HomeMy Public PortalAbout5521 SULTANA AVE_Plumbing__ BOB
17 &00 APPLICATION FOR PLUMBING PERMIT
DIVISION OF BUILDING AND SAFETY
D$Pwtmenf of Cort f Engineer
CDOn1Y Of Los Angeles BUILDING 1
JOHN A LAbF12
MBIE COUNTY ENGINEER ADDRESS YVG 360tans
CASSATT D GRIFFIN,SUP T OF BUILGINa
LOCALITY Temple' Cit
FOR APPLICANT TO FILL IN NEAREST
C OSS ST
OWNER - DISTRICT NO 'GROUP ZONE I YVADY FOR,NSPQCTION
MAIL
ADDRESS R,99.1 SnItans;
CITU TEL NO INDUSTRIAL
W
WASTE APPROVAL
PLUMBER William J• Pauley INSPECTION RECORD
ADDRESS
CITYRreadia Calif TEL NoEi 77386
LICENSE NO 15404 A cis
NUMBER "PH OF FIXTURE OR REM FEE _
WATER CLOSET (TOILET) Q $1 00 $ A
1 BATH TUB 0 $1 00
SHOWER a s100
1
LAVATORY (WASH BASIN) Q $100 1
KITCHEN SINK !gl $100 1
DISHWASHER Q $1 00
' LAUNDRY TUB OR TRAY @ $100
CLOTHESWASHER Q $100
WATER HEATER @ $1 00
GAS SYSTEM ;too
APPROVALS
DATE INS ECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT ' $ ROUGH PLUMBING ']
TOTAL FEE GAS PIPING
GASVENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE E COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
I HEREBY CERTIFY THAT I As PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES CO AND STATE OF
CALIFORNIA OR THAT, I AM THE LEGAL OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIA► PROPERTY
SIGNATURE
OF PlRMITTEH ` FINAL
JOHN A LAMBIE COUNTY NG HHR VALIDATION ROBERT A WOOD CHIEF PLSG INSPECTOR
CE ■ 0 CASH
M6 1 2 3In WAR 18 3 800 In