HomeMy Public PortalAbout5657 CAMBURY AVE_Plumbing__ ,.76A667-CE817 12/59 �. �
APPLICATION FOR PLl' MBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF CANDOUNTYsT�ENGINEER
' BJOHN�ACLAM BIE, CFENTY tNGiNEOERv ADDRESS 5657 Cambury
WILLIAM A. JENSEN, SUPT OF BUILMMO
LOCALITY #Vdd&W Tem le Cit.
FOR APPLICAPIT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM OWNER on Rogers
S
WATER CLOSET MAIL
BATH TUB ADDRESS 9222 Deadelina
C17Y ROseme$d&L NO.
SHOWER
CONTRACTOR Valle'y g Plumbin CO.
' � LAVATORY
SINE _ ADDRESS 42 W. Fleetwood Pl .
DISHWASHER = CITY Glendora TEL. No. Ed 5-129
_ CONTRACTOR'Sr� STATE ❑
LAUNDRY TUB REGISTRATION No.16041 COUNTY ❑
1� CLOTHES WASHER DISTRICT O. GRO � NE P CESSED BY
WATER HEATER �� V
l GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
SAL LPC \ �.AA U
o
U
a
Po z
aP51.00 PER ITEM _ /t
OR PDCTURE $. - 40APPROVALS DATE/ INSPECTOR'S SIGNATURE
PERMIT $ ? 100 UNDER SLAB WORK (/ Cwv�if
TOTAL FEE 13 OO ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ TRF§'APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES wZT
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST BO .GGR 7
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF-THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. - UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTE yy'' FINAL
®e VALIDATION ROBERT A. WOOD,
Y.0. CASH 'SUPERVISING MECHANICAL ENG'R
LAU0 5 2 5 3 APR 12 5 D 13 .0