HomeMy Public PortalAbout5523 WELLAND AVE_Plumbing__ 76A667-CE.#817 2-62 TEMPLE 17 f11 LE CETT
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDI s,j"Sv�.3
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
EARE T CROSS
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25 MAIL
BATH TUB 1.25 ADDRESS,lf D
SHOWER 1.25 CITY -rl e 1 TEL. NO. 9;2
LAVATORY 1.25 CONTRACTOR
SINK 1.25 ADDRESS
DISHWASHER 1.25 CITY TEL. NO.
LAUNDRY TUB 1.25 CONTRACTOR'S STATE [:3
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE R CESSED BY
WATER HEATER 1.50' 6
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 J INSPECTI
yyO
xxN RECORD
„ 3 til Y"Act�l" lr
o
i V
W
. V!
UAPPROVALS DATE INSPECTOk'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK l '`
1 ROUGH PLUMBING 1 ( t
TOTAL FEE �y l.. . 1 GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT 1
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER l J 1
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES I
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF.AND INTEND TO 1 L
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE FMAL
VALIDATION ROBERT W WOOD
CK. M.O. CASH SUPERVISING MECHANICAL ENG'R
LA60 2 ,2 1 6""o i'AR 5 D 3.50- .
76A607-CE81710-60
APPLICATION FOR PLUM • ING PERMIT
COUNTY OFLOS ANGELES
DEPART�iT OF COUNTY &EMEER
BUILDING AND SAFETY DIVISION BUILDING tr- Q�t
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS J�
WILLIAM A. JENSEN, SUPT of BUILDING e�
LOCALITY `
FOR APPLICANT TO FILL IN NEST 1.
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER 4el f
WATER CLOSED s D Mm
i BATE TUB r yr ADDRESS
CTfY TEL NO.
SHOWER
�. LAVATORY sq.p
CONTRACTOR ' ciivL S
ADDRESS i 1 ye�M
DISHWASHER CITY�l w N mm-NO.6V 710 6
CONTBACTOLAUNDRY TOB REGISTRATION NO. 11-715-6 COUNTY
CLOTHES WASHER /zs- DISTRICT I GROUP ZONE PROCESSED Y
1 WATER HEATER
GAS SYSTEM SCS INDUSTRIAL
WASTE APPROVAL y,
/ 5 I
II_V, S/PECTIoN RRCORD D'
O
a.
z
G $1.00 PER ITEM I
OR $ �� R
FACTURE APPROVALS DATE INsPECTORjSSIGi,VnTugB
PERMIT $ 2100 UNDER SLAB WORK °.sf"?&f �':r%��"�
TOTAL FEE ,�c" ROUGH PLUMBING 4 A3 ----)J-1
GAS PIPING t♦�-��. ''�"�r���- �f
I HEREBY ACKNOWLEDGE THAT I. HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IB CORRECT AND AGREE•TO COMPLY GAS VENT d
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING p L ,} i
t,PLUMBING. HOT WATER HEATER Aq� p `/„�,.y Jt i"?I
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF Y
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE GAS TEST
`. DESCRIBED RESIDENTIAL PROPERTY. _ UTILITY CO.NOTIFIED 4��;'�,•.�J rJ�';1 �` �,.;.fir'"✓ta��Y�
M1 SIGNATURE
OF PERMiTTE 'FINAL
ROBERT A:WOODCALnATION
. CASH SUPERVISING MECHANICAL ENG'R
L.wtuo' 7 6 7� ;� ;t 7 5 D 1 5.7 5 r.