HomeMy Public PortalAbout10037 LA ROSA DR_Plumbing__ 76A667-CE617-8-58
APPLICATION FOR -,PLUMBING PERMIT 1
_ COUNTY OF LOS ANGELES-
- DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
BUILDING
ADMIECouty £ng�n.. ZOO
7 a 'Rosa Drive
CASHATTG8QF,i.Sup't
of Ruildiag
LOCALITY Tem le Cit
FOR APPLICANT TO FILL IN - C8088SsT. Baldwin Avenue
NUMBER FIXTURE OR ITEM
OWNER S . ' Hau en
1 WATER CLOSET MAIL
1 BATHTUB ADDRESS 10035 La Rosa Drive
SHOWER CITY Temple City TEL. No.
1 LAVATORY CONTRAcrq�obbins & Wann Plbg & Ht
1 SINS ADDRESS$725 Norwalk Blvd; ,
DISHWASHER CITY Los Nietos TEL. HO.OX. 2-12
CONTRACTOB'S
LAUNDRY TUB REGISTRATION NO. 156272 C.-36
_ 1 CLOTHES WASHER DISTRICT NO. UP I ZONE P OCESSED BY
1 WATER HEATER
1 GAS SYSTEM INDUSTRIAL.
WASTE APPROVAL
1 INSPECTION RECORD
L; =NiJ"j'9
APPROVALS
@ EOI80 FIXTURE
IIS DATE INSPECTOR'S SIGNATURE
7 00 UNDER SLAB WORK /1-499 >� Y
PERMIT $ 2 'OO ROUGH PLUMBING (�'yj r✓'�
TOTAL FEE 9.90
. O GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT i (, J
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY-
WITH
OMPLY ry0T 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 ( --(' Ie a ��'✓
LICENSED AS REQUIRED LOS ANGELES COUNTY AN STATE OF e �-
CALIFORNIA OR THAT THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESL OP STY.
SIGNATURE FINAL -�' O ("✓'Y
OF PERMITTE
ROBERTA.WOOD.
®C VALIDATION e SUPERVISING MECHANICAL ENG'R
CASH
inn 6 5 7 7 OCT 2 7 5 A 9.0 0 n
76A667-CE817-B-58
APPLICATION FORPLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION - BUELDDIN 100; & La. Rosa Dr...
JOHN A. LAMBIE, County Enfg�nnear
CASSATr D. GRIFFIN. Sup t of BnBding LOCALITY
Temple Cit
FOR APPLICANT TO FILL IN hAMDMDwsl00l,5
O3s TT: Baldwin,
NUMBER FIXTURE OR ITEM
WATER cyosEr
WNER S'everti'� Haugen
'
BATE TUB La"Rosa Dr..
SHOWER CTIT Temple City xFy. No.GI 4.3338
LAVATORY CONTRACTOR Wm.. F'.. Lumble
sINR ADDRESS 6 2 rSan Bernardino Rd .
DISHWASHER - CITY El Mme TEL. NO.GI - 8 4
LAUNDRY TUB
CONTRACTOR'S
scs�T it NO. 155334 COTUNTY
CLOTHES WASHER 'DISTR NO. GROUP ZONE OCESSED B
WATER HEATER / A
1 GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
�S T
APPROVALS
@ O �c'EcE?
9 PER
ITEM
�-` F $ DATE INSPECTOR'S SIGNATURE
RFIXTURE 2.00
UNDER SLAB WORK
PERMIT $ 00 ROUGH PLUMBING
2
TOTAL FEE .00 GAB PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT �..- ✓�
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HDT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1 .HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER P THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL P OPE
SIGNATURE � FINAL
���... ROBERT A.WOOD,. -
.Or OALIDATION. SUPERVISING MECHANICAL ENG'R
CK. M.0. CASH `
i
�IC�as-2 0 F' DEC 2 4
5 4 .Q 0