HomeMy Public PortalAbout5623 PAL MAL AVE_Plumbing__ 76A667-0F.P 19-P 57
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION FNEAREST
7
JOHN A. LAMBIE. COUNTY ENGINEER eef
CASSATT D. GRIFFIN. SUPT OF BUILDING Y
FOR APPLICANT TO FILL IN T.
NUMBER FIXTURE OR ITEM
E udWATER CLOSETBATH TUB Nd
SHOWER CITY (::- TEL.NO. a p�f
LAVATORY CONTRACTOR $p
SINE ADDRESS �J -4--
DISHWASHER CITY TEL.NO.
LAUNDRY TUB CONTRACTOR'S STATE LJ
REGISTRATION NO. COUNTY
CLOTHES WASHER
DISTRICT NO. GROUP ZONE READY FOR INSPECTION
WATER HEATER
-5- S //S�
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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APPROVALS
$1.00 PER ITEM DATE INSPECTOR'S SIGNATURE
OR FIXTURE B / UNDER SLAB WORK
PERMIT f 1 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING.
1 HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR GAS TEST /7
LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO. NOTIFIEDJ 2 IL
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE
OF PERMITTEE 6 FINAL L7
VALIDATION ROBERT A. WOOD.
,/� SUPERVISING MECHANICAL ENG'R
f'^CK M. O. CAS.
! AP-1263 �9 FEB14 3 A 2.00 M
90p867 APPLICATION FOR PLUMBING PERMIT 1
oes-IT(DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County Of LOB Angeles BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
CASSATT D. GRIFFIN. SUPT OF BUILOINc
LOCALITY
71"F
PLICANT TO FILL IN NEAREST
CROSS ST.
��)) nn DISTCRICT NO. GROUP ZONE READY FOR IxxvEcr loxMAIL
AIL (/'eco ,✓ /
USTRIAL
TEL. NO� / `� Wq TE APPROVAL
-r�tl—yl��'✓ INSPECTION RECORD ?
ADDRESS
CITY TEL. NO.
LICENSE
NUMBER TYPE OF FIXTURE OR ITEM FEE
` WATER CLOSET (TOILET) @ $7.00 S -
/ BATH TUB @ $7.00 ...
SHOWER @ $1,00
LAVATORY (WASH BASIN) @ $7.00
KITCHEN SINK @ $1.00
DISHWASHER @ S1.00
LAUNDRY TUB OR TRAY @ $7.00
CLOTHES WASHER @ $t.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
GAS PIPING S
TOTAL FEE o GAS VENT �(
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER J
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES 7�
PLUMBING.
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 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED S
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE r
OF PERMITTE FINAL
JOHN A. LAMBIE, COUNTY ENGINEER -VALIDATION ROBERT A.WOOD. CHIEF PLBG. INSPECTOR
-VALIDATION
e. GSH
LACO5 3 5 3 FEB 2 J 3 8.0 0 n