HomeMy Public PortalAbout10023 LA ROSA DR_Plumbing__ 76A6/7 QE817 10-60
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER'
BUoILDING AND SAFETY Y DIVISION
NVG SIOEH B
UILDING 10023 La ,Rosa Dr.
WILLIAM A. JENSEN, SUPT OF BUILDING CALITY Temple City
FOR APPLICANT TO FILL IN - - ST Baldwin Ave. -
OSS ST.
NUMBER FIXTURE OR ITEM
NER ' Owen
MA
2 WATER CLOSET
1 .BATH TDB ADDRESS
CITY - TEL NO.
1 SHOWER
2 LAVATORY _ CONTRACTOR Owen Bros. Flmbing
1 SINE ADDRESS 5255 N. Baldwin Ave.
DISHWASHER CITY El Monte TEL. NO- GI- 37b1�4
LAUNDRY TDB REGISSTSATIOCONTRACTORN NO. 1971Bµ COUNTY
1 CLOTHES WASHER DISTRICT NO. GROUP ZONE P ESSED BY
1 WATER HEATER S o- � -A
1 GAS SYSTEM INDUSTRIA �.
WASTE APPROVAL }
INSPECTION RECORD O
.��zv Fay 'k„rP. zaG 0
® $1.00 PER ITEM
10 OR FIXTURE. $ 10.00 APPROVALS DATE MS ECTO 'S SIGNATURE
PERMIT $ 2 OO UNDER SLAB WORK
TOTAL FEE 12 00 ROUGH PLUMBING.
GAS PIPING -
1 HEREBY ACKNOWLEDGE THAT ]`HAVE READ THIS APPLICATION
D
ANSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT ``
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATERI. A II/V
PLUMBING. - -
1HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED`'.ANDIOR PLUMBING FIXTURES
LICENSED AS REQUIREDBY LOS ANGELES COUNTY AND STATE OF y -
CALIFORNIA OR THAT'I AM THE LEGAL OWNER OFT- THE ABOVE GAS TES
DESCRIBED RESIDENTIAL PROPERTY.
_ unurr co. NonPIED / /I/G
SIGNATURE.
OF PERMITTE
FINAL
VALIDATION ROBERT A. WOOD v
CK
M.0. CASH SUPERVISING MECHANICAL ENG'R
LAUC b 5 OCT. -7 -- 5 b -1 "2.00