HomeMy Public PortalAbout10507 LYNROSE ST_Plumbing__ 76A667 - CE X817 5-61
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIMION BUILDING
I JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS 105 `' .IIyn- -3P
WILLIAM A. JENSEN, SUPT OF BUILDING �,
LOCALITY ".., l F �_t y
FOR APPLICANT TO FILL IN
CROSS T. pal
NUMBER FIXTURE OR ITEM OWNER FF:keY' Land DF?ij•
7 WATER CLOSET MAIL
ADDRESS
BATH TUB
CITY TEL.NO.
SHOWER
LAVATORY CONTRACTOR Cnre
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SINS ADDRESS
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DISHWASHER CITY 'j. _O'TtE TEL NO.
CONTRACTOR'S , 7 1 STATE Q_
LAUNDRY TUB REGISTRATION NO. j i COUNTY
CLOTHES WASHER DISTRICT NO. GRO P ZONE PROPESSED BY
WATER HEATER Al tl,�-� CL
GAS SYSTEM INDUSTRIAL 0
WASTE APPROVAL
INSPECTION RECORD ix
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$1.00 PER ITEM �J
OR FIXTURE $ 7
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE ^ '; ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I 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 HOT WATER HEATER -
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
L'CENSEDAS REQUIRED 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
�/ ^ �,I�/r,L.
OF PERMITTE
SIGNATURE -
FINAL
j VALIDATION ROBERT A. WOOD
l\ CK./ M.0. CASH SUPERVISING MECHANICAL ENG'R