HomeMy Public PortalAbout6132 ROSEMEAD BLVD_Plumbing__ 76 A 667—CE 817 8/68
APPLICATION FOR PLUMBING PER T
COUNTY OF LAS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING %ry
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS ,,/. /3dry
COLEMAN W. JENKINS. SUP'T. OF BUILDING LOCALTfY
FOR APPLICANT TO FILL IN(PR NT OR TYPE) NEAREST
NUMBER FIXTURE OR ITEM EACH FEE CROSS ST.
OWNER
WATER CLOSET 1.50
MAIL
BATH TUB 1.50 ADDRESSlal
Al
SHOWER 1.50 CITY TEL. NO. ip`
LAVATORY 1.50 CONTRACTOR
SINK 1.50 ADDRESS
DISHWASHER 1.50 CITY TEL.NO.
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROyP ZONE 7015
Y
LAWN SPRINKLER SYSTEM 2.00 V , TY12 o
WATER HEATER 1.50 INDUSTRIAL v
WASTE APPROVAL
O
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD
OUTLETS OVER
5 PER SYSTEM .30
y
Z
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address PAS PIPING
GAS VENT
City Tel. No. HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 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 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
RESIDE IN.THE ABOVE DEBCRIBED RESID TIAL PROPERTY. FINAL
C
SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICAL ENG-R.
OF PERMITTEE
PERMIT VALIDATION CK. M.O. ASH
'!PLAN CHECK VALIDATION CK. O. CASH
I•" s&-19 5 D :5 5 0
. V