HomeMy Public PortalAbout6052 CAMELLIA AVE_Plumbing__ 76A667-CE817-8-57
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING -
ADDRESS (1 S
JOHN A. LAMBIE. COUNTY ENGINEER
CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY ny C,
FOR APPLICANT TO FILL IN NEAREST L
CROSS ST. Q
NUMBER FIXTURE OR ITEM
OWNER4 Al
S (J
WATER CLOSET MAIL
BATH TUB ADDRESS
SHOWER CITY TEL.NO.
LAVATORY CONTRACTOR
SINK ADDRESS (�./VQI
DISHWASHER CITY 1'n D/,//l v/w TEL.NO.
LAUNDRY TUB CONTRACTOR'S STATE
REGISTRATION NO. +C1�J COUNTY ❑
CLOTHES WASHER
DIST R CT NO, GROUP ON READY FOR INSPECTION
WATER HEATER 7
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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� 06
S_,
APPROVALS
DATE INSPECTOR'S SIGNATURE
@ $1.00 PER ITEM
OR FIXTURE $ Q UNDER SLAB WORK ---
ROUGH PLUMBING, %J717<
PERMIT s 1100
GAS PIPING
TOTAL FEE '0 GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES _
PLUMBING. 1 A;
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF UTILITY CO. NOTIFIED -/ '" �>f
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE -
DESCRIBLD RESIDENTIAL PR� ERTY.
SIGNATURE (/`,— \
OF PERMITTE FINAL
ROBERT A. WOOD,
VALIDATION SUPERVISING MECHANICAL ENG'R
K. M.O. CASH
12 2 6 4,a; JUN -2S 3 A 8.0 0L.Co
I
78Ak67-CE#�407 5-61 �
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 6052 Camellia Ave.
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY Temple Cit
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER Paul Disselkoen
WATER CLOSET 2 I MAIL
BATH TUB ADDRESS 1008 Encino
SHOWER CITY Arcadia TEL NO. HI-67468
LAVATORY L CONTRACTOR Parker Plumbing
/ SINS Z ADDRESS 14617 E. Ramona Blvd.
DISHWASHER CIrYBaldwin Park TEL. NO. ED-81127
CONTRACTOR'S jNa
LAUNDRY TUB REGISTRATION NO. 1 7747 COUTNTY
CLOTHES WASHER DI$TRICT NO. GROUP ZONE P Y
WATER HEATER a
GAS SYSTEM INDUSTRIAL V
- WASTE APPROVAL
INSPECTION RECORD
0
I—
U
W
a
kn
Z
o $1.00 PER ITEM
OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEEROUGH PLUMBING
UD GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND S E
CALIFORNIA OR THAT I AM THE LEG OWNER O E E GAS TEST
DESCRIBED RESIDENTIAL P RTY. j UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITT
AL
"VALIDATION ROBERT A. WOOD
cK.
M.0. CASH SUPERVISING MECHANICAL ENG'R
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