HomeMy Public PortalAbout5916 ROSEMEAD BLVD_Plumbing__ 7SM67-CE817-11-57
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER R
BUILDING AND SAFETY DMSION BUILDING
1rOHN A.LAMBIE. County Engineer ADDRESS (�
CASSATT D. GEMM.Sup t of wilding LOCALITY R
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. lawom
NUMBER FIXTURE OR ITEM
WATER CLOSET OWNER / ^1
BATH TUB ADDRESS
SHOWER CITY A6& TIC
NO.
LAVATORY CONTRACTO. J
gig ADDRESS
DISHWASHER CITY TEL NO.
CONTRACTOR'S STATE ❑
—"LIICHnDRY-�S_ REGISTRATION NO. COUNTY ❑
CLOTHES WASHER
DISTRICT-NO. GROUP ZONE, READY F.H.INSPECTION
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
. •N
APPROVALS
$1.00 PER ITEM DATE INSPECTOR'S SIGNATURE
O8 FDrrQaE $ I9}a�l'.
UNDER SLAB WORK
PERMIT 00 ROUGH PLUMBINGfd. MulfrIeNj
TOTAL FEE v GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING _
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF -
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROP•
SIGNATURE
OFPERMIITEFINAL
ROBERTA.WOOD.
®P VALIDATION SUPERVISING MECHANICAL ENG'R
CK. N.0. CASN
LA0 5 5 7 1 r' OCT 7 5 A 6.0 0
MM67--CE817-11.57
APPLICATION FOR PLUMBING PERMIT 1 ,
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A.LAMBIE, Count�mees ADDRESS
CASSATT D. GRIFFIN,Sup 4 of-Ruildiag LOCALITY
w }'
FOR APPLICANT TO FILL IN t:NgEAREST
ROSS ST.
NUMBER FIXTURE OR ITEM
WATER CLOSET OWNER
BATH TUB ADDRESS
SHOWER CITY' TEL.NO.
LAVATORY CONTRACT&
Sig ADDRESS v W
DISHWASHER CITY TEL.NO.
LAUNDRY TUB CONTRACTOR'S STATE E3
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER IDISTRICSNO. GROUP ZONE READY FOR INSPECTION
WATER HEATED
GAS SYSTEM ti INDIISTRIAL
WASTEAPPROVAL
INSPECTION RECORD
1
+ or
i9I ,�•/R'� . 9' IIT
1O -
/ APPROVALS
i C8 O PER ITEMS I A�1 DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GkS TEST rJ�•
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPER
I
SIGNATURE
OFPERMITTE ^ FINAL '�• `�` �
ROBERTA.WOOD.
®F VALMATION��SUPERVISING MECHANICAL ENG'R
CN. M.o. ,/CASH/
iljCo 5 7 9 3 8 OCT 15 5 R 1.0 0