HomeMy Public PortalAbout5215 SANTA ANITA AVE_Plumbing__ )OA007)Bs-27 10,9a APPLICATION FOR PLUMBING 'IPERMIT" .1
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of LOB Angeles BUILDING ] /0B / 1 h�+
JOHN A.LAMB:IE. COUNTY ENGINEER ADDRESS I / C $J
CASSATT D.GRIFFINS SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN I NEAREST
�w� CROSS ST. ei C dF—
OWNER Cy- G DISTRICT GPWP I `ZO E I READY FOR INSPECTION
MAIL SJ GP
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ADDRESS _ l
INDUSTRIAL
CITY TEL.NO. WASTE APPROVAL
PLUMBER �OhYI , f/ (i1e(p14 INSPECTION RECORD
ADDRESS OL J Q T
CITY G' TEL.NO. / ;? 46 4 v
LICENSE NO. y b_/'J
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 $
BATH TUB @ $1.00
SHOWER @ $1.00
LAVATORY (WASH BASIN) @ .$1.00
KITCHEN SINK @ $1.00 Ob
'DISHWASHER @ $11.00
LAUNDRY TUB OR TRAY @ $1.00 D
CLOTHES WASHER @ $1.00
J WATER HEATER @ $1.00 DO
GAS SYSXEM @ $1.00
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT 7 00'
ROUGH PLUMBING JJs `iJ• //.• • !' �!y/
$
GAS PIPINGS
TOTAL FEE 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 D
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 I M T LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENT[ ROP
SIGNATURE
OF PERMITTEE FINAL
OHN A.LAM ,COUNTY ENGINEERLIDATION ROBERT A.WOOD.CHIEF PLBG. INSPECTOR
• CH. R.0. CASH
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9 .3 0
5 8 '2 3� MAY5.0 0 �