HomeMy Public PortalAbout4811 RIO HONDO AVE_Plumbing__ 3 76A887
APPLICATION FOR PLUMBING PERMIT - �• .
DBS-17 f0-SS• '..
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of LOS Angeles BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS1�10 ® o
CASSATT D.GRIFFINS SUPT OF BUILDING
LOCALITY • (/�
FOR APPLICANT TO FILL IN NEARESTr.® V1r M Z.U
OWNER R 1�L DISTRICT NO. GROUP Z EREADY FOR INSPECTION
MAIL I I I
ADDRESS
INDUSTRIAL
CITY TEL.IVO. WASTE APPROVAL
PLUMBER C�✓r �y INSPECTION RECORD
ADDRESS � a s"t-�rb SNER-Y LGA. T--O$�
.
CITY a 9 f' ?TEL.NO . % �\1-P '^ I->I>nc z 11q-'`M &
LICENSE NO. .[� 2--s"3
NUMBER TYPE OF FIXTURE OR ITEM FEEcz
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
1 WATER HEATER @ $1.00
GAS SYSTEM @ 11.00
APPROVALS
DATE INS CTO S SIGNATURE
UNDER SLAB WORK
PERMIT 8 ]AND/OR
ROUGH PLUMBING I.
GAS PIPING
TOTAL FEEGAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS HOT WATER HEATER A
AND STATE THAT THE ABOVE IS CORRECT AND AGREE
WITH ALL COUNTY ORDINANCES AND STATE LAWSG r PLUMBING FIXTURES L LYt"`Z• jrv9f��,Pela
PLUMBING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTER GAS TEST � 'bLICENSED AS REQUIRED BY LOS ANGELES COUNTY AFCALIFORNIA OR. THAT I AM THE LEGAL OWNE$ OFE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIA OPERTY.
SIGNATURE
OF PERMITTEE FINAL
JOHN A.LAMBIE,C TY ENGINEER VALIDATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR
CK. M.D. CASH