HomeMy Public PortalAbout10122 NADINE ST_Plumbing__ DBIS17 to as APPLICATION FOR PLUMBING PERMIT 1
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DIVISION OF BUILDING AND SAFETY
Dep rA But of County Engineer
County of Los Angeles BUILDING JOHN A LAMBIE. COUNTY ENGINEER ADDRESS
CASSATT D GRIFFIN.SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO M IN NEAREST
,'l CROSS ST
OWNER /L, . A/V� DISTRICT NO GROUP ZONEREADY FOR INSPECTION
AMAIL
DDRESS I
INDUSTRIAL
CI TEL NO T WASTE APPROVAL
PLUMBER Uyi INSPECTION RECORD
ADDRESS / (0� gy7 pp '
CITY r TEL NO CO� O'Iia-
LICENSE NO /
NUMBER TYPE OF FIXTURE OR ITEM FEE pp
OZ/ WATER CLOSET (TOILET) @ $100 V
BATH TUB @ $100 0
SHOWER @ $1 00 O
LAVATORY (WASH BASIN) @ $100 O
I KITCHEN SINK @ $100
I DISHWASHER @ $100
LAUNDRY TUB OR TRAY @ $100
I CLOTHES WASHER @ $100
WATER HEATER @ $1 00
GAS SYSTEM @ $1 00 0
/ B'0
APPROVALS
DATE INSPECTOR S SIGNATURE
UND R$LdCCWORK ,a7
PERMIT $ 1 00 ROUGH PLUMBING
/ GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER r
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENi1ALOPER
LVLI� �A�
SIGNATURE
OF PERMITTEE FINAL 01,
JOHN A LAMBIE COUNTY ENGINEER �jAMATION ROBERT A WOOD CHIEF PLBG INSPECTOR
w M 0 CASH
3130^ KC 7 3 12.00 a