HomeMy Public PortalAbout5426 ACACIA ST_Plumbing_7/15/1965_fix leak -6A667 CE#817 2'62
'--'�'`�APPLICATION MiR PLUMB G ,PERM[-
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING'AND SAFETY DMSION BUILDING �, .5r,` Tr
JOHN A LAMBIE, COUNTY ENGINEER ADDRESS
' WILLIAM A JENSEN SUP T OF BUILDING "`
LOCAL'IT'Y
-FOR APPLICANT TO FILL IN ` 4 CROSS sr � `
NUMBER FIXTURE OR ITEM EACH "FEE
OWNER,
WATER CLOSET $1 25 MAIL
BATTUB I ADDRESS
SHOWER 125 CITY TEL.NO
LAVATORY1 x O CONTRACTOR
SINK 125 �/ 'ADDRESS
DISHWASHER 1 25 CITYU TEL NO
LAUNDRY fUBCONTRACTOR'S STATE
125
t REGISTRATION NO � 3p / COUNTY
CLOTHES WASHER 121 DISTRICT NO GR Z E PR S BY
WATER HEATER 1 50 0 � r
GAS SYSTEM OUTLETS 1 50 INDUSTRIALWASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD
10U
W
ae- ,z
. ... 04 .
AA °" . ,
-I APPROVAL'S PAT INSPE OR S SIG14ATLIAE
S PERMIT $ 2 l00' UNDER SLAB WORK '/
ROUGH PLUMBING _ <
TOTAL FEE -7 GAS PIPING
t
I THEREBY 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 PLUMBING HOT WATER HEATER `� •�
,
1 HEREBY, CERTIFY, THAT I AM PROPERLY REGISTERED AND/OR PLUMBING,FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY'AND STATE OF "N
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF'AND INTEND TO GAS TEST f]J4
RESIDE IN THE ABOVE SCRIBED RESIDENT[ L PROPERTY UTILITY CO NOTIFIED
1 SIGNATURE
OF PERMITTEE '
FINAL it INC
LIDATION ROBERT A WOOD
CK M'J CASH SUPERVISING MECHANICAL ENG R ,
3 7 6 LACO 0 JLL' .7 5 �>
, 15 5 D 1 3 N I
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