HomeMy Public PortalAbout9824 LA ROSA DR_Plumbing__ �7EA667-CE81712/59 TEMPLE COTT
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER /) ^
BUILDING AND FET Y RN`G SEON [BUILDINGRESS 0 /L L�5HWILLIAM A. JENSEN. SUPT OP BUILDING
ALITY
FOR APPLICANT TO FILL IN NEAREST I/ .
CROSS ST. YY
NUMBER FIXTURE OR ITEM OWNER 1 0
WATER CLOSET
ADDRESSDh
IL
BATH TUB
SHOWER - CITY / ��yf-LJ— TEL. NO.C� �r761
LAVATORY CONTRACTOR �• 1'
SINK ADDRESS
DISHWASHER CITY TEL. NO.
CONTRACTOR'S !� p �7 STATE
LAUNDRY TUB REGISTRATION NO. ( / / COUNTY ❑
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CLOTHES WASHER D 15TRICTCN�iO. GROUP ZO C� P E BY
WATER HEATER L5', O U / C
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD y
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ER ITEM
OP
R F IXTURE $ / U
APPROVALS GATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK ,./ y
TOTAL FEE 7 .) ROUGH PLUMBING O' Imo[! �l Ate.__ ,
•J 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
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGA OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PR ERTY. UTILITY CO.NOTIFIED
SIGNATURE 12
OF PERMITTE -c'
FINAL
®. �V0. ON ROBERT A. WOOD,
M.
m.0. tnsR SUPERVISING MECHANICAL ENG'R
L 7 'w 6 0 SEP 'j 0 5 D 3 .0 0 G.
76A667-CE8V 359 -
APPLICATIOFOR PLBINq�G PERMIT
COUNTY OF LOS ANGELES OF-Irl f y
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, County Evginset ADDRESS
CASSATT D. GRIFFIN, Supt of Building /
_ LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER �-
_ WATER CLOSET SIL
BATH TUB ADDRESS
' CITY TEL. NO.
_ SHOWER
LAVATORY CONTRACTOR
SINK ADDRESS 2
DISHWASHER CITY KiTEL. NO. r �✓
CON IMAUTUE'5 STATE
LAUNDRY TUB REGISTRATION NO. ( COUNTY ❑
I CLOTHES WASHER DISTRICT No. GROUPON P E S BY
WATER HEATER ,'� �- !J 'Ta
1 GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
_ �lr
® $1.00 PER ITEM /,
/Q OR FIXTURE S 1 p APPROVALS DATE� INS,P,,ECTOR'S SIGNATURE
! PERMIT $ 2 00 UNDER SLAB WORK SII/l[l!d'�/LT
..�ol ie ll fd� ,
TOTALFEE ` .� QV ROUGH PLUMBING
v GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
ANO 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 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 I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEM
FINAL IP
Or ALIDATION ROBERT A. WOOD.
cK. M.o, cnsx SUPERVISING MECHANICAL ENG'R
rCo.2879S SUN' ? ] 5 D 12.00 a
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