HomeMy Public PortalAbout6212 ROSEMEAD BLVD_Plumbing__ BS-17
)BS-17
APPLICATION FOR �PLuMBING PERMIT r
Bg.,�,o.BB � :�..
DMSION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles , ZUILDING
JOHN A.LAMBIE. COUNTY ENGINEERDDRESS CASSATT D,GRIFFIN,SUPT OF BUILDING1OCALITY
FOR APPLICANT TO FML IN I NEAREST
CROSS ST.
OWNER DISTRICT NO. GR UP Z E READY FOR INSPECTION
MAIL I I / I
ADDRESS +
INDUSTRIAL
CITY TEL.NO. - WASTE APPROVAL
PLUMBER !2 �AA Q Af INSPECTION RECORD
ADDRESS
CITY TEL. O.
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) . @ $1.00
BATHTUB @ $1.00
SHOWER @ $1.00
LAVATORY (WASH BASIN) (b $1.00
KITCHEN SINK @ $1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSXEM @ $1.00
APPROVALS
DATE INSPECTORS SIGNATURE
UNDER-BLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE ot GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST L I * r
LICENSED AS. REQUIRED BY LOS ANGELES COUNTY AND jjTATEOF
CALIFORNIA OR THAT 1 AM THE LE L OWNER OF ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE
OF PERMITTEE FINAL
OHN A.LAMBIE. NTY ENGINEER. VALIDATION - ROBERT A.WOOD.CHIEF PLBG. INSPECTOR
CK. M.0: CASH
M— 4406 NOV19 3 2.00 .9
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FGA667 APPLICATION FOR PLUMBING PERMIT 1 .
)BS-17 10.88
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles. B,UILDiNG.
JOHN A.L.AMB•IE, COUNTY ENGINEER ADDRESS
CASSATT D..GRIFFIN.SUPT OF BUILDING
LOCALITY' / p
FOR APPLICANT TO FILL IN NEAREST
a-y� CROSS ST..
OWNER G�'L 4rje ,s� DIST NO. GROUP I READY FOR INSPECTION
MAIL i� J� A�� `�
ADDRESS ��// J e Com✓ / c�^�
CITY dy�i�A� TEL.NO' WA TE APPRINDUSTRIALOVAL
PLUMBE INSPECTION RECORD
ADDRESS 2 -
GITY� r r TEL.N
LICENSE NO. /46O/13'40
NUMBER TYPE OF FIXTURE OR ITEM FEE
oe WATER CLOSET (.TOILET) Q. $1.00 $
HATH TUB Q $1.00 _ _ r�! F- 1.0 W -wye7^
,SHOWER Q :$1.00
LAVATORY (WASHBASIN) Q '$1.00 ge—�—�— Pf'p•
KITCHEN SINK Q $1.00
DISHWASHER Q $1.00
LAUNDRY TUB OR TRAY Q $1.00
CLOTHES WASHER Q $1.00
WATER HEATER Q $1.00
GAS SYSTEM Q $1.00 i-
.APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK ��S�/
ROUGH PLUMBING- .O•
PERMIT $ I 1 00 `
GAS PIPING p b
TOTAL FEE GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO ,COMPLY HOT WATER HEATER •� !•1 r.I� !7!!
WITH ALL .COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING, PLUMBING FIXTURES J .
I HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE •OF �/ �� F
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATUREy
OF PERMITTEE FINAL
JOHN.A.LAMBIE,COUNTY ENGINEER ALIDATION ROBERT A.WOOD.CHIEF PLBG. INSPECTOR
CK. N.0. CASH
752 x'27 3 .00 2