HomeMy Public PortalAbout6119 ROWLAND AVE_Plumbing__ 1
76AG67A (CPC 61713).-4/77
APPLICATION FOR PLUMBING PERMIT
BUILDI AND SAFETY DIV[ ON.
FOR APPLICANT TO FILL IN[PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM ® FEE ADDRESS t RO�Pl�nd
3 WATER CLOSET LOCALITY Temple City
1 BATH TUB 31
NEAREST
CROSS ST.
SHOWER -31 OWNER Olin 993.
MAIL
3 LAVATORY ADDRESS 2023 Bollib Vista
SINK 3 CITY Arcadia, Ca, 9 TEL.NO.4J4j-2'x'72
1 DISHWASHER 3 CONTRACTOFrank Marrobe & Sons P'lbg, Co,
1 CLOTHES WASHER - • ee AVeO
ADDRESS ,
SWIMMING POOL RECEPTOR CITY El Monts, C8• TEL NO. 444-H93
LAWN SPRINKLER SYSTEM
STATE LIC.
WATER HEATER 4INtDUSTRIAL
NO. 2612 CLASS C36
1 GAS SYSTEM OUTLETS STRICT NO. G�QUP E CESSED BY
OOUTL .L -+'
OVER
55 PER SYSTEM TEM v
PPROVAL C
INSPECTION RECORD
• W
d
y
Z
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INS E TOR'S 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
THATTHE ABOVE IS CORRECTAND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES HOT WATER HEATER
AND STATE LAWS REGULATING PLUMBING.
I HEREBY.CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 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 AB .E DESCRIBED RESIDENTIAL - v
PROPERTY. UTILITY CO.NOTIFIED
9
i
SIGNATURE
OFPERMITTEE ��'��` FINAL
PLAN Nk SH PERMIT VALIDATION CK. M.O. CASH
'OLICY FOLDER:�' '�r S 5 'O r--FEB 27 5 1 4 3.5 0 A:8
'OLICY NUMBER& 11.7.2o3&1