HomeMy Public PortalAbout9860 LEMON AVE_Plumbing__ 7BAS67-CM173 59
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, County Engineer ADDRESS B
CASSATT D. GRIFFIN, Supt of Building LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER s/� _ �s
WATER CLOSET MAIL
BATH TUB ADDRESS1441
SHOWER CITY /V �� �' i/sus NO. .S
C
LAVATORY ONTRACTOR valley Plumbing
SINS ADDRESS 442 W. Fleetwood
DISHWASHER ;_ t` CITY Glendora qr�TEL NO. - _
LAUNDRY TUB y' STATE-
REGISTRATION ON NOa6O841 COUNTY
CLOTHES WASHER DISTRICT NO. GROUP ZONE P CESSEC BY�
WATER HEATER lip
GAS SYSTEM INDUSTRIAL
_- WASTE APPROVAL
it A - INSPECTION RECORD
t- -
i
G J7- /9-/l Or
$1.00 PER ITEM / l- 1v6r, '0 ut
OR FIXTURE $ I APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $- 21
00UNDER SLAB WORK �IO1J (/ a
TOTAL FEE ROUGH PLUMBING-.74 'I4A
G'AS PIPING
1HEREBY ACKNOWLEDGE THAT I HAVE READ-THIS APPLIGAS VENTAND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CWITH ALL COUNTY ORDINANCES AND STATE LAWS REGUHOT WATER HEATERPLUMBING.I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED APLUMBING FIXTURES .^ %QLICENSED AS REQUIRED BY LOS ANGELES COUNTY'AND STAGAS TEST '/CALIFORNIA OR THAT [ AM THE LEGAL OWNER OF THE DES SiSCRIBED RESIDENTIAL ROPER Y. UTILITY CO NOTIFIEDIGNATURE
OF PERMITTE ��L[/ LLFINALOF TION ROBERT A. WOOD,
CK. M.o. CASH SUPERVISING MECHANICAL ENG'R
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF•LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING, �/ O ) (–_LGA�BVI I
`�y�
NUMBER FIXTURE OR ITEM - @ FEE ADDRESS b
2 p
WATER CLOSET LOCALITY -
BATH TUB
CROSS ST
SHOWER OWNER
LAVATORY MAIL
,ADDRESS60 F LGAM '
SINK CITY TEL NO 0
DISHWASHER C)p CONTRACTOR apj)C6 �I G (I)STA ZS
CLOTHES WASHER ADDRESS I/1 eo C__ GRAM
SWIMMING POOL RECEPTOR C
CITY ,� TEL NO _
LAWN SPRINKLER SYSTEM STATE ((�� p 1 LIC
WATER HEATER '
LICENSE NO L\ p b CLASS
GAS SYSTEM OUTLETS APPROVALS DATE INSPECTOR'S SIGNATURE
OUTLETS OVER UNDER SLAB WORK
S PER SYSTEM ROUGH PLUMBING
GAS PIPING
GAS VENT
HOT WATER HEATER
- -_
PLUMBING FIXTURES—
GAS TEST , u'
us
Plan check fee UTILITY CO NOTIFIED us
PLUMBING PERMIT ISSUING FEE$ V o
TOTAL FEE FINAL KIM—
Plan check applicant ;q*.EC'K ALIDATN
,I
Name
Address
City Tel No :
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE �•4 A
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES #a1 0•0 0 0 O JC
AND STATE LAWS REGULATING PLUMBING PERMIT VALIDATION ,•
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS - 1 0 0 '1 0 O O
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT AM THE 1 l/, '
LEGAL OWNER OF,AND INTEND TO gLaIPE IN THE ABOVE DESCRIBED RESIDENTIAL '
GNATURE 0 x 2 3-79
OFP
DISTRICT NO PRO D BY
INDUSTRIAL
WASTE APPROVAL
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