HomeMy Public PortalAbout5100 GLICKMAN AVE_Plumbing__ e-58 J ob 588
APPLICATION FOR PLUMBINGPC, RMIT 1
COUNTY OF LOS ANGELES l c::; 0 L {
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING �sl ^r ter, c+
JOHN A. LAMBIE, County Engineer ADDRESS n �.�---
CASSATT D.GRIFFIN,Sup t of Building LOCALITY Temple City
FOR APPLICANT TO FILL IN NEAREST
CROSS sT. Baldwin Ave.
NUMBER FIXTURE OR ITEM OWNER Adstad
2 WATER CLOSET MAIL
BATH TUB ADDRESS
SHOWER CITY TEL. NO.
2 LAVATORY CONTRACTOR Belvedere Plumbing Co.
4
1 `
SINK ADDRESS 11900 E. Garvey Blvd.
DISHWASHER CITY El Monte TEL. NO. GI 89836
1
LAUNDRY TUB CONTRACTOR'S STATE REGISTRATION NO. 179568 COUNTY ❑
l CLOTHES WASHER DISTRICT NO. GROUP ZONE P}�OCESSED BY
WATER HEATER .�/fJ�Yy
1 GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
@ $1.00 PER ITEM
10 OR FDCTUHE $ 1Oe00 DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2 00 ROUGH PLUMBING A.--r—�
TOTAL FEE12 00 GAS PIPING
I 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
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST �f.. .. •-,
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 RESIDENTIAL PROPERTY.
SIGNATURE ,CLe21 /� FINAL
OF PERMITTEE -
ROBERT A.WOOD.
®F VALIDATION SUPERVISING MECHANICAL ENG'R
CK. M.O. CASH i
,',,8 06 5 �10y 2 4 5 A 1 2.00