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HomeMy Public PortalAbout5027 CLOVERLY AVE_Plumbing__ 76A667 APPLICATION FOR PLUMBING PERMIT CE 817 8_59 BUILDING AND SAFETY DIVISION - Department of County Engmeer County of Los Angeles BUILDING JOHN A L.AMBIE,COUNTY ENGINEER ADDRESS 50227 Cloverl Avenue CASSATT D GRIFFIN,SUP T OF,BUILDIN6 LOCALITY y 121 City t FOR APPLICANT TO FILL IN I CROSS ST T La Rosa Drive IT OWNER Ra V • Bottorff DISTRICT NO GRO�U - ONE I READY FOR INSPECTION MAIL ADDRESS 5031 Cloverl I .� INDUSTRIAL CITY Temple Cit TEL NO •WASTE APPROVAL PLUMERobbins & Wann P1bg & Htg Co INSPECTION RECORD ADDRESS 86ZO Blvd. CITY Los Nieto s TEL NCO X2-1286 LICENSE NO 166272 0-36 NUMBER TYPE OF FIXTURE OR ITEM FEE 1 WATER CLOSET (TOILET) @ $1 00 $l 00 1 BATH TUB @ $1 00 1 00 SHOWER @ $1 00 1 LAVATORY (WASH BASIN) @ $1 00 1400 1 KITCHEN SINK @ $1 00 1400 DISHWASHER @ $100 LAUNDRY TUB OR TRAY @ SI 00 CLOTHES WASHER @ $100 WATER HEATER @ $100 GAS SYSTEM @ $1 00 APPROVALS DATE INSPEC 07 Sj§IGNATURE UNDER SLAB WORK PERMIT $ 1 00 ROUGH PLUMBING i r1l GAS PIPING TOTAL FEE 860 Lo GAS VENT I HEREBY ACKNOWLEDGE THAT 1 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 D PLUMBING �c I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF / CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED DESCRIBED RESIDENTIAL PR RTY l SIGNATURE OF PERMITTEEFINAL ROBERT A WOOD, JOHN A L.AMSIE COUNTY ENGINEER ALIDATION SUPERVISING MECHANICAL ENG R C M 0 CASH 1ACo 5459- oec31 -3 8010 tn 1 76A667 CE817 8 57 APPLICATION FOR PLUMBING PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADDRESS JOHN A LAMBIE COUNTY ENGINEER CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY Z, FOR APPLICANT TO FILL IN NEAREST 4 CROSS ST NUMBER FIXTURE OR ITEM ry WATER CLOSET OWNER MAIL BATH TUB ADDRESS SHOWER CITY TEL NO LAVATORY CONTRACTOR SINK ADDRESS DISHWASHER CITY TEIF NO �� W LAUNDRY TUB CONTR-ACTOR STATE REGISTRATION NOCOUNTY El CLOTHES WASHER DISTRIC NO GROUP ZONE READY FOR INSPECTION WATER HEATER GAS SYSTEM 4 INDUSTRIAL WASTE APPROVAL INSPECTION RECORD APPROVALS �,( @ $1 00 PER ITEM DATE INSPECTOR S SIGNATURE O/�-- OR FIXTURE $ UNDER SLAB WORK PERMIT S 1 00 ROUGH PLUMBING_ GAS PIPING 6 TOTAL FEE 3 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 I HEREBY 'CERTIFY-THAT 1 AM PROPERLY REGISTERED-AND/OR GAS TEST LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OW R OF THE ABOVE UTILITY CO NOTIFIED DESCRIBED RESIDENTIAL PROPERTY SIGNATURE OF PERM FINAL ROBERT A 'WOdD ©� VALIDATION SUPERVISING MECHANICAL ENG R CK M O Q12-le--l' C 208 ?OR M18 3 A 3.00 M