HomeMy Public PortalAbout6040 IVAR AVE_Plumbing__ 76A667 -CE#817 4-64
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING -- `
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS 60 .0 Ivar Ave.
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY `j' i le Cit
FOR APPLICANT TO FILL IN CROS SST.
NUMBER FIXTURE OR ITEM EACH FEE OWNERRalph Adams
2 WATER CLOSET $1.25 2 0 MAIL - 1151 Shasta Br.
1 BATH TUB 1.25 l 25 ADDRESS
I SHOWER 1.25 l �5 CITY I"eSt 6ovina TEL. NO. ED _2-3420
2 LAVATORY 1.25 2 .5o CONTRACTOR Belvedere Plumbing Co.
1 SINS 125 1125 ADDRESS 13350 Ector St.
DISHWASHER 1.25 CITY City of Industry TEL. NO. 448_9836
CONTRACTOR'S179568STATE
LAUNDRY TUB 1.25 REGISTRATION NO. COUNTY
1 CLOTHES WASHER 1.25 1 25 DISTRICT NO. GROUP ZONE P OCESSED BY
WATER HEATER 1.50 1.50
GAS SYSTEM_5_OUTLETS 1'� WASE AIP AL 9L
TAPPROVAL 0
OUTLETS OVER 5 PER SYSTEM- .30
INSPECTION RECORD V
APPROVALS TOR'SGATURE
PERMIT $ 2 00
UNDER SLAB WORK Y�
ROUGH PLUMBINGiE��tr%
TOTAL FEE 1000 GAS PIPING l G'
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ TH I5 APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING o HOT WATER HEATER m
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND'TO x
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED A 1A
"pr�r�Y—wv
SIGNATURE _
OF PERMITTEE
FINAL
V LIDATION ROBERT A. WOOD
CK.
M.0. CASH SUPERVISING MECHANICAL ENG'R
, , 2 6 si���15 r, 1 5.00
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