HomeMy Public PortalAbout9117 PRIMROSE AVE_Plumbing__ 'eAee� APPLICATION FOR PLUMBING PERMIT 1
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DMSION OF BUILDING AND SAFETY
DeporI out of County Engineer
County of Los Ange,, BUILD'ING,�� 0.01
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JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFINSUPT of BUILDING
LOCALITY
FOR APPLICANT TO FILL IN I NEAREST
CROSS'ST.
OWNER 2. DISTRICT NO. GROUP
MAIL ZONE. READY FOR INSPECTION
ADDRESS
INDUSTRIAL
CITY /TEL.NO. WASTE APPROVAL
PLUMBER P INSPECTION RECORD
ADDRESS �.+ 0'(/ �t ` o
CITY TEL.NO
LICENSE NO.
1S3``ra c1rtRL-Ace.A C'131...
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NUMBER TYPE OF FIXTURE OR ITEM - FEE
WATER CLOSET (TOILET) @ $1.00 $
BATH TUB @ $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 ,per
GAS SYS'CEM @ $1.00' �/v
APPROVALS
DATE INSPECTORS SIGNATURE
UNDER SLAB WORK q
PERMIT $ 1 00 ROUGH PLUMBING
GAS PIPING Ul u`
TOTAL FEE (f
GAS VENT
I HEREBY ACKNOWLEDGE THAT I 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 e.PLUMBING FIXTURES 1'2 I a4. �.�+ L
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 I THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED l�
DESCRIBED RESID NTI ERTY.
SIGNATURE
OF PERMITTs F(NAL �� I
OH'N A.LAMBIE.COUNTY ENGINEER VALIDATION ROBERT A.WOOD.CHIEF PLBG. INSPECTOR
CK. M.D. CASH
9-8 O 0A AUG 31 3 4.0 0 .�
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