HomeMy Public PortalAbout6158 LOMA AVE_Plumbing__ 76A667 - APPLICATION. FOR PL� � � NO -�� I�' 1. :. .
CE 817 8-56'
BUILDING AND SAFETY DIVISIN
Department of County,Enginee,r
os Angeles Buli
. . - DING
JOHN A CLAMBIEounty ofLgCOUNTYENGFNEER ADDRESS
'CASSATT D:GRIFFIN,SUPT OF BUILD NNc
LOCALITY .FOR APPLICANT. TO;-FILL IN : NEAREST
CROSS ST.
OWNER ''DISTRICT.NO. I GRROUPZONE READY FOR INSPECTIONMAIL .
ADDRESS I ��� "
INDUSTRIAL +'
-CITY TEL. NO. WASTE.APPROVAI_ - -
I=I AMBERAe Ca 0' INSPECTION.RECORD
ADDRESS
CITY ` TEL. NO. 243.
LICENSE'NO. A ....7/- -7
NUMBER' .TYPE OF FIXTURE OR ITEM FEE 3 �-+• ),'7 NCT .y` y
WATER CLOSET (TOILET) @ .$1.00. $ _ -
BATH TUB'.. .. @ $1.00
SHOWER @ $1.00
,LAVATORY (.WASH BASIN) -@ $1-.00 - •� / - - /�J/
KITCHEN SINK @. $1:00 - i�Y.�'•.-_nA/ L1`pV'E —�19)5A
DISHWASHER @ $5.00 • ��}'T S .mi -nsife -
LAUNDRY TUB OR TRAY-, @ $1:00 _ b • � e - -
CLOTHES WASHER @. $1.00
WATER HEATER @ $,1.00
GAS SYSTEM @ $1.00
10,
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK -
PERMIT $ - 1 00 ROUGHPLUMBING
.GAS PIPING
TOTAL FEE r0►L GAS VENT
'I HEREBY,ACKNOWLEDGETHAT I HAVE READ THIS APPLICATION -
,AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY -ORDINANCES-.AND STATE LAWS REGULATING. LUMBINGFIXTURES '
PLUMBINGp
'.
I HEREBY CERTIFY THAT .t AM PROPERLY REGISTERED AND/OR- _GAS TEST
- LICENSED AS REQUIRED BY, LOS ANGELES COUNTYANDSTATE OF -
CALIFORNIA,OR TH I AM THE LEGAL OWNER OF - E ABOVE 'UTILITY CO.NOTIFIED '
DESCRIBED RESIDE I L PROPE TY, • - - ga
SIGNATURE- - 2t,!-1
OF PERMITTEE FINAL '
ROBERTA.WOOD,.
JOHN A. LAM h COUNTY ENGINEER ALIDATION SUPERVISING MECHANICAL ENG'R
.
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