HomeMy Public PortalAbout5430 ROBINHOOD AVE_Plumbing__ 76A,G.yc f lrx-ai7111) -9/75
` - APPLICATION FOR PLUMBING PERMIT
HUILDfNG AND SAFETY DIVISION
FOR APPLICANT TO FLLL IN (PRINT OR TYPE) BUILDING
NUMBER FIXTURE OR ITEM FEE ADDRESS
L WATER CLOSET LOCALITY PIG
NEAREST
BATH TUB I CROSS ST. lbLA\j�
SHOWER 3 OWNER <�,,L, �j��(!Zj-
LAVATORY ADDRESS 3O
SINK CITY TEL. NO.
DISHWASHER CONTRACTOR G ,
CLOTHES WASHER
ADDRESS ��� w,
SWIMMING POOL RECEPTOR � f`Cts 77�"'l Iq
CITY TEL NO.
LAWN SPRINKLER SYSTEM r pp
WATER HEATER STATELICENSE NO. '34) C CLASS
GAS SYSTEM OUTLETS DISTRICT Na GROUPONE CESSED BYOUTLETS OVER
- '
6 PER SYSTEM WADS? APPROVAL
aL
INSPECTION RECORD
Plan check fee
PLUMBING PERMIT ISSUING FEE 8
TOTAL FEE
Plan check applicAnt
Name APPROVALS DATE IH8P[CTOn'e 8I9HATURE
UNDER $LAB WORK
Address ROUGH PLUMBING
City Tel. NO. GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AMD STATE THAT THEABOVE IS CORRECT AND A:AREE TO CONI-PLY
WITH ALL COUNTY ORDINANCES AND STATE LWS. REGULATING HOT WATER HEATER
FL UMBIKG.
I HEREBY CERTIFY THAT I AM PROPERLY RYGISTERED AMD/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOd AMSELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RE.I OE IN THE ABOVE DESCRIB[Q RES PROPERTY.
51
UTILITY CO. NOTIFIED
9I GNATU RE [F�JY,Oa..�Q`�•'!-
OF PERMITTEE FINAL
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M,O. CASH
3. 4 5�:J" 26 ' 9 1 6-5 0 A-% .
t -
rM°°'� APPLICATI I�uMBINC PERMIT 1
DIVISION OF BUILDING AND SAFETY
n.pob-- t of Cctu t F-0—
Count! of Los BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
CAEILATT D,GRIFFIN,JBVP'T dF BUILDINO
LOCALITY
FOR APMCANT TO AM IN N FAR r
OWNER G DISTRICT NO. GROUP ZO 6 ■[ADT FOR mr¢CTIOM
MAI
ADD ESi
INDUSTRIAL
CITY T NQ, WAYTE APPROVAL
PLUMBER Valley .Plumbing Co. igp�ON RECORD
ADDRESS 442 W.
Fleetwood P1.
en ora Ed b-129'
TEL NO.
LICKK"NO.
T/UYm<N TYrI qF rD(TURi 9R rrKK rim
WATER SBY (TOILET 91,00
BATH TU19 i.00
SHOWER 91.00
7` LAVATORY(WASH BASIN) I.00
KiTCH[N SINK 51.00
D12HWASHBR fi.co
LAUNDRY TvB OR TRAY 91.00
CLOTHES WASHER 4 11.0-0
WATER HEATER Q 41-CIO
GAb SFY13FEAM 01.00
AMOVA 8
DATE IABP CTOR'S SIGNATURE
UNDRNSLAD WORK
PERMIT ocr
UGH PLUMBING
OAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT'I WAVE MEAD THIS APPLICATION
AND STATE THAT YHE ABOVE 15 CORRECT AN-D AGREE TO COYpLY HOT W TER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1.14I HEREBT CERTIFT THAT ( AY PROPERLY REGISTERED AWD/OR G TEST
N¢Ep AS REQUIRED BY 09 AN-CELI;S COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE. LEGAL OWNER OF THE ABOYK UT TY CO.NOTIFIED
DESCRIBED RESIDEANTIA P P TY,
E I G NATUR N
OF PXRINITI FINAL
JOHNA.IJAMBIF, COUNTY ENGINEER ALIDAITON ROBERT A.WOOD, CHI[F PI-13G. FN!<PECTOR
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