HomeMy Public PortalAbout10938 DANBURY ST_Plumbing__ 76A567-CM17 3-59
APPLICATION FOR PLUMBING PERMIT �
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION aU[LDIN _ J/
ttOHN A. LAMM County,Eng'neez ADDRESS ZIp nhi I-pi
CASSATT D. GRIFFIN, SuP t of Building ~ 1
_ . . LocALrtY Templ e City
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM OWNQI Larkwood L'onst.
2 WATER CLOSET MAIL
1 BATH TUB ADDRESS
SHOWER C17Y TEL NO.
2 LAVATORY ccliTAACToR Richard Cavanaugh Plumb'
1 SINK ADDRESS 13354 Central Ave
DISHWASHER CITY Chino TE- No- NA 84721
CONTRACTOR'S STATE ❑
LAUNDRY TUR REGISTRATION NO. 155164 Ci-36;OUNTY
1 CLOTHES WASHER DISTRICT GRQUB ZONE PROCESSED BY
1 WATER HEATER L../ � /
1 GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
._ Cp A; 4 �C odd_ /' ! r -
$1.00 PER ITEM
10 OR FIXTURE S 10.00_ APPROVALS DATE,/ INSPEC R'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK - (Q lCC'JL /—L-
rm Y t�
TOTAL FEE �00 ROUGH PLUMBING �oIi3 QAC' �p/ L-+�/J--���
LLL GAS PI PING �i�l �-�D U/.G[il•�4rw-Y
I 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 HOT WATER HEATER
PLUMBING,
1 XEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST i'SO-G�
CALIFORNIA OR THAT 1 AM THEAEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL P E ' UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTE y�
FINAL
®, LIDATION ROBERT A. WOOD,
cK. N.o, CASH SUPERVISING MECHANICAL ENG'R
! Ar, 7838 "IAP 16 5 A 12.00f