HomeMy Public PortalAbout10018 LA ROSA DR_Plumbing_3/12/1959_heater 76A667-CE817-8-58 _
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, CoantF Ea oor ADDRESS ' 001 R ATNO. ,' R
CASSA'R'D. GRIFFIN,Sup t of wilding LOCALITY
FOR APPLICANT TO FILL IN NE "S
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET -
BATH TUB - �ESS ,/SHOWER CITY 6 A-E �3TLAVATORY CONTRACTOR
SINE ADDRESS
DISHWASHER CITY CONTRACTOR'SSTATE ❑LAUNDRY TUB REGISTRATION NO - COUNTYCLOTHES WASHER DISTRIC?O. GROROCESSED BYWATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
mm
OR PER $ DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2 00 ROUGH PLUMBING- A
TOTAL FEE GAS PIPING
I.HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT e
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST S •as..
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RES]
SIGNATURE /
OFPERMITTEDENT PRO RTY. FINAL
ROBERTA.WOOD.
®• VALIDATION_ SUPERVISING MECHANICAL ENG'R
c.. Y.O. CASH 1
M �c3 3 7` 7 n :,v� 12 5 A 3.00