HomeMy Public PortalAbout5023 SERENO DR_Plumbing__ ^•°� APPLICATION FOR PLUMBING PERMIT 1
oe° "'Di RSION OF BUILDING AND SAFETY
Depo=tmwl of County Engineer
County O1 1.08 Angeles BUILDING
JOHN A L.AMBIE COUNTY ENGINEER ADDRESS 5023 N S erano XU Dr
CASSATTD GRIFFIN.SUP T OF BUILDING LOCALITY Temple Cit
FOR APPLICANT TO FILL IN c"ossa 5osemead aj-d
OWNER Kenneth Petersen DISTRICT NO GROUP ZONE I v EADY MR INSPECTION
MAIL
ADDRBSB 441 Jefferies
CITY Monro ,ia TEL NO Hl 7-4201 INDUSTRIAL
OVAL
PLUMBER Statevide Plumbinq Co INSPECTION-RECORD
ADDRESS 10024 F allev R1c-
CITY El Monte TEL NO G1 4-3717
LICENSE NO 160930 C-36 '
NUM5KRj TYPE OF FIXTURE OR ITEM FEZ Se
1 WATER CLOSET (TOILET) a $100 S 1 OO
1 ]BATH TUB a $1 Do 1 00 Lt�
SHOWER @ $100 Q
1 LAVATORY (WASH BASIN) !I 00 1 OO
KITCHEN SINK Q $100 1 OO
DISHWASHER @ $f 00
1 LAUNDRY TUB OR TRAY Q 0100 1ec
1 CLOTHES WASHER $1 00
WATER HEATER $100 r) 9
GAS SYSTEM @ $100
APPROVALS
DATE IN6 CYTO S SIGNATURE
UNDER SLAB WORK .r
PERMIT 0 t 00 ROUGH PLUMBING
OAS PIPING
TOTAL FEE 9 00 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
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AB REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL P PE TY
SIGNATURE
OF PERMITTEE FINAL
JOHN A LAMBIE COUNTY ENGINEER OVALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR
CE ■ E DASH
L&5800S w 6 3 9.00 0