HomeMy Public PortalAbout5946 1/2 CLOVERLY AVE_Plumbing__ 6
DES177 10 S9 APPLICATION FOR PLUMBING PERMIT
DBS
DIVISION OF BUILDING AND SAFETY
Department of County Engmeer
County of Loa Angeles BUILDING 1
JOHN A LAMBIE COUNTY ENGINEER ADDRESS L
CASSATT D GRIFFIN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
OWNER O DISTRICT GROUP ZONE READY FOR INSPECTION
MAIL
ADDRESS ��iiY��"
INDUSTRIAL
CITY TEL NO WASTE APPROVAL
PLUMBER j . X W 0 INSPECTION RECORD
ADDRESS %► V r^
CITY MLIbtr
//�� �aa TEL NO
LICENSE NO C_ —
NUMBER TYPE OF FIXTURE OR ITEM FEk
WATER CLOSET (TOILET) @ $100 $
BATH TUB @ $100 ( ='Aj_4-,Sa� Aar I?E9DY
SHOWER @ $100
LAVATORY (WASH BASIN) @ $100 _ jam G
KITCHEN SINK @ $100 ���/��//���,� �'ri"f""' / may /�r `�✓
DISHWASHER @ $100
LAUNDRY TUB OR TRAY @ $1 00 J
CLOTHES WASHER @ $1 00
WATER HEATER @ $1 00
GAS SYSTEM @ $1 00
/�rdp� �.Sit�T
APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
ROUGH PLUMBING IL [- �0
PERMIT $ 1 0 - v
GAS PIPING
TOTAL FEE
GAS VENT
1 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 PLUMBING FIXTURES
� p
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST On- "� 1':W 1jYJAA6
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED TO fl.51 S Sk ,D /2A M G .0 Ay
DESCRIBED RESIDENTIAL PROPER Y !
SIGNATURE
OF PERMITTEE FINAL
JOHN A LAMBIE C U TY ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR
CK M O
nq a
LACO2 9 8 7 UOR APR 16 3 A 3.0 0 M
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76AW-CE817 3-59
APPLICATION FOR PLUMPING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE County Engmeer ADDRESS
CASSATT D GRIFFIN Sup t of Building =NEAREST
FOR APPLICANT TO FELL IN
NUMBER FIXTURE OR ITEM � w/L
OWNER
WATER CLOSET MAILG
BATH TDB
ADDRESSJ�/Y
^�' �.
CITY / TEL NO
SHOWER
LAVATORY CONTRACTOR
SINK ADDRESS
DISHWASHER CITY /� C TEL NO
CONTRACTOR S _ �7 STATE
LAUNDRY TUB REGISTRATION NO f2 J COUNTY ❑
CLOTHES WASHER FW:ASTE
ISTRIC NO G� v ZONE
� PrROC�Y
WATER HEATER icy 1/
GAS SYSTEM �^
INDUSTRIAL 1
APPROVAL
INSPECTION RECORD
0 $1 00 PER ITEM
OR FIXTURE APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY OS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 �THE LE 49OWNER OF HE ABOVE
DESCRIBED RESIDENTIA UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTE -
FINAL
OF }VALIDATION -ROBERT A WOOD
cry m O CASH SUPERVISING MECHANICAL ENG R
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