HomeMy Public PortalAbout4901 CLOVERLY AVE_Plumbing__ '• C
7BA6 18 7 Mg
APPLICATION FOR PIAJME31NG PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS �+ 0
JOHN A LAMBIE County En weer
1 cloverly
CAssATT D GRIFFIN shpt of Builamg LOCALrn Temiple Cit
FOR APPLICANT TO FILL IN CROs sT 1,8 Rosa Drive
NUMBER FIXTURE OR ITEM OWNS{ Mr. Tinsley
2 WATER CLOSET SII,
ADDRESS
1 BATH rv8
CITY TEL NO
SHOWER
LAVATORY CONTRACTOR Earl "Pat" Standley,le
1 SINS w/disp
ADDRESS 201 N.Ho t P.0 e Bo 408
DISHWASHER CITY El Mont TEL NO GI 4-l
CONTRACTOR S STATE
LAUNDRY TUB REGISTRATION NO COUNTY
1 CLOTHES WASHER DISTRI T N GROUP ZONE PR CESSED BY
WATER HEATER ' Zi
/f
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
L r�
ITEM
10 ORFIXTURE I 10.00
APPROVALS DATE INSI'�CTOR S SIGNATURE
-H PERMIT 51 2100 UNDER SLAB WORK
TOTAL FEE 12 O ROUGH PLUMBING e f ..
I- . GAS PIPING N T
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIONLHOT
VENT \
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WATER HEATER
PLUMBINGI HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/ORMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF TEST JYE4.0CALIFORNIA OR THAT I AM THE LE L OWNER OF THE ABOVEDESCRIBED RESIDENT L PROPS Y ITY CO NOTIFIED
SIGNATURE
OFF RMIiTL
Or ALIDATION ROBERT A WOOD,
CK m o CASH SUPERVISING MECHANICAL ENG R
1�;r, 2 2 2 5 D JIv1 14 5 D 1 2 .0 0 '�