HomeMy Public PortalAbout5604 WELLAND AVE_Plumbing__ )SIS-17 10-55^887 410APPLICATION FOR PLUMBING PERMIT
DIVISION OF BUILDING AND SAFETY g
Department of County Engineer
County Of LOS Angeles BUILDING
JOHN A.L:AMBIE, COUNTY ENGINEER ADDRESS
CASSATT•D.GRIFFIN,SUPT OF BUILDING
Y
FOR APPLICANT TO FILL IN NEARESLOCALITT f
CROSS ST.
OWNER ` DISTRICT NO. GROUP .IZONE I READY FOR INSPECTION
MAIL �
ADDRESS till I.
` INDUSTRIAL
CITY TEL NO. WASTE APPROVAL
PLUMBER " ��--✓r„ L�- INSPECTION RECORD
ADDRESS ,`' c%:�f f:I �l�—.0 rr S r
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CITY ` TEL.NO. I`•r/4
LICENSE.NO./ :J °/ as 3y fpA �"�', � �
NUMBER TYPE OF FIXTURE OR ITEM FEE Ld'! 1+ ,`��1 y�r j"te,�.,-^_� Ile --�.
WATER CLOSET (TOILET) @ $1.00
BATH TUB @ $1.00 / l�
$HOWER @ $1.00 r
LAVATORY(WASH BASIN) @ $.1.00 �% A'
KITCHEN SINK. @ $1.00'
DISHWASHER @ $1..00 T���� dF✓
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPE$TOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 7 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE GAS VENT Q�
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. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNAN TATE OF y
CALIFORNIA OR THAT I AIIS�. THE LEGAL 'OWNEY O ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL Pk%P 7 n
SIGNATURE
OF PERMITTEE FINAL ' 7
IOHN A.L.AMBIE.COUNTY ENGINEE V ATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR
CK.
M.O. CASH
6 2A SEP 2 f 3 3 7.0 0 +�