HomeMy Public PortalAbout5004 HELEO AVE_Plumbing__ 76A687APPLICATON /F'O PLUMSING PERMIT
DBS-17 10-55
OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles 5292 BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 500 N- HP-1-e0
CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY Temple City
FOR APPLICA TO FILL IN NEAREST Loser Azusa & 7aosal
CROSS ST.
OWNER DIS ROUP ZONE
MAIL Same DY FOR INSPECTION
ADDRESS
INDUS IAL
CITY TEL. NO. WASTE APPROVAL
PLUMBER GENERAL INSTALLATION CO. INSPECTION RECORD
ADDRESS 6558 West Blvd.
CITY L•A. 43 TEL. NO. PLeasant 3-2541
LICENSE NO. 787 C-36 151839
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 $
BATH TUB @ $1.00
SHOWER @ $1.00
LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ $1.00 —
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
WAIT R
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 10F
ROUGH PLUMBING
GAS PIPING
TOTAL FEE GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICAHOT WATER HEATER `
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CO
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULAPLUMBING FIXTURES
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANGAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATCALIFORNIA OR THAT IAM E LEGAL OWNER OF THE AUTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PRRTx/f
SIGNATURE
OF PERMITTEE FINAL
JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR
CK. d.•. CASH
4 3 l5 .x .00
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