HomeMy Public PortalAbout5304 WELLAND AVE_Plumbing__ '7GASS7 (Ce-ell) - 1/79
APPLICATI . FOR P MBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO: BUILDINGADDRESS 5_30�
HARVEY T. BRANDT, COUNTY ENGINEERLOCALITY
e i
FOR APPLICANT TO FILL IN (PRINT OR TYPE! NEAREST
4. CROSS ST. — /L
NUMBER FIXTURE OR ITEM ® FEE
WATER CLOSET 2.00 OWNER
MAIL I
BATH TUB 2.00 ADDRESS.
SHOWER 2.00 CITY Pd TEL. NO.;l
LAVATORY 2.00 CONTRACTOR ,
SINK 2.00 ADDRESS
DISHWASHER 2.00 CITY TEL: NO.
CLOTHES WASHER 2.00 STATE LIC.
SWIMMING POOL RECEPTOR2.00 LICENSE NO.20 CLASS
�
DISTRICT NO.GROUP ONE PRO SS BY
LAWN SPRINKLER SYSTEM 2,pp
WATER HEATER 2.00 IN`•/USTgIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 2.00INSPECTION RECORD
OUTLETS OVER V
5 PER SYSTEM .30
O
W
0 Z
Plan check fee See Reverse
PLUMBING.PERMIT ISSUING FEE $
TOTAL FEE
APPROVALS DATE INSPECTOR".S SIGNATURE
Plan Check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address. GAS PIPING
City Tel. No. GAS VENT
HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 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 TI
HEREBY '
CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOFIED
LICENSED AS REdUIRED BY LO
V
S AN ELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LE AL OWNER OF, aNB fRTEHD TO
RESIDE IN THE ABO - ESCRIBED R IDENTIAL PROPERTY. FINAL �r
SIGNATURE
OF PERMITTE 6
PERMIT VALIDATIO cK. M,0; CASH
PLAN-CHECK& IDATION CK. M.O. CASH
4 4 .1N11EC 1 V.,)
76A667 (CE-617)- 5/79
APPLICATION FOR PLUMBING PERMIT
'COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER Corner Duplex
BUILDING AND SAFETY DIVISION
MAKE CHECKS.PAYABLE TO: ADDRESS 5304 Welland Ave & 10909 Freer $
HARVEY T. BRANDT, COUNTY ENGINEER
LOCALIn le City
FOR APPLICANT TO FILL IN (PRINT OR TYPE) NEAREST
CROSS ST.
NUMBER "FIXTURE OR ITEM @ .FEE
WATER CLOSET 5.00 ��;� OWNER Jim Dillman
MAIL
BATH TUB 5.CM ADDRESS 311. Walnut
SHOWER 3. .} }g CITY Costa Mesa TEL. NO.(714) 642_ 4
LAVATORY R• CONTRACTOR CUSTI
SINK R 141715 ADDRESS. 4265 N. Baldwin Ave.
DISHWASHER -� fira
CITY El Monte TEL.,No. 443-0078
CLOTHES WASHER ,� STATE
LICENSE NO. 231 741 c ass .C36-20 T
SWIMMING POOL RECEPTOR 1.75
DISTRICT NO. GROUP ZONE PROCESSED BY
LAWN SPRINKLER SYSTEM 1,75 ^
WATER HEATER 3.� 1,75 6'O- INDUSTRIAL
WASTE APPROVAL d
GAS SYSTEM OUTLET�� 6 ' INSPECTION RECORD v
OUTLETS OVER
5 PER SYSTEM ,30 .pt QM(w CD
F-
LU
' W
d
ti
Plan check fee See Reverse 4
4SQ
PLUMBING PERMIT ISSUING FEE $ r
TOTAL FEE
APPROVALS ~ DATE INSPECTOR•5 SIGNATURE
Plan check applicant ,Ev UNDER SLAB WORK,• ✓/ -7.5-
Name ROUGH PL MB.M.G
Address GAS PIPING
City Tel. NO. GAS VENT '
HOT WATER HEATER
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THEABOVE 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 REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO A
RESIDE IN THE ABOVE D ED RESIDENTIAL PROPERTY. FINAL
SIGNATU RE
OF PERMITTEE
PERMIT VALIDATION OCK ..O. CASH
PLAN CHECK VALIDATION CK. M.O. CASH
5 4 91 SEP 10 5 0 - -0.5 0 &°S