HomeMy Public PortalAbout6128 AVON AVE_Plumbing__ 76A667 CE#1317 5 61
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING A E COUDMDSHNAANNTYNGINEER BUILDING / i —z�—t�✓
WILLIAM A JENSEN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NaosT 1 L '
NUMBER FIXTURE OR ITEM '
I OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
SHOWER CITY TEL NO
1 LAVATORY CONTRACTOR \ `A
SII ADDRESS a t
DISHWASHER CI17 914,044 TEL NO 5f t S'")
CO R A
LAUNDRY TUB REGISTRATION NO COUNTY
CLOTHES WASHER DISTRICT GROUP_ P SSED BY
WATER HEATER ` Off.
GAS SYSTEM INDUSTRIAL O
WASTE APPROVAL
INSPECTION RECORD ce
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® 3100 PER ITEM ( 1
OR FIXTURE $ APPROVALS DATE IN i0ECTOR 8 SIGNATURE
HPERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
1 GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 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
PLUMBING HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY STATE OF GAS TEST
CALIFORNIA OR THAT I A THE LEGAL OW HE ABOVE
DESCRIBED RESIpENTI L P OP TY UTILITY CO NOTIFIED
SIGNATURE I
OF PERMITTE
FINAL
VALIDATION ROBERT A WOOD
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CK M o UPERVISING MECHANICAL ENG R
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