HomeMy Public PortalAbout10124 GREEN ST_Plumbing__ APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FNEAREST
G
BUILDING AND SAFETY DIVISION S to/ �� f PP
JOHN A. LAMBIE. COUNTY ENGINEER C�
CASSATT D. GRIFFIN, SUPT OF BUILDING Y l
FOR APPLICANT TO FILL IN T. W
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
SHOWER CITY TEL.NO.
LAVATORY CONTRACTOR i ✓ �°
SINK ADDRESS e C'TY A
DISHWASHER CITY1141, TEL.NO.
,117-, a
LAUNDRY TUB CONTRACTOR'S STATE
REGISTRATION NO. COUNTY I0
CLOTHES WASHER
DIST GROUP ZONE READY FOR INSPECTION
WATER HEATER � � �
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
$1.00 PER ITEMDATE INSPECTOR'S SIGNATURE
n
OR FIXTURE $ L� Q UNDER SLAB WORK
PERMIT $ 1100
ROUGH PLUMBING
GAS PIPING
TOTAL FEE 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.
IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST f '� C C✓�-v�
LICENSED AS REQUIRED BY LOS ANGEL OUNTY AND STATE OF r• ry. /��i
CALIFORNIA OR THAT I A THE OWNER OF THE BOVE UTILITY CO. NOTIFIED
DESCRIBLD RESIDENTIAL P OPERT
SIGNATURE - t
OF PERMITTEE FINAL
ROBERT A. WOOD,
T), VALIDATION SUPERVISING MECHANICAL ENG'R
11,0 CASH
-: s y,• i.
T03 8 O 0 P AIG 1 2 5 A 8.0 0 .
r 2 �
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING /
BUILDING AND SAFETY DIVISION f L/!.� n
ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
CASSATT D, GRIFFIN. SUPT OF BUILDING 11
LOCALITY
FOR APPLICANT TO FILL IN NEAREST ;t
CROSS ST.
NUMBER FIXTURE OR ITEM `
OWNER ;, � ,L• �� -
WATER CLOSET
MAIL
BATH TUB ADDRESS
SHOWER CITY TEL.NO.
LAVATORY CONTRACTOR
SINK ADDRESS ?.. rr4 r
DISHWASHER / , r
CITY / dot -y' TEL.NO.
LAUNDRY TUB CONTRACTOR'g STATE
REGISTRATION NO. _ 6 COUNTY LlCLOTHES WASHER
DISTRICT NO. GROUP ZONE READY FOR INSPECTION
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
I
APPROVALS
�'- @ $1.00 PER ITEM // DATE INSPECTOR'S SIGNATURE
OR FIXTURE $ UNDER SLAB WORK
Gu
PERMIT S 1100
ROUGH PLUMBING
---- �
GAS PIPING
TOTALFEE
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 V.
PLUMBING.
1I,.HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST ' f
LICENSED AS REQUIRED BY LOS ANGELES COU NTYND E OF
CALIFORNIA OR THAT 1 AM THE LEGAL-:OWNE F THSTAJJE lIBOVE UTILITY CO. NOTIFIED
DESCRIBLD RESIDENT14L ,PROPE Y. i
1,2
SIGNATURE
OF PERM ITTEE FINAL
IDATION ROBERT A. WOOD,
P•
SUPERVISING MECHANICAL ENG'R
CK. W O. CASH
!3 3 6 7 u° JUL 31 5 A 8.0 0