HomeMy Public PortalAbout6240-6242 ROSEMEAD BLVD_Plumbing__ i6A1i67-VLDI/PYi
APPLICATION FOR PLUMBIN PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY.ENGINEER �/
BUII.DING AND SAFETY DIVISION L hDDRE S / (J
_JOHN A. LAMRIE, County E�er
CASSATT D. GRIFFIN,Supt of uilding .
LOCALITY '
FOR APPLICANT TO FILL IN NEAREST '
CROSS ST.
NUMBER FIXTURE OR ITEM
• OWNER
WATER CLOSET MAIL
RATS TUB ADDRESS
CITY TEL.NO.
SHOWER
LAVATORY CONTRACTOR ✓ !
Sm ' ADDRESS/ � -, �� (, �s,.c,;•
DISHWASHER ;..,,A-TEL. NO.f(J
CONTRACTOR'S n STATS ❑
LAUNDRY TUB REGISTRATION NO. COUNTY ❑ '
CLOTHES WASHER L)IIS^TRICTNO. GROU ZO E PROCESSED BY
WATER HEATER ✓ L V' - O ,
GAS SYSTEM INDUSTRIAL
w WASTE APPROVAL
INSPECTION RECORD
a 41-1
/Y On �ej .f pG h O�) �...e'P r`f CC/ I•"'r S
0 00 PER ITEM C)
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 200 UNDER SLAB WORK
TOTAL FEE 2L
p ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY f /� /
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER `� -07-0 � L✓IA ��C1J
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF - GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL WNEB OF H6 ABOVE
DESCRIBED RESIDENT BOP R UTILITY CO.NOTIFIED
SIGNATURE
OF PERMUTE FINAL 6'O -- j;i��'r �J
�@ VAIMATII��nAAA°°°TTT����111��-ROBERT A.WOOD.
/SUPERVISING MECHANICAL'ENG'R;