HomeMy Public PortalAbout9822 LA ROSA DR_Plumbing__ 76A667-CE817 12/59 TEMPLE CiT R
APPLICATION FOR PLU BING PERMIT
COUNTY OF LOS ANGELES LZ�
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY RIVISION BUILDING / /1 O /��i
JOHN A. LAMBIE, COUNTY NGINEER ADDRESS _S /�
WILLIAM A. JENSEN, SUF'T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST /,( C
CROSS ST. ( G�
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET
BATH ,TUR ADDRESS //r
CITY / TEL. NO. �^ 1'fd� TSE
SHOWER rn
LAVATORY � CONTRACTOR a ' 1 �—
SINK ADDRESS
DISHWASHER, CITY TEL. NO.
CONTRACTOR'S C) / c�� ^7 STATE
LAUNDRY TUB REGISTRATION NO. / 6 E / COUNTY ❑
CLOTHES WASHER DISTRICTpN�O. GROUP /ZyON O B 5 BY
WATER HEATER s- o o � /1 y I'
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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F
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/ ® $1.00 PER ITEM /
OR FIXTURE S APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2.100 UNDER SLAB WORK
TOTAL FEE —131 ' p ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 14 CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES 41
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST 11. 0
CALIFORNIA OR THAT i AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL R PERTY. n UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTE FINAL
®r /---V)Fi 0. ON ROBERT A. WOOD.
M.
ce. ry M.O. CASH SUPERVISING MECHANICAL ENG'R
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76A667-CE817 z59 l L
APPLICATIZOR PLU GING P MIT
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COUNTY OF LOS ANGELES 4L _-
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING 2 Y
IOHN A. LAMBIE, County En neer ADDRESS
CASSATT D. GRIFFIN, Supt of Building
LOCALITY
.FOR APPLICANT TO FILL IN NEAREST
CROSS ST, /
NUMBER FIXTURE OR ITEM OWNER rte/
WATER CLOSET MAIL
BATH TUB AUDRESSci.
SHOWER /
/ CITY TEL. NO. -
CONTRACTOR
LAVATORY
SINK ADD
DISHWASHER CITY / NO.
CONTRACTORS STATEko
LAUNDRY TUB REGISTRATION NO. COUNTY ❑
CLOTHES WASHER PISTRICTN�OO. GROUP ZO E� PQ0QE5 E BY
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD )/
®/s/ s .
a $1.00 PEA ITEM /D
/Q OR FIXTURE S / APPROVALS DATE INSPECTOR' SIGNATURE
PERMIT $ 1 2100 UNDER sena- o . -o
TOTALFEE I(' ROUGH PLUMBING
GAS PIPING
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. I HOT WATER HEATER A
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES Y {
LICENSED AS REDU I RED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR'THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY., UTILITY CO.NOTIFIED _
SIGNATURE
OF PE RMITTE FINAL �✓ I ✓
OF ALIDATION ROBERT A. WOOD,
M:O. CASH SUPERVISING MECHANICAL ENG'R
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