HomeMy Public PortalAbout5459 SARA MAR LN_Plumbing__ TBA°••
D••` APPLICATION FOR PLUMBING PERMIT 1
,(DIVISION OF BUILDING AND SAFETY
Department of County Enenew
County of Los Angeles su ILDING [��
JOHN A LAMBIE COUNTY ENGINEER ADDRESS I"T
CASSATT D GRIFFIN.SUP T OF BUILDING
LOCALITY ;C G /
FOR APPLICANT TO FILL IN NEAREST
CR SS 8T
OWNER Y C DISTRICT NO GROUP I ZONE/ 11 EADI FOR INSIZUEON
MAIL S A
ADDRESS
INDUSTRIAL
CITY TEL NO WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS // G�
CITY L TEL NO 4
LICENSE NO /d S g
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) $1 00 S
BATH TUB sI 00 `
SHOWER @ s100 1i
LAVATORY (WASH BASIN) 1 00 1
KITCHEN SINK sl O0 O
DISHWASHER st 00
LAUNDRYTUB ORTRAY $1]COPLY
OCLOTHESWASHER slWATER HEATER 1OAS SYSTEM $1DAPPROVALS
DATE INSPECTOR 9 SIGNATURE
UNDER SLAB WORKPERMIT 00 RO 'S6ATOTAL FEE ld 00 GA$veNT
1HEREBY ACKNOWLEDGE THAT I HAVE READ TCATIONAND STATE THAT THE ABOVE 19 CORRECT AND AGOYPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LALATING PLUMBINO PI%TURES
PLUMBINGI HEREBY CERTIFY TXAT 1 ANPROPERLY REGND/OR GAS TESTLICENSED A9 REQUIRED BY OS A GELES COUNTYTE OFCALIFORNIA OR THAT 1 TH LE OWNERABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENT( ROP
SIGNATURE
OF PERMITTEE PINAL
JOHN A LAMBIE COUNTY ENGINEER ALIDATION ROBERT A WOOD CHIGF PLBG INSPECTOR
4 4T4,4,,A,N JAN 24 3 1 0.0 0 0