HomeMy Public PortalAbout5136 ROSEMEAD BLVD_Plumbing__ .22
76A667-CE617-11-57
APPLICATION FOR :PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, County Engineer ADDRESS 5136 N.. Rosemead Blvd.
CASSATT D. GRIFFIN, Sup.'t of Building LOCALITY
Rosemead .
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM -
OWNER, Calvin R. Cambell
1 2 WATER CLOSET
_ MAIL -
1 BATHTUB ADDRESS
1' SHOWER CITY TEL. NO.
LAVATORY CONTRACTOR Belvedere PlumbingCO.
l
SINK = ADDRESS 11900 E. 'a rvey Ave.
DISHWASHER CITY El MOrit'ie TEL. NO.,GI. 898 j6
LAUNDRY TUB CONTRACTOR'S 179768 coUrlTYr p
REGISTRATION NO.
1 CLOTHES WASHER s. DISTRICT l GROUP ZONE READY,FOR INSPECTION
] WATER HEATER '/ '
GAS SYSTEM INDUSTRIAL
1 WASTE APPROVAL
INSPECTION RECORD
APPROVALS
@ $1.00 PER ITEM °
DATE INSPECTOR' SIGNATURE
10 OR FIXTURE $ lO.00 UNDER SLAB WORK
PERMIT $ 00 .ROUGH PLUMBING
TOTAL FEE 12.00 GAS PIPING
1 HEREBY'ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION'S GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING '
PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST 613" F - --r.,a'
LICENSED AS REQUIRED BY LOS ANGELES C TY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL 0 ER OF THE ABOVEUTILITY CO.NOTIFIEDDESCRIBEDRERESIDENTIAU 9 OPERTY. "
SIGNATURE
OF PERM ITT FINAL
ROBERTA:WOOD.
®F VALIDATION SUPERVISING MECHANICAL ENG'R
N.o, CASH
Co 2 .3 0 ?'" •JAW 2 9 •5 A 1,2 0'o:
,,.