HomeMy Public PortalAbout5835 PRIMROSE AVE_Plumbing__ 76A687-CE817-8-58 T � ��•�s����� ���� �V
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING p.
IOHN A. LAMBIE, County Engineer ADDRESS -4) O /� f /An 0 s
CASSATT D. GRIFFIN,Supt of Building 1.
LOlCLITY
FOR APPLICANT TO FILL IN fCROSSNEEARREST
NUMBER FIXTURE OR ITEM �y
OWNER /
WATER CLOSET MAIL
® BATH TUB ADDRESS
® SHOWER CITY TEL.NO.
p2 LAVATORY C&THACTOR Tjt/a Qr v/v h,,A/Q
SINK ADDRESS q e -n Ot T;i,/v�0^�// A—
DISHWASHER CITY /�? OlY""O vTEL.
QNO. .IG-� lS p�I D-7
p r) STATE
LAUNDRY TUB REGISTRATION NO. oC 7 COUNTY
CLOTHES WASHER DISTRICTGROUP ZO E RSSED,�Y
T WATER HEATER �•- ,IF r , :�• s'C
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
i
APPROVALS
l@ $1.00 PER TPIAK
1
OR
pgE Q t) t. DATE INSPECTOR'S SIGNATURE
UNDER BLAH WORK
PERMIT $ 2 00 ROUGH PLUMBING -Z Q
TOTAL FEE / 3 � GAS PIPING --
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR `? GAS TEST / - � y
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE L&GAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED 9 ��
DESCRIBED RESIDENTIAL P RTYr7
SIGNATUREc.,
OF PERMITTE n / FINAL
ROBERTA.WOOD.
®p VALIDATION SUPERVISING MECHANICAL ENG'R
CK. M.0. CASH
76A667-CE817 12159 T MINF-1LE CRTY
APPLICATION FOR PLUMBING PIE.RMI_T,
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
B�]ILDINCG�iND�SAFETY 2IVISION BUILDING
OHN A. MBI COUNTY NGINEER ADDRESS
WILLIAM A.JENSEN.SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FlU IN NEAREST
ST.
NUMBER FIXTURE OR ITEM CROSS CROSS t
OWNE
WATER CLOSET
MAIL
BATE TUB ADDRESS-
CITY
DDRESS CITY 45k-7iL NO.
SHOWER
LAVATORY CONTRACTOR
sm ADDRESS ,P
DISHWASHER.
* TEL NO�' 6 x
CONTRACTOR'S J! STATS
LAUNDRY.TUB REGISTRATION NO. - ` COUNTY ❑
CLOTHES WASHER DISTRICT NO. GROUP ZONE PIRCMESSED BY
WATER HEATER '
GAS'SYSTEM IND M
WASTE APPROVAL
INSPECTION RECORD
to
v
o
w
rn
1 PER ITEN
OR FIXTTURE $ I e
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING '
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS A LICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
i HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY IAS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER F E ABOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTE FINAL
wAl ffTON ROBERT A.WOOD,
pl .pi CASH SUPERVISING MECHANICAL ENG'R
1 J �� w OCT '7
Lr:�o �.7 5 D 3.�)