HomeMy Public PortalAbout5428 PERSIMMON AVE_Plumbing__ IBS-17 APPLICATION FOR P-Ll�J I�'I B I IVCD PEFd�IVI IT J'B5.17 10-59
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles BUILDING g.Q
JOHN A.LAMBIE, COUNTY ENGINEER ADDRESS o v
CASSATT D,GRIFFIN,SUPT of BUILDING t
LOCAL)TY
FOR APPLICJfflT TO FILL IN NEAREST /n
CROSS ST.. e(Y
OWNE DISTRICT NO. GRI ONE I READY FOR INSPECTION
MAIL ' S/
ADDRES
Q INDUSTRIAL
CITY TEL.NO O WASTE APPROVAL
PLUMBS INSPECTION RECORD
ADDRESS
CI TEL.N �V f
a
LICE O aw
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 $' OO
BATH TUB (9 -$1.00
SHOWER @ $1.00
LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ $1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $.1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPECTORS SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 '00 ROUGH PLUMBING
GAS PIPING
TOTAL FEEDD `-
GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING.
1 HEREBY.CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY OS AN LES COUNTY AND STATE OF .
CALIFORNIA OR THAT I THP-LEGAL OWNER OF THE ABOVE TILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL OP ITY.
SIGNATURE �
OF PERMITTEE FINAL
OHN A.LAMBIE,COUNTY ENGINEER VALIDATION ROBERT A.WOOD.CHIEF PLBG. INSPECTOR
CE. Sx
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78A86 ov,2-62 TEMPLE CITY ,
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY,.ENGINEER
BUILDING AND SAFETY DIVISION 7AUDDR ..7 0-
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING FOR APPLICANT TO FILL IN a/ /
NUMBER: FIXTURE OR ITEM EACH FEE �. ]E0
WATER CLOSET $1.25. OWNER
MAIL
BATH TUB 1.25' ADDRESSCITY L. NO.
SHOWER 1.25
LAVATOAY 1.25 CONTRACTORSINS1.25 ADDRESS DISHWASHER 1.25 CITYLAUNDRY TUS 1,� CONTRACTOR'S STATREGISTRATION NO d d COUNT
CLOTHES WASHER- 1.25 _ DISTRICT NO. GROUP ;TE OGE p Y
WATER HEATER 1.50
GAS SYSTEIK r O TS 1.50 INDUSTRIAL
WASTE APPROVAL
OUETS OVER 5 PER• YST M .30 INSPECTION RECORD
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pr `i s _ , r�2 t 1�1 a.�, A PP kb_lf i*0
APPROVALS DATE INSPEC 'S SIGNATURE
PERMIT $ 00 UNDER-SLAB'WORK
ROUGH PLUMBING
TOTAL FEE _ GAS PIPIlK . NG
1 HEREBY ACKNOWLEDGE 'THAT 1 HAVE READ THIS APPLIC ION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER '
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/'OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE 'OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OW R OF,AND END TO.
RESIDE IN,THE ABOVE DESCRIBED REBID L.PROPE UTILITY CO.NOTIFIED, Li
is
:: SIGNATURE ol
OF PERMI�y '
FINAL r�t
VALIDATION' ROBERT A.WOOD
cK. M.o: • CASHSUPERVISING MECHANICAL ENG'R
LAW 7 5 5 3 APR 10 5 D 8.75- -
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