HomeMy Public PortalAbout6126 ROWLAND AVE_Plumbing__ 76A667A (CE 61713) -4/77 ,J'I
APPLICATION FOR PLUMBING PERMIT ylu1'
BUILDINGSAFETY DIVISIO
FOR APPLICANT TO FILL IN IPRINT OR TYPEI BUILDING & �j Rowland
NUMBER FIXTURE OR ITEM @ FEE ADDRESS
3 WATER CLOSET LOCALITY Temple Cit
NEAREST
1 BATH TUB CROSS ST. L.
SHOWER 3 OWNER John Sell
LAVATORY MAIL ADDRESS 2023 Bella Vista
i SINK 3 CITY Arcadia, Ca. TEL.NO. 445-2772
DISHWASHER CONTRACTOR J?rank Marrone & Sons Plbr, Co
CLOTHES WASHER 13
ADDRESS 3220 N• Ih1I'tee Awe,
SWIMMING POOL RECEPTOR CITY El Monte, Ca. TEL NO. 444-1193
LAWN SPRINKLER SYSTEM pL
1 WATER HEATER LICENSE NO. 286612 CLASS C36
GAS SYSTEM OUTLETS DISTRICT NO. GROUP �,!�E, PRO ESSED B
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OUTLETS OVER
5 PER SYSTEM INDUSTRIAL
WASTE APPROVAL
IN ECTION RECORD H
L
LL
CL
CA.
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTALFEE v
Plan check applicant
APPROVALS DATE INSPECTOR'S SIGNATURE
Name
UNDER SLAB WORK -.;?''H2
Address ROUGH PLUMBING
City Tel.No. GAS PIPING t
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE GAS VENT i
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT I 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, �TDIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. ! UTILITY CO.NOTIFIEDSIGNATUREOF PERM ITTE � /— v FINAL
PIAN_CHKK.VAlLDATION PERMIT VALIDATION
4 3.5 u m
POLICY HOLDER:
POLICY NUMBER: zo-3S7/,9 ,
76A667A L(fE 817E3) -4/77
APPLICATION FOR PLUMBING PERMIT
BUILDING SAFETY DIVISIOa
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING
ADDRESS V, ' dl$�1(1 ��
NUMBER FIXTURE OR ITEM ® FEE
3 WATER CLOSET LOCALITY Temple Cit
NEAREST
1 BATH TUB CROSS ST. Lc
SHOWER 3 OWNER John Sell
MAIL
LAVATORY ADDRESS 2023 B932a Vista
SINK CITY Arcadia, ca, TEL.NO. ��+2772
DISHWASHER CONTRACTOR Frank Marrone & Sms P]b • Co
1. CLOTHES WASHER ADDRESS 32,29 N. Dwfee Ave.
SWIMMING POOL.RECEPTOR CITY ElMO>r8'te� Ci8• TEL.NO. 444-1193STATE LIC. 3
LAWN SPRINKLER SYSTEM
WATER HEATER LICENSE NO. 286612 CLASS C
DIST ICi NO. GROUP Z E PR ESSED B
GAS SYSTEM OUTLETS 0 'I
40
55 PER SYS EM INDUSTRIAL \ v
WASTE APPROVAL O.
IN PECTION RECORD
a
Plan check fee
PLUMBING PERMIT ISSUING FEE$
TOTAL FEE
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK 7-/v 7
Address ROUGH,PLUMBING �p
City Tel.No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE GAS VENT
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REOU IRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM.THE GAS TEST
LEGAL OWNER OF, ND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. c UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE FINAL 71
P� KS1Ia Q1v$pE 5 H PERMIT VALIDATION C.cK! M.o. CASN
�i 6 ;tea 5 2-FEB. 27 5. a 4 3.5 O
POLICY HOLDER:
POLICY NUMBER: C11'7