HomeMy Public PortalAbout10214 LA ROSA DR_Plumbing__ ,76A667-CE877 12159
APPLICATION FOR PLUMBING PERMI'p%�
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETYIVISION BUILDING
JOHN A. LAM BI E. COUNTY NGINEER ADDRESS �,n q a
- WILLIAM A. JENSEN. SUPT OF BUILDING _
LOCALITY . / c
FOR APPLICANT TO7FILLIN CROSSr
CROSS ST. '�NUMBER FIXTUTEM /�!
OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
CITY TEL. NO.
SHOWER n
LAVATORY CONTRACTOR G
/
SINS: ADDRESS
,.{ p ..5 a (D !G-
DISHWASHER CISY /�'G 1'%/1!/'I FJ fl /CL-T''EEL. NO. 5`y 6,l/ D3
STATE 0
LAUNDRY TUB AEGICONBTAAT ONSNO. 7� 3 G Y COUNTY ❑
CLOTHES WASHER Ll
NO. ZONE GRO PRO S BY
WATER HEATER L/ . L V I
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
3-60 0,i Gni" Glenrteldr0
ia'tnrt 9� y
LL z
7 0 0 PER
ve� X93 Z � la? —/Vn kldTE? .3"'.
OR O O APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK A
TOTAL FEE <� �Q ROUGH PLUMBING u i.Le
7 GAS PIPING of Al
1 HEREBY ACKNOWLEDGE THAT 1 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
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES r Al
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST 4
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEP I �
FINAL �,� ^
I t./ ./ef V
®. OVALIDATION ROBERT A. WOOD, v
cc. B.0. CASH SUPERVISING MECHANICAL ENG'R
(�(07'J 4 '7 UU"CT ?G 5 0 91.0 0 0