HomeMy Public PortalAbout5943 SULTANA AVE_Plumbing__ I,76A667C (C6-61713) -9/78
APPLICATION FOR PLUMBING PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING - Sultana ✓rt. .
NUMBER FIXTURE OR ITEM @ FEE
WATER CLOSET ,0 LOCALITY Te le Cit
BATH TUB NEAREST
CROSS ST.
SHOWER OWNER Rosemead Construction
LAVATORY MAIL
ADDRESS 527 q- Atl antic
SINK 4 .6 CITY xMtere Paj?k TEL.NO. "3_957,x,
DISHWASHER CONTRACTOR Owen Bros. Plumbing
CLOTHES WASHERADDRESS 4265 N. Baldwin Ave.
SWIMMING POOL RECEPTOR
CITY E], Ntonte TEL. N O. 3-00
LAWN SPRINKLER SYSTEM STATE LIC
WATER HEATER LICNSE NO. 231 741 C ASS 036-M 78.1CD
DISTRICT NO. GROUP ZONRO SED BY v
GAS SYSTEM OUTLETS O� vv I I� E
OUTLETS OVER 0 t Z
y
t-
5 PER SYSTEM INDUSTRIAL LUiI
WASTE APPROVAL y
INSPECTION RECORD Z
1
Plan check fee
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE 1
Plan check applicant
Name APPROVALS DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Address
ROUGH PLUMBING
City Tel. NO. GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THEABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING. _
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST �)
CALIFORNIA OR THAT I. M THE LEGAL OWNER OF, AND INTEND TO 77
RESIDE IN THE ABOVE CR RESIDENTIA PROPERTY. UTILITY CO. NOTIFIED 7-ZI-
S1GNATURE — _ �u _
OF PERMITTEE FINAL �,.fy�+ '-�,,,`
PLAN CHECK VALIDATI N CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
-01717` L -9,5 3.&AM a7 :5 9- 13.5 0 As$