HomeMy Public PortalAbout6126 AVON AVE_Plumbing__ 76A667,CE817 6 60
APPLICATION FOR PLUMBING PERMIT �
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS 61A- N. Aman
WILLIAM A JENSEN SUPT OF BUILDING LOCALITY San Gabriel Count
FOR APPLICANT TO FILL IN
NEAREST
CRT Garibaldi
F--
FIXTURE OR ITEM
OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
CITY TEL NO
SHOWER
l LAVATORY CONTRACTORE'i a
1 SDM ADDRESS 2019 NO Hot P.O. 40
DISHWASHER CITY E1 Monte TEL. NO
CONTRACTOR S STATE -15
LAUNDRY TUB EGISTRATION NO 149236 COUNTY
Z CLOTHES WASHER ! DISTRI ZONF, FROCESArkD Y
WATER HEATER EAl �A (2
l GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD // d
10
as
0
�p � i. u
P.
a $1 M PER ITEM
7 OR FIxrU$E $ 7.00 APPROVALS DATES p INSPECTOR S SIGNATURES e^
PERMIT $ 2 00 UNDER SLAB WORK n y�/7/ ` D-
TOTAL FEE 00 ROUGH PLUMBING
GAS PIPING r I
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER Ar
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST �o�
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE '
DESCRIBED RESIDENTIAL PROPER W `-
� UTILITY CO NOTIFIED
SIGNATURE �i I / 1 All-e AL
OF PERMITTE
FINAL
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MLIDATION ROBERT A WOOD
CS It C CAM SUPERVISING MECHANICAL ENG R
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