HomeMy Public PortalAbout4821 DOREEN AVE_Plumbing__ 76A667-CE817-9-58
APPLICATIONTY FOR PLUMBING PERMIT 1
OS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BIIILDING oI
JOHN R. LAMRIE, CoontF Evgiaenr ADDRESS O9 { � �!
CASSATI D. GRIFFIN,Sup f of Building LOCALITY
FOR APPLICANT TO FILL IN NEARESTE ✓
NUMBER FIXTURE OR ITEM OWNER W` � �37 J d'
WATER CLOSET MAIL
BATH TUB ADDRESS
SHOWER C is Cl(�-L. TEL. NO. eq
ley
LAVATORY CONTRACTOR
SINK ADDRESS
DISHWASHER CITY TEL. NO.
- CONTRACTOR'S STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY ❑
CLOTHES WASHER DISTRICT NO. GROUP ZONE PROCESSED BY
WATER HEATER � }I/,JI �
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
@ $1.0OR FIXTURE PER
IXTU ITEM
$
to DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT S Z DG ROUGH PLUMBING
TOTAL FEEGAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST -1e.6 /� �-y—`�_
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDEENTTI L P OPERTY. J/
SIGNATURE
OF
PERMISIGNATURE
TEFLF r �Ji fOd'Q'C1J FINAL
®r 1 ROBERTA.WOOD.
VALIDATION
SUPERVISING MECHANICAL ENG'R
CK. S.0. CASN
"��8 7 1 A HC1 0 5 A 3 .00 N .
1.
76A667-CE81712/59 TEMPLE CHTY
APPLICATION FOR. PLUMBING PERMIT.
COUNTY
COUNENGINEER
BUILDING AND SAFETY DIVISION BmLnmG i l F209 f"
JOHN A. LAM BIE. COUNTY ENGINEER ADDRESS/
WILLIAM A. JENSEN, SUPT of BUILOING
.. .. .- LOCALI
FOR APPLICANT TO FILL IN Naos SST A/
NUMBER FIXTURE OR ITEM
OWNER /I �/�&4 //'v.
WATER CLOSET MAIL
ADDRESdoa�
BATH TUBC 17
ADD
SHOWER
LAVATORY CONTRACTOR
SINK ADDRESS
DISHWASHER CITY TEL.. NO..
CONTRACTOR'S STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY ❑
CLOTHES WASHER_ DISTRICT NO. GROUP ZONE PR/OCES D;BY
WATER'HRATE� ./�J L -�I // J
GAS SYSTEM / INDUSTRIAL
WASTE APPROVAL
INSPECT ON RECORD
UU
0
F
w
z
r -
0 PER ITEM
OR /--'/
OH IIXTURE $ y_J APPROVALS OATS INSPECpTOR'S'SIGNATURE I
PERMIT $ 2 100 UNDER SLAB WORK 2 (e/i ..JCC •—� f
V
TOTAL FEE ROUGH PLUMBING
GAS PIPING G IvLL)I ^/J, /
rl
LEDGE THAT I HAVE READ THIS PPLICAiION
E ABOYE IS CORRECT AND AGREE TO COMPLY GAS VENT A
ORDINANCES AND STATE LAWS REGULATING I HOT WATER HEATER 1.-L.,J
PLUMBING. _
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURESLICENS ED
CALIFORNIASORE THAT DI BAML THE OS ANGELES
OW ERY OF THE AND AABOYE TE OF
GAS TEST OJJII ,/ ^ .tf
DESCRIBED RESIDENT! PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE I w f e
OF PERMITT J /
FINAL
®. VALIDATION ROBERT A'WOOD.
cs. M.O. cpsH SUPERVISING MECHANICAL ENG'R
' " 1798 Mi 30 5 0 7 .00