HomeMy Public PortalAbout6421 TEMPLE CITY BLVD_Plumbing__ UA667 IeE $17)-4/72 `
APPLICATION F PLUMBING PERMIT {�
COUNTY OF LOS ANGELES �J
DEPARTMENT OF COUNTY ENGINEER Al
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO ADDRESS l /1 ,( ]do
HARVEY T BRANDT, COUNTY ENGINEER LOCALITYGFOR APPLICANT TO FILL IN (PRINT OR TYPEI CRO$$ST NUMBER FIXTURE OR ITEM ® FEE
OWNERG S
WATER CLOSET 1 75 �!BATH TUB 1 75 ADDRESS H r TQM Ar C/7' DLti10
SHOWER 1 75 CITY p r TEL NO !f jLAVATORY 1 75 CONTRACTORSINK 1 75 ADDRESSDISHWASHER 1 75CITY TEL NO �CLOTHES WASHER 1 75 STATE z 3 r L 9 CLIC
LASS G Z
LICENSE NO
SWIMMING POOL RECEPTOR 1 7$
DISTRICT NO GROUP ONE R CESSE BY
LAWN SPRINKLER SYSTEM 1 75
WATER HEATER 1 75 WASTE APPROVAL
GAS SYSTEM / OUTLETS 1 75
INSPECTION RECORD
OUTLETS OVER
6 PER SYSTEM 30
yd
Z
Plan Check fee See Reverse
PLUMBING PERMIT ISSUING FEE a 3 00
TOTAL FEE
APPROVALS DATE Ive PCL Ton s eicHAruRE
Plan Check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
City Tel NO GAS VENT
HOT WATER HEATER
HERESY THAT
TH LEDOE THAT I RAVE HEAD THIB APPLICATION
ANO STATE THAT THE DIVANBOVE IB CONFECT TE LAWS E ILA INT PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND !TATE LAW! RE OULATINO ZY
PLUMBING GAS TEST
1 HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED A9 REQUIRED By
LO! ANGELES COUNTY AND !TATE Or
CALIIORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY FINAL
SIGNATU RE
OF PERMITTEE
PER V ATION CK M D CASH
PLAN CHECK VALIDATION CK M D CASH
IAc 18 2 $73 22 5 D 4,75 =
7eA607.CER0I7 B/M
APPLICATION F R PLUUM G PERMIT
COUNTY OF LOS ANGELES
DEP�A�RTTME�NTp�OpF COUNTY pEN�INFER ON �a ss
B oF(ivin L1lM�1ESNOUA @NPA
WILLIAM A JENSEN SDP T OF EDILDING LOO
WJTY
FOR APPLICANT TO FILL. IN CROSS
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET BI n
TEAM
BATH Will ISS ADD]IERB
SHOWER 115 CTTT NO
LAVATORY ISS CONTRACTOR
BIN[ 115 ADDRESS
DISHWASHER 115 C NO G
LAUNDRY TIJB 125 COIITRACTOR STATE
BEOIBTRATIO NO �� COUNTY
CLOTHES WASHER ISS DISTRICT NO GRO P NE PR ESSED BY
WATER HEATER 1 50
17
MDUSTRLAL 0-
OAS SYSTEM OUTLETS 0
ISO WASTE APPROVAL 0
OUTLETS OVER S PER SYSTEM .SO INSPECTION RECORD
16114144W if 0
H
Z
APPROVALS DATE INBRECTOR SILO IwTU ME
PERMIT j 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HERESY ACRNOWLCDGK THAT I MAYS READ THIS APPLICATION GASVENT
AND STATS THAT TH[ ABOVE It CORNRCT AND AORE TO COMPLY
WITH ALL COUNTY ORDIMANCRA AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
1 NSROY CERTIFY THAT I AM PROPERLY RNGIm11[O AND/OR PLUMBING FIXTURES
LICEMSSD AS RSOUHMO BY LOB ANGELS[ COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE "GAL OWNER OF AND INTEND TO
RESIOS IN THE ABOVE DRAKMI§FD RKSICSNTIAL PERry UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL
ALIDATION ROBERT A WOOD
cR M o CASH SUPERVISING MECHANICAL ENG R
LpLo4 3 7 7� SEP29 5 D 3,50- a
1
7-69
76 A 667 - CE e17APPLICATION FOR PLUMEANG PE MIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUH DING AND SAFETY DIVISION I°ID�DnR as j
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPT OF BUILDING LOCALITT
FOR APPLICANT TO FILL IN PR NT OR TYPE CRNEARESOSS S r'
NUMBER FIXTURE OR ITEM
EEACH FEE S
OWNER
WATER CLOSET MAILBATH TUB ADDRffi8
SHOWER CITY TEL NO
LAVATORY SINK ADDRESS
DISHWASHER STA E / ,p /
CLOTHES WASHER 150 LICENSE el;r CLASS(i 3 T�
SWIMMING POOL RECEPTOR 150 DI SiTRICT NO GROUP Z014E P BY
LAWN SPR rNKLER SYSTEM 2 00 LJ r�
WATER HEATER 1 50 QmORTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 150 INSPECTION RECORD
OUTLETSOVER 30
5 PER SYSTEM
N
Z
Plan check fee 2]�MF
bove See rej
PLUMBING ISSUING F2 00
TOTAL F
APPROVALS DATE IN[ CTOR 9SIGNATURE
Plan check appliUNDER SLAB WORK
Nme ROUGH PLUMBING
Address GAS PIPING
CityTel GAS VENT
HOT WATER HEATER
1Ne11[Cr Ac[NowNAT 1 NAV[ RA-u--p NAND [TAT[ THAT TNI[ C0111RCT A [ TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY CE[ AND STAWOULATINO GA$TENT
PLUMSINOIN[REST CERTIFY1 AM PROPERLYERED ANO/OR UTILITY CO NOTIFIED
LICENSED AS SEQUALOS ANGELES CND RATE OFCALIFORNIA OR THATHE L[OAL OWNND I O TOREEID[ IN TH[AEOKKo R[Elo[NTn FINAL 2
SIGNATURE JACK R. ALLEN, SUPERVISING
OF PERMITT HANK AL ENG R
PERNUT VALIDATION CK M o CASH
PLAN CHECK VALIDATION CK M o 5H
IA(„ 8134P, DEC24 s D 3,50-
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