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET 1,75 OWNER Robert Dominguez
MAIL
BATH TUB 1.75 ADDRESS 4937 Persimmon Ave .-
SHOWER 1.75 CITY Temple City TEL. No.-444 0073
LAVATORY 1.75 CONTRACTOR Valle Heating Go.
SINK 1.75 ADDRESS 30$ E Valley Blvd.
DISHWASHER 1.75 CITY San Gabriel TEL. No288 6812
CLOTHES WASHER 1.75 STATE LIC I _
SWIMMING POOL RECEPTOR 1.75 LICENSE NO. 147899 . CLASS C 20
D.WRICT O. GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 1.75 .4
WATER HEATER 1.75 INDUSTRIAL
WASTE APPROVAL o.
GAS SYSTEM OUTLETS 1.75 ' INSPECTION RECORD v
OUTLETS OVER 30
5 PER SYSTEM p
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE 4
APPROVALS DATE INS PEC TO R'9 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING /
Address GAS PIPING C/-/17 s%Lf 'W, '9111111,-1_.
City Tel. No.
GAS VENT
HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION.
AND STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST L .s •/
I HEREBY CERTIFY THAT I AM PROPERLY R STEREO AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY L S ANGELES CO TY AND STATE OF
CALIFORNIA OR THAT I AM E LEGAL OW OF, D/CNTEND
RESIDE IN THE ABOVE DES BED RESIDE PROP TY.
FIN L .rf'�••'A7F. ../;y
SIGNATU RE "
OF PERMITTEE
PERMIT VALIDATION- `K M.O. CASH
PLAN CHECK VA6DATION CK. M.O. CASH
6
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