HomeMy Public PortalAbout5207 ARDEN DR_Plumbing__ 76A667-CE$r'`617 5-61
APPLICATION FOR PLUMBING PERMIT f�
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 1 LO : t
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY �
FOR APPLICANT TO FILL IN NEST
- CROSS ST.
NUMBER FIXTURE OR ITEM -
OWNER
WATER CLOSET MAIL
J BATH TUB ADDRESS
CITY TEL. NO.
! SHOWER CONTRACToRVal l ey Plumbing Co.
LAVATORY ADDRESS 442 W. Fleetwood P1.
SINS
1 DISHWASHER CITY Glendora TEL NO. �d ---129'7
CONTRACTOR'S1G .. STA ❑
LAUNDRY TUB REMTRATION MOS4 i COUNTY
CLOTHES WASHER DISTRICT NO. 11 GROUP ZONE PROCESSED BY }
WATER HEATER `j � L ! ' - �C " O.
GAS SYSTEM INDUSTRIALWASTE APPROVAL V
INSPECTION RECORD
O
F-
U
W
O.
Vf
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@ $1.00 PER ITEM
OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE / ROUGH PLUMBING '� ✓ �0"J.. * ---
/ !.
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING,
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE -
FINAL
,—VALIDATION ROBERT A. WOOD
hi.0. CASH SUPERVISING MECHANICAL ENG'R
�U 0 16-2- 5- 0