HomeMy Public PortalAbout10122 LA ROSA DR_Plumbing__ 76A%7-CE917 12/59 TEMPLE CITY
t APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OFyeCOUNTY
TY +T�ENGINEER
BUILDING A. AgIC. COUNTY tNGISEON BUILDING
ADDRESSI
WILLIAM A. JENSEN. SUPT OF BUILDING `� � CILOCALITY FOR APPLICANT TO FILL IN RcAREST (lIJlNUMBER FIXTURE OR ITEM OWNERWATER CLOSET MAILADDRESSHATH 7UB SHOWERCITY �1 /`T + TEL. NO. .CONTRACTORLAVATORYSINE ADDRESS
DISHWASHER CITY TEL. NO.
CONTRACTOR'S LAUNDRY TUB REGISTRATION NO.
CLOTHES WASHER DISTRICTNILP GROUP I ZONE I ROCE D B
�T I
WATER HEATER O
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
G C{ e- L l.L P l G _ INSPECTION RECORD S,
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1 0 $1.00 PER ITEM /
/ OR FIXTURE $ ! APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ E 00 UNDER SLAB WORK
TOTAL FEE .z.l ROUGH PLUMBING
V GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
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 ] AM ,THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENT AL PRO ENT // UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTE K /�
FINAL
®r OVA 0. ON ROBERT A wood.
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7BA667-CE8173-59Mp"'��'
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, Couutp Engineer CASSATT D. GRIFFIN. Supt of Building LOCALITY
FOR APPLICANT TO FILL IN NEAREST
DROSS ST.
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET MAIL
ADDRESS
BATH TUB
CITY TEL NO.
SHOWER
LAVATORY CONTRACTOR 0 /0/
SING ADDRE//SS�� D _5FN UE
DISHWASHER C17Y grOl e(J Of TEL. NO. 0 ^�
CONTRACTOR'S --YT p STATE
LAUNDRY TUB REGISTRATION NO. �41.g `7 0 COUNTY ❑
CLOTHES WASHER DISTRICT NO. GROUP ZONE_ O ESS BY
WATER HEATER ✓�^ l/`I C/y Z
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
Sdzpv I-GIS a I V,
�. Sr,oL 4- a�9
i
® $1.00 PER ITEM v
9 OR FIXTURE OQ APPROVALS ,type DATE INSPECTOR'S SIGNATURE
r
PERMIT $ E 00 UNDER SLAB WORK -ipll4' l
TOTAL FEE /! oa ROUGH PLUMBING .4A
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER 1
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES /i�n� 6 �/A'� �:{.r
LICENSEDCALIFORNIASO TH
AT DI BY LOS EANLE LES COUNTYOWNER OFD STATE
OF GAS TEST �D-N�"rJD
DESCRIBED RESIDENT[ R7Y. UTILITY CO.NOTIFIED _
SIGNATURE _
OF PERMITTE �.y
FINAL
®. VALIDATION ROBERT A. WOOD,
CARR SUPERVISING MECHANICAL ENG'R
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