HomeMy Public PortalAbout5835 TEMPLE CITY BLVD_Plumbing__ 76A867 (C6-817) - 1/79
APPLICATION FOR PLUMBING PERMIT
66NTY OF LOS ANGELES
tp 'RTMENT OF COUNTY ENGINEER
ILDING AND SAFETY DIVISION BUILDING 6
' MAKE CHECKS PAYABLE TO: ADDRESS a
COUNTY;ENGINEER LOCALITY
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST y
CL�J�
NUMBER FIXTURE OR ITEM @ FEE CROSS ST
WATER CLOSET 0 �'•
MAIL J� r
BATH TUB 2 0 -ADDRESS .0
SHOWER 2 CITY �. TEL. NO
LAVATORY 2, CONTRACTO � ��G
SINK 2, ADDRESS . . {l�A� ,�dr�
DISHWASHER 2. 0 CITY TEL. NO. �.
CLOTHES WASHER zfio STATE 'LIC
2 O LICENSE NO. �((� CLASS
SWIMMING POOL RECEPTOR
DISTRICT NO.GRQUP ZONE OCE ED BY
LAWN SPRINKLER SYSTEM A
0 � o�f Com.
WATER HEATER INDUSTRIAL
WASTE.APPROVAL
GAS SYSTEM OUTLETS 00 &L INSPECTION RECORD
OUTLETS OVER v
5 PER SYSTEM
CD1...
C.7
- W
a
y
- Z
Plan check fee See.Reverse
PLUMBING PERMIT ISSUING FEE $
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant *7's-v UNDER SLAB WORK
Name ROUGH PLUMBING ,
Address GAS PIPING vl
City Tel. No. GAS VENT ° f
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION /
'AND- STATE THAT THE ABOVE IS CORRECT AND 'AGREE TO COMPLY PLUMBING FIXTURES !
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS RECIUIRED LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 M HE LEGAL 0 N R OF, ANG IATERD TO..
RESIDE IN THE ABOVE ESCR BED RESID 1 P .PERTYi. FINAL
SIGNATU RE
OF PE RMIrT--E:E
PERMIT VALIDATION ck. M:O: ' 'CASH
J.
PLAN CHECK VALIDATION CK. X.O. CASH
17 5 Q A�
_ i
=76067 - CE817,5/70
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUII.DING AND SAFETY DMSION ADDRESS ", ,, ' .
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W:JENKINS.SUPT. OF BUILDING LOCALrrY
FOR APPLICANT TO FILL iN R NT OR TYPE NEARESTO
NUMBER FIXTURE OR ITEM EA H FEE
OWNER
WATER CLOSET 1. 0
BATH TUB 1. 0 ADDRESS
SHOWER 1. a CITY f TEL'NO.
LAVATORY 1. 0 CONTRALTO ¢'
SINK 1. 0 ADDRESS
DISHWASHER 1. 0 CITY 'NO• Vp�
CLOTHES WASHER 1. 0 STAT LIC
LICENSE NO. (Y / CLASS
SWIMMING POOL RECEPTOR i.. 0 DISTRICT NO. GROUP ZONE PRbCESSED BY
LAWN SPRINKLER SYSTEM 2. 0 r C
WATER HEATER 1, 0 INDUSTRIAL
WASTE OVAL
Q
GAS SYSTEM OUTLETS 1. 0 INSPECTIOIS RECORD
OUTLETS OVER 4.30
5 PER SYSTEM
i
Za
44, / o
Plan check fee'2,.'i%'of above. See reverse.
PLUMBING PERMIT ISSUING FEE.8 00 �~'f
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING .
GAS VENT
City_ Tel.. No. HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION PLUMBING FIXTURES
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OFj AND INTEND TO
RESIDE IN,THE SCRIBED RESIDENTIAL PROPERTY. F1N'PiL
SIGNATURE
.TACK R. ALLEN, SUPER SI G MECHANICAL £NG'R.
OF PERM ITTE PERMIT VALED Cjc. M.O. r CASH
PLAN.CHECK VALID ION CK. M.O. CASH CQ
q ..2 5 1 sj f 26 5 47�JN
76'A667 (CF2-817)-8-71 Gam'
APPLICATION FOR PLUMBING PERMIT
HARVEY T. BRANDT, COUNTY ENGINE-M,
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION sUILDING !�' �p
ADDRESS o4114a
LOCALITY J
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET 1.75 "OWNER
MAIL
BATH TUB 1.75 ADDRESS 00-1 ff
SHOWER 1.75 CITY r TEL. NO.
LAVATORY 1.75 CONTRACT i !
SINK 1.75 ADDRESS
DISHWASHER 1.75 CITY TEL. NO.
CLOTHES WASHER 1.75 STATE LIC
LICENSE NO.. CLASS
CLASS
SWIMMING POOL RECEPTOR 1.75
•• DISTRICT NO. :FP ZONFJ Il�RESSED B'Y
LAWN SPRINKLER SYSTEM 1.75 'ji J5.-O C/
WATER-HEATER 1.75 INDUSTRIAL 6 L
WASTE APPROVAL 0
GAS SYSTEM OUTLETS 1.75 INSPECTION RECORD
OUTLETS OVER 30
5 PER SYSTEM
1 s
_ H
z
o
Plan check fee See reverse.
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel. No. GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY • PLUMBING FIXTURES a .D
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. GAS TEST
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF; AND INTEND TO _
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. FINAL
SIGNATURE
OF PERMITTEE ^
PERMIT VALIDATION < M.O. CASH
PLAN-CHECK VALIDATI N CK. M.O. CASH
!.Ar .000773 PEAR 15 5 D 4.7 5 Q