HomeMy Public PortalAbout5000 ROSEMEAD BLVD_Plumbing__ 76A667 - CE817'5/70
'APPLICATION FOR F'LIJN[BIN PERMIT
COUNTY OF LOS_ANGELES
U_ .
DEPARTMENT OF COUNTY. ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A:LAMBIE, COUNTY ENGINEERADDRESS
COLEMAN W:JENKINS. SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
•CROSS ST.
NUMBER - FIXTURE OR ITEM EACH. FEE
'OWNER ("
WATER CLOSETS MAIL.
BATH TUB Jap, ADDRESS
SHOWER CITYTEL. NO.
LAVATORY L5& CONTRACTOR
. SINK - ♦/ I-rS'91 ADDRESS
DISHWASHER - •3-7Q'' •CITY '� ..TE
i
CLOTHESWASHER . STATE _ - LIC
LICENSE NO. - CLASS _
SWIMMINGPOOLRECEPTOR - DISTRICT N GROUP ZONE PR_O S BY
LAWN SPRINKLER SYSTEM '
WATER HEATER }-gQ INDUSTRIAL
WASTE APPROVAL O
' GAS SYSTEM OUTLETS - INSPEC N RECOAD �•
OUTLETS OVER J
5 P SYSTEM .30. � C
uja-
z z
Plan check fee 25% of above. See,reverser
PLUMBING;PERMIT'ISSUING FEE $ :. 00
TOTAL FEE
--APPROVALS - DATE .INSPECTOR;S SIGNATURE '
Plan check applicant UNDER SLAB WORK, a
''Name, 'ROUGH PLUMBING
Address GAS PIPING
_ GAS VENT -
City. Tel. No. ... HOT`WATER HEATER
.. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS"CORRECT AND AGREE„TO COMPLY" PLUMBING FIXTURES, _.
WITH ALL' COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING. - - ✓1•,
I' HEREBY CERTIFY THAT I AM PROPERLY'REGISTERED' AND/OR UTILITY CO. NOTIFIED ,
•.LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF -
.CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO I-S
RESIDE-IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY..' -FINAL - / J '
L.GNATURE� �` JACK R. ALLEN✓, SU PERVISI N.G' HAN,ICAL ENG'R.,
OF PERMITTEE
PERMIT VALIDATION cK. M.O. CASH
PLAN CHECK VALIDA'T'ION CK.. M,.o. CASH
s• uG �' o 65 ON