HomeMy Public PortalAbout5079 SULTANA AVE_Plumbing__ �17 x ex
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUIIDINGLAAND S 'uNT RM'ION "Dells Sultana
JOHN A MBIE OUNTY RM
EER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN CROSS T
NUMBER FIXTURE OR ITEM EACH FEE
ST
OWNER V. A. Johnson
WATER CLOSET 81.15
BATH rus 125 1 KM ADDRESS2428 LaTkaood
1 SHOWER 115 1,25 clxr West Covina TEL NO ED 2x80
LAVATORY 125Cla CONTRACTOR Wm. F. Lumbley
1 Sw 1 T5 1 2 ADDRESS 11530 E. Ramona Blvd.
DISHWASHER 125 Crtr El Monte 1 TEL NO GI 87455
LAUNDRY TDR 123 REGISTRATION No 155334 CODrn
CLOTHES WASHER ITS DISTRICT Na, ORO 'ZONE PR SED BY
WATER HEATER 150 i D (o,
-GAS SYSTEM OUTLETS I so DmUSiBIAI.
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM AS ) RIBPECTION RECORD -6
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AP AT INSPECT"661 [
PERMIT S 2 OO UNDER WORK
ROUGH PLUMBING
TOTAL FEE 1 GAS PIPING
1 H[R6TY AC[NOWL[OO[ THAT I NAV[ READ THIS APPLICATION GAS VENT
AMD RAT[ THAT TIL[ AMV[ 1[ CORN[CT AND AOR[[ TO COMELY `/J
WITH ALL COUNTY ORDIMANC[[ AND RAT[ LAW[ WOULATINO / ^
PLUM[INO HOT WATER HEATER
I H[RSDY C[IRIry THAT 1 AM PROP[RLr R[OIR[R[O AHO/OR PLUMBING FIXTUR f , I
LIC6N[e0
AS R[OUIRK R Of AHa6W COUMn AND RAT[ OP SI
TEST
CALIFORNIA OR THAT 1 AM I. L[ L R OP AND IHT[NO TO
ARSIM 1N TH.AOOV[ 166 ID[ F[RY UTILITY CO N IFIED (�
SIGNATURE 64 1
OF PERMITTEE
FINAL
ATION I ROBERT A NVD
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUDJ04D G AND SAFETY IVLSION ADDRESS Sultana
JO N A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN CUP T of BUILDING
LOCALITY Tem le Cit
FOR APPLICANT TO FILL IN CROSS
YLQ/�L�W/t
NUMBER FIXTURE OR ITEM EACH FEE pW1�S P.A. 170I1T19011
WAILS CLARET M 15
BATH Tae 125 DDRESS P.O. Box 93
SHOWER i15 CITY Temple C3.ty TEL NO ED 280
LAVATORY 125 CONTRACTOR Wm F LumblO
RINE 125 ADDRESS P.o. Box 61
DM WASHER 1 u CITY El Monte TEL NO GI 8
LAUNDRY Tae 125
CONTRACTOR;mTRNo 155334' Comiir
CLOTHES WARM 115 01CT NO GR UP ZONE PROCESSED BY
6.[R''I
WATER HEATER 150 ✓lo -r GOLOVK[D
GAS SYSTEM OUTLETS 150 INDUSTRLIU.
WASTE APPROVAL
OUTLE73 OVER 5 PER SYSTEM to INSPECTION RECORD 7'
d
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V
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N
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APPROVALS DATE INSPECTOR[SIONATUN[ `\
PERMIT S 2 00 UNDER SLAB WORK _ 1
ROUGH PLUMBING ✓vim
TOTAL FEE Z GAS PIPING
I HKIII wCK.OWLKOGK THAT I HAVE RKAD TNIS wPP GTION GAS VENT
AND STAT[ THAT THE ASOVE IS COSK[CT AND AOR[[ TO COMPLY
WITH ALL COUNTY ORDIMAMCSS AND SLAT[ LAW[ MODUTINc HOT WATER HEATER
PLUMBING
I H[Rmr C[RLIIY THAT 1 AM v R[OI[rt AND/oR PLUMBING FIXTURES r' _
LIC[NS[O AS R[OUIR[D BY LO[ A COUNTY AN TATS OI GAS TEST
CALIFORNIA OR TNAT I AY N A WN[S OF
AN NTSND TO
Rwlo[ IN iH[• [I IAL PROP[ UTILITY CO NOTIFIED r
91ONATUR! '414.119 4z"
OF PERMITTE C FINAL
ALIDATION ROBES W
CK M o CASH SUPERVISING C 1$k CAL ENG R
LAAO 2.3 5 9 G MR 21 5 D 325- ,
TSMBTC ICK-81791 -8/TS ' 1
- , APPLICATION FOR PLUMBING PERMIT
GI TY 01= �N1P� CITY
7298 38-B4
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TV PEI BUILDING
NUMBER FIXTURE OR ITEM ® FEE ADDRESS 5079 N. Sultana ave.
WATER CLOSET LOCALITY TempleCity
BATH TUB NEAREST CROSS ST ACa80 and Pentland St.
SHOWER OWNER
LAVATORY MAIL
ADDRESS
SINK CITY TEL NO
DISHWASHER CONTRACTOR
Terry Ti-le
CLOTHES WASHER
ADDRESS W B
SWIMMING POOL RECEPTOR 52110
LAWN SPRINKLER SYSTEM CITY La. TEL NOq31-1864STATE LIC
WATER HEATER LICENSE NO 10 264 CLAS
DISTRICT NO GROUP 20NE SED BYCD
GAS SYSTEM OUTLETS , Og y U
OUTLETS OVER
5 PER SYSTEM IND�J$TRIAL IC�J
WASTE APPROVAL yVj
Cl
INSPECTION RECORD h
2
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE to —
Plan check applicant
Name APPROVALS DATE IHB occ TOR B BiGNAT unc
UNDER SLAB WORK
Address
ROUGH PLUMBING
City Tel NO GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMB NO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSE DAS REOUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CAU PO RNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENT( ROP TY UTILITY CO NOTIFIED
SIGNATURE I
OF PERMITTEE X7 FINAL
PL ®I�"K%TIftM PffNsrATIM
PERMIT VALIDATION '� M 0 CASH
POLICY HOLDER,�r,,--' f 1�p5 5 OMI 18 5 D C1.0 0
POLICY NUMBER' 42.5>Z1g