HomeMy Public PortalAbout9404 LA ROSA DR_Plumbing__ 76A667-CES17-11-57
APPLICATION FOR PLUMBING PERMIT
COUNTY OF-'LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, County. Engineer ADDRESS
CASSATT D. GRIFFIN, Sup t of Building LOCALITY
FOR APPLICANT TO FILL IN NEAREST '
NUMBER FIXTURE OR ITEM CROSS ST. 1
OWNER [//J
WATER CLOSET
MAIL
r BATH TUB ADDRESS v
SHOWER CITY TEL. NO
LAVATORY CONTRACTOR
SINK ADDRESS
DISHWASHER CITY NO. T r
' - CONTRACTOR'S f ATE
LAUNDRY TUB
REGISTRATION NO. 11X-3 f COUNTY
CLOTHES WASHER DISTRICTNO.,. GROUP ZONE READY FOR INSPECTION
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
I I INSPECTION RECORD
PROVALS
$1.00 PER ITEM AT INSPE_gjOR:S41, NATURE ~
D OR FDITUBE $ D
UNDER SLAB WORK
PERMIT $ 00 ROUGH PLUMBING 1
TOTAL FEE h GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT '
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER �r
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST `•,/ Iy.g-�l ���_-a_1 J.f
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF -
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE AB OV UTILITY CO.NOTIFIED -Z
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE .�
OF PERMITTEE' FINAL
ROBERTA.WOOD-
®F VALIDATION SUPERVISING MECHANICAL ENG'R "
CK. Y.O. CASH '
2 3 3--5" FES 10 5 A -10.0.0