HomeMy Public PortalAbout10786 LYNROSE ST_Plumbing__ 78A867-CE817-11-57 .
APPLICA` .ION FOR PLUMBING .PER 1
COUNTY OF LOS ANGELES Job lam
DEPARTMENT OF COUNTY ENGINEER :F::
BUILDING AND SAFETY DIVISION d BU 10 : L y n r o s e
TrORN A.LAM M County er
CASSATT D. GZMM.Sup t of Buil lmg yo ,may Tem 1 e C i t
y 44
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
2 WATER CLOSET OWNER L a r k W o o d o s u. °
1 RATH MB ADDRESS10229 Lower Azusa Rd.
SHOWER CITY El MO n e TEL NO.
2 LAVATORY CONTRACTOR R i c h a r d Ca v a a a u h P l b 0
1 snvs ADDRESS 1 �3 So Central
DISHWASHER CITY Chino TEL NO.
LAUNDRY TUB CONTRACTOR'S STATE Q.
REGISTRATION NO. 1 164 C 6 COUNTY O
1 ....:....:......
CLOTHES WASHER _ DISTRI O: GROUP NE ORINSPBCTION
1 WATER HEATER
] GAS SYSTEM
WASTE:APPROVAL
INMECTION RECORD
rC9
ra c�t141M.
_
APPROVALS
0 $1.00 PER ITEM DATE INSP.ECTOR:S Sjd ATURE
-9- /6 OR FDITIIRE $ I /� 00
UNDER'Sh4MWORK A j
PERMIT $ F 00 ROUGH PLUMBING
'TOTAL FEEL: GAS PIPING
1 00 G
.' v
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT'
AND STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY HOT WATER HEATER Iff'p
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AN PROPERLY. REGISTERED.AND/OR GAS TEST -
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
r CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE. :` UTI LITYCO.NOTIFIED
DESCRIBED RESIDENTI PROPERTY.
SIGNATURE
OFPERMITTEIf
ROBERTA.WOOD.
®p VALIDATION SUPERVISING MECHANICAL ENG-R
•CK
M.0. CABH
L,hf'-5074V� APR 14 5 A 12.0 0 �'