HomeMy Public PortalAbout4906 PERSIMMON AVE_Plumbing__ 3ip�
3s ",D.SB APPLICATION FOR PLUIOii.BI-IVGPERMIT
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iMIVISION OF BUILDING AND SAFETY y
Department of County Engineer _
County of Los Angeles BUILDING r �+
JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS �'� �V
CASSATT D..GRIFFINa SUPT.OF BUILDING
_
FOR APPLICANT TO FILL IN NEAREST
c CROSS ST.
OWNER V MAIL /� y /`Irr► DISTRICT GROUP ZONEIii[ADYBEADY FOR INSPECTION
ADDRESS �+/C , I r
r 1 INDUSTRIAL `
TEL.N ! !� '7 l WASTE APPROVAL
PLUMBER B �` C/,�� - INSPECTION RECORD
ADDRESS v/ �rJ/�L�lD�L.. l%.� stl. .�iL�l",
CITYSA J Ara r� TEL.NO' tJ ��r��r �Y ,' /J O d 1�►
LICENSE NO.
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NUMBER TYPE OF FIXTURE OR ITEM FEE /„y��IA/.
WATER CLOSET (TOILET) @ $1.00 S
HATH TUB @. $1.00. D b
SHOWER @ $1.00 • / r
LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ $1.00
I d�
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @• $1.00 J 16 .0. f ~'+
CLOTHES WASHER @ $1.00 "•
WATER HEATER $1.00
$1.00 /0 �A/�¢.f-r. + ,
n GAS SYSTEM
AMID
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK /__l
h-
PERMIT $ 1 00 ROUGH PLUMBING 7(/
GAS PIPING •�,
TOTAL FEE
GAS VENT
1 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 pLUMBlNG FIXTURES
PLUMBING. '
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REOUIRED BY LOS ANGELES-COUNTY AND STATE
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVlOEF UTILITY CO.NOTIFIED
DESCRIBED RESIDENTI - PROPEtTY.
SIGNATURE
OF PERMITTED FINAL.
IOHN A.LAMBIE.COUNTY ENGINEER VALIDATI12 ,ROBERT A.WOOD,. CHIEF PLBG. INSPECTOR
.CE. M.O. 0 rw.3 6 OCT-2 2 : 3 8.00