HomeMy Public PortalAbout4824 PERSIMMON AVE_Plumbing__ 78A667-CE817 12/59 TEMPLE CHTY
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTYDENGINEER
BJ IN. [.AAMBIE Co�NTYY ENG NE�EN ADDRESSING �ISZ7 ./V. rG�MInlrnon Aft,
WILLIAM A.JENSEN,SUPT OF BUILDING 1
LOCALITY �s vi� CiT C a , .
FOR APPLICANT TO-FILL 3N NEAREST r.. . O r2 V` 205 f•
NUMBER FIXTURE OR ITEM - OWNER '
WATER CLOSET .
SATS TUB
nnnREss it s zl N. -&rsimmapi Aye
SHOWER CITY C TEL.NO. G T .8..AZc
LAVATORY CONTRACTOR J ow he.v
SINK ADDRESS
DISHWASHER CITY TEL NO.
:,CONTRACTOR'S STATE• ❑
LAUNDRY.TUB REGISTRATION NJ. COUNTY ❑
CLOTHES WASHER. DIST ICT NO. GROUP ZONE PR=ESSED BY
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
/ INSPECTION RECORD
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APPROVALS DATE INSPECTOR•'SpSiG 7UR.E`
PERMIT $ 2 OO UNDER SLAB WORK
TOTAL FEE {
ROUGH PLUMBING � 1 1 �
GAS'PIPING ! "00"
ANDHEREBY STATE THAT HE ABOVEDGE HAT I HAVE READ THIS IS ICATION
CORRE T AND AGREE TOL COMPLY' GAS VENT ��1J?. ✓`l' .y�.G �'��
WITH ALL COUNTY ORDINANCES AND STATE LAWS. REGULATING
PLUMBING. H07 WATER HEATER f
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES /
LICENSED AS REQUIRED BY L09 ANGELES COUNTY AND STATE OF GAS TEST 1
CALIFORNIA OR THAT I AM THE LEGAL WHIR OF'THE ABOVE
DESCRIBED'RESIDENTIAL PROPERTY.
UTILJTYCQNOTIFjg
SIGNATURE
OF FERMITTE19
FINAL
®e VALIDATI ROBERT A.WOOD,
cs. M.o. cesR SUPERVISING MECHANICAL ENG-R,
-� M.7 4 7 3 JAN 2 6 5 D 4.0 0`
SAB CE817-846
J-ob 594-
. _ •- . ,�. -. -
APPLICAT•IOI\IFOR 'PLUMB,ING:'PERMIT :•} 1 '
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER F
BUILDING.AND SAFETY DIVISION' suizDnpc .' ;
o>nv A. LAMRIE, co,>se�.g��a� ADDRESS :4824.Persimmon .
:cssATr a.GRIeI�Rv,slsa.t of Building LOONY' Temple..Cl '
FOR APPLICANT.TO Fill.IN. NEABSST'
CROSS.ST.
NUMBER. FIXTURE OR ITEM _
WATER CLOSET ' OWNER'—: m'..w ells
], SATS TUB -ADDDDRP�S
SHOWER �; CITY TEL NO.
1 LAVATORY CONTRACTOR' "
snvs ADDRESS-. 7 a lv
DISHWASHER ..C1TY El Monte Tm NO. GT 89836
TUB CONTRACTOR'S STATE •(].
LAUNDRYHEGISTRATlON NO. COUNTY
CLOTHES WASHER DiSTR�T N0. ' GROUP ZONE P OCESSED BY
WATER HEATER
GAS SYSTEMIIRDUSTRIAL' '
,VVASTE'APP80VAL _
INSPECTION RECORD .
• ,c; Cl7•'7'�,��•.S.`.i.':J.9!✓!r•#�1t'.�.ls'
- �'r�'�� 4 ."vim- -0v1��.vI' �:Y,:.•�..a e:1- .���... o ••�- ,
APPROVALS
@ $1.ODYER ITEM..
OR F3+ RE $ �0
DATE, INSP. TOR'S,SIGHATU.RE
3 . 3° UNDER SLAB WORK' •�-2
I PERMIT $ 2 00 ROUGH PLUMBING
TOTAL FEE- GAR PIPING:
i HEREBY ACKNOWLEDGE'THAT I HAVE,READ THIS APPLICATION GAS VENT. ' y �..
AND STATE THAT THE ABOVE'IS CORRECT AND AGREE TO COMPLY HOT WATER.HEATER
WITH ALL COUNTY•ORDINANCES AND STATE 'LAWS REGULATING
PLUMBING: PLUMBING FIXTURES '. . J"
I HEREBY At
THAT I AM PROPERLY REGISTERED AND/OR
LICENSED•AS REQUIRED BY.LOS.ANGELES COUNTY AND STATE:OF' GAS'TEST
CALIFORNIA OR THAT I .AM THE LEGAL OW ER OF THE-ABOVE UTILITY CO.NOTIFIED
DESCRIBED' RESIDENTIAL ROPERTY...
SIGNATURE FINAL ' r�I.A/47lI ,r�" ry f�
OF PERM 17TE y
�ROBERT'A.Wdod.
�r ALIDATION. SUPERVISING IVIECIIANICAL ENG'R
CASH
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