HomeMy Public PortalAbout10206 RANDWICK DR_Plumbing__ 7GA887A('C6•81781 -4177
APPLICATION FOR PLU M B IN.G-PE RM.IT
BUILDING AND SAFETY.DIVISION
FOR APPLICANT TO FILL IN(PRINT OR TYPE) BUILDING•
NUMBER FIXTURE OR ITEM FEE ADDRESS,
WATER CLOSET 3 LOCALITY T. `' `
BATH TUB NEAREST .�
CROSSST.
SHOWER OWNER.
i
LAVATORYMAIL
ADDRESS
SINK CITY TEL.NO.,
DISHWASHER CONTRACTOR
CLOTHES WASHER
ADDRESS
SWIMMING.POOL RECEPTOR
CITY TEL.NO.
LAWN SPRINKLER SYSTEM
STATE LIC.
WATER HEATER LICENSE NO. CLASS
/ GAS SYSTEM OUTLETS DISTRICT NO. G UP Z E PESS 3 .Y�
OUTLETS OVER O
5 PER SYSTEM INDUSTRIALore e V
v �rWASTE APPROVAL C
INSPECTION RECORD:
1. W
N
Z
Plan check fee
PLUMBING PERMIT ISSUING FEE•$
TOTAL FEE
Plan check applicant 'sv
APPROVALS DATE INSPECTOR'S SIGNATURE'
Name
- UNDER SLAB WORK
Address ROUGH PLUMBING /
City Tel.No. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION.AND STATE GAS VENT
TRATTHE ABOVE IS CORRECT AND-AGREE TU COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING PLUMBING. HOT WATER HEATER _
I HEREBY CERTIFY THAT IAM PROPERLY REGISTERED AND/OR LICENSED AS PLUMBING FIXTURES
REQUIRED BY LOS ANGELES COUNTY.AND STATE OF CALIFORNIA OR THAT I AM THE .GAS TEST
LEGAL OWNER OF.AND INTEND TO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL
PROPERTY. UTILITY CO.NOTIFIED.
SIGNATURE ��-
OFPERMITTEE FINAL
PLAN CHECK VALIDATION CK. MA. CASH PERMIT VALIDATION CK.
7 8.5 r DR: 2:8 5 1 9.5 Q A68
76AG67•CE#817 5.61•
APPLICATION FOR PLUMBING PERMIT,
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY .DIVISION. BUILDING /
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS O aZ
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY 7 e-
FOR APPLICANT TO FML IM NEARCROSS ST.
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET `
BATH TDB
/ �S
CITY
TEL NO.
SHOWED
CONTRACTOR Va118Y P1Umbing Co.
'L LAVATORY
SINS ADDRESS 2 W. Fleetwo'od-P1.
DRiHWASFB:S crrYGlendora, TEL.NO.. Ed 5-1293
LAUNDRY TUB REG�a°RT ION me-SONS' . COUNTY
CLOTHES WASHES DISTRICTNO. GROUP ZONE P SED BY
1NDUSTRM
WATER HEATER z Is.
GAS SYSTEM WASTE APPROVAL V
INSPECTION RECORD s
to
Z
APPROVALS DATE INSPECTOR'S SIGHATURIL
PERMIT N 2100 UNDER.SLAB WORK
ROUGH.-PLUMBING s•.
TOTAL FEE
��
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS PIPING
nJJ
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY GAS VENT ttpp �'+.Y
WITH ALL Y:OUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER 11110'9 _ .+n�rE';JY/�
PLUMBING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES .--11 rJ C/.�-"•- �O
LICENSED AS REQUIRED BY LOS,ANGELES COUNTY AND STATE OF GAS TEST A. F.i+':
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER. OF THE ABOVE
ff
DESCRIBED RESIDENTIAL.PROPERTY. ' UTILITY CO.NOTIFIED.
SIGNATURE >y P <+ �B n
OF PERMITTE22tFINAL WIN �=
-VALIDATION' ROBERT A"WOOD
EK.
M.0. CASH SUPERVISING MECHANICAL ENG'R
L&O 7 0 2.6 Q; DEC 4 5 D 1 5.30-