HomeMy Public PortalAbout5104 SULTANA AVE_Plumbing__ DEt617I ffis APPLICATION FOR PLUMBING PERMIT 1
DIVISION OF BUILDING AND SAFETY
• Deparbum of Camp Engin
County of Les Angeles "HE'S .S V lJ
JOHN A LAMBIE COUNTY ENGINEER A
CASSATT D GRIFFIN.SUP TOP BUILDING '
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CR SS ST
OWNER DISTRICT NO GROUP ZONE READY MR IIIRPRCT IOP
MAIL
ADDRESS
INDUSTRIAL
CITY TEL O WASTEAPPROVAL
PLUMBER f INSPECTION RECORD
ADDRESS
CITY TEL NO
LICENSE NO 3
NUNeXR TYPE OF FIXTURE OR REM FIR
WATER CLOSET (TOILET) VI00 $1 Q O
BATHTUB ® 1 00
SHOWER v 00
LAVATORY (WASHBASIN) 31 OD
KITCHEN BINK @ $100
DISHWASHER Q $t 00
LAUNDRY TUB OR TRAY B $1 DO
CLOTHESWASHER Q $100
WATER HEATER Q $100
GAS SYSTEM @ v 00
APPROVALS
DATE
NSPECTOR 5SIGNATURE
UNDER BLAB WORK D /Le
PERMIT >< t 00 ROICU aj,
UGH PLUMBING S
GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT i 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 FIXTURES
PLUMBING
I HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITYCO NOTIFIED
DESCRIBED RESIDENTIAL RO TY
SIGNATURE `
OF PERMITTE PINAL
Wl IN
JOHN A LAMBIE Cou ENGINEER /"yALMATIQN ROBERTA WOOD CHIEF PLBG INSPECTOR
GE ��5827�� NAY 8 3 800 in
76A667-CES617 6 55
APPLICATION FOR PLUMBING PERM
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION SUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL M cNEAREST ROSS T
NUMBER FIXTURK OR ITRM EACH FE e OWNER
WATER CLOSET S125 NAM
RATH TOR 125 ADDRESS
SHOW125 CITT
ER NO
LAVATORY 125 CONTRACTOR
SDYE 125 ADDRESS lZ 7
DISHWASHER 125 CITY TEL NO
LAUNDRY TDR 125 STATE d '` LIC
LICENSE NO v [{ CLASS
CLOTHES WASHER i 125 y' 1 ICY N 6R D
WATER HE#14 150
}
OAS SYSTEM GOTLETS 1 m WAAST1APPROVAL Q
OUTLETS OVER 5 PER SYSTEM 50 INSPECTION RECORD V
aY
H
V
w
o_
h
Z
APPROVALS DATE INSPECTOR•SIGNATURE
PERMIT f 2 OO UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAB PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND [TAT[ THAT THE ABOVE IS CORRECT AND AOR[[ TO COMPLY
WITH ALL COUNTY ORDINANCES AND [TAT[ LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STAT[ OF GAS TEST
GLI FORMIA OR THAT 1 AM TH[ L[OAL OWIRR OF AND INTEND TO
RESIDE IM THE ABOVE DESCRIBED R{SNDEMT L PERT UTILITY CO NOTIFIED
SIGNATURE
OF PERM ITT.
FINAL
MMATION
m4aa,lI CK M O CASH
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