HomeMy Public PortalAbout5828 ROWLAND AVE_Plumbing__ C 60 /G�`�1/ - Ot/L
APPLICA'T'ION FOR PLUMBING PERMI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGBCMR
BUILDING AND SAFETY DIVISION BUILDING �Op RpwL,414v
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING
111 LOCALITY
FOR APPLICANT TO FILL IN NEST
CROSS ST.
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET �fN
MAIL
BATE TUB ADDRESS
SHOWER CITY TEL.NO.
LAVATORY CONTRACTOR �. 0-41vis
SINS ADDBRW� 17 a j&, 1 3 -r Z
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DISHWASHER CITY 4R nt"y TEL.NO.�/yt 1.f'fjrp 0
TTE BEI
LAUNDRY TOB REGISTRATION NO. CCONTRACTOWS OUNTYY
CLOTHES WASHER DISTRICT NO. GR P ZD P O B HY
WATER BEATER _ t �� �
GAS SYSTEM j INDUSTRIAL '
WASTE APPROVAL �.
INSPECTION RECORD n.
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V
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$1.00 PER ITEM
OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 1-1 100 UNDER SLAB WORK
TOTAL FEE � ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ' PLUMBING FIXTURES -�
LICENSED AS REQUIRED BY L08 ANGELES COON AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWN F THE ABOVE
DESCRIBED RESIDENTIAL PR ERTY. _ UTILITY CO.NOTIFIED
SIGNATURE &y�
OF PERMITTER
FINAL r
VALIDATION ROBERT A. WOOD
M.o. CASH SUPERVISING MECHANICAL ENG'R
Lilo 9 3 0 1 JAN 17 5 D 3.50- v
76AG6.7-CERS17 10-6 /&_%p le—
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY 'DIVISION BUILDING ,� q
JOHN A.,LAMBIE, COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUP'T..OF BUILDING LOCALITY R
FOR APPLICANT TO FILL IN PR NT OR TYPE) NEAREST
CROSS ST.
:NUMBER FIXTURE OR ITEM EACH FEE
ER -�
WATER CLOSET 1.50 OWNER
BATH TUB 1.50 ADD
SHOWER1.50 CI TEL..NO.
LAVATORY 1.50 CONTRACTOR t
SINK 1.50 ADDRESS ,-7_
DISHWASHER 1.50 CITYr. i
CLOTHES WASHER 1.50 STAT C T �P LIC
LICENSE N / u (p CLASS
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GROUP ZONE PROCESSED BY
LAWN SPRINKLER S TEM 2.00 CD
WATER 1.50
WASTE APPROVAL C
GAS SYSTE OUTLETS 1.50 INS CTION RD V
OUTLETS OVER 30 Jj y
5 PER SYSTEM rz
H
i
Plan check fee 25% of above. See reverse.
PLUMBING PERMIT ISSUING FEE 8 2 00'I
TOTAL FEE .3 V APPROVALS DATE INSPECTOR'S SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS:VENT
City Tel. No. HOT WATER HEATER
I 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.
I HEREBY CERTIFY THAT 1 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'APOVE DESCRIBED RESIDE A PROPERT FINAL
SIGNATURE JACK R. AL,L.EN,SUPERVISIN HANICAL ENG'R.
OF PERM ITT4,
�
PLAN CHECK VALIDATION CK.. M.0. AASH PERMIT VALIDATION /C K. M.O. CASH
Q5 5 5 8�S :JUL 22 0 3.54Nco