HomeMy Public PortalAbout5622 ROSEMEAD BLVD_Plumbing__ 76A867-CEJl817 10-67
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER '
BUILDING AND SAFETY DMSION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS �yT!'T/ /1 ` /` ,%>•^�
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN(PR NT OR TYPE) RAREST �, �J I /1
CROSS ST. IL
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET 1.50
MAIL °
BATH TUB 1.50 ADDRESS •��'`�jy del //t ii/' i:. �_
SHOWER 1.50 CITY TEL. NO.
LAVATORY 1.50 CONTRACTOR 'i:►r; �'- ����'� -� (t•,` '
SINK 1.50 ADDRESS w �•"o
DISHWASHER 1.50 CITY TEL.NO. ,I
CLOTHES WASHER 1.50 STATE �,;i �� LIC
LICENSE NO. CLASS `_= _� �•��
SWIMMING POOL RECEPTOR 1.50 DIS RICT GROUP ONE ESSED BY
. V �-
LAWN SPRINKLER SYSTEM 2.00 C
WATER HEATER 1.50 INDUSTRIAL OVAL
GAS SYSTEM OUTLETS 1.50 V INSPECTION RECORD OCD
OUTLETS OVER W
5 PER SYSTEM .30 y
ti
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE '5'U
APPROVALS DATE INSPECTOR'S SIGNATURE
s Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel. No. HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY ` PLUMBING FIXTURES44- if ge
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO.NOTIFIED
LICENSED AS REQUIRED BY P --ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 Ap-'eTHE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE SCRIBED RESIDuATIAL PROPF,RTY. FINAL
VA
SIGNATURE � �''� ' JACK R. ALLEN, SUPERVISING HANICAL ENG'R.
OF PER
. - PERMIT VALIDATIO' CK. M.O. CASH
PLAN CHECK YALIDATION CK. M.O. CASH
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iu,A3J D 3.50 ' ',