HomeMy Public PortalAbout10702 ARROWOOD ST_Plumbing_12/20/1963_gas system 76A667-CE#817 5/63 6`/�(/ i'v al7o�r�
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER-
BUILDING AND SAFETY DIVISION BUILDING /f"ADDRESS � P�� � ��JOHN A. LAMSIE, COUNTY ENGINEERWILLIAM A. JENSEN, SUPT OF BUILDING G'i
FOR APPLICANT TO FILL IN l
NUMBER FIXTURE OR ITEM EACH FEE
OWNER �'
WATER CLOSET $1.25 MAIL
BATH TUB 1.25
ADDRESS ® J 4
CITY TEL. NO.
SHOWER 1.25
LAVATORY 1.25 CONTRACTOR 4:7
SINK 1.25 ADDRESS c�7fv
DISHWASHER 1.25 CITY sr)TEL. NO. �41 )3
CONTRACTOR'S STATE
REGISTRATION NO. Q COUNTY
LAUNDRY TUB 1.25 ❑
CLOTHES WASHER 1.25 DISTRICT NO GROUP ZONE P ESSED BY
WATER HEATER 1.50 !/
1.50 - INDUSTRIAL
GAS SYSTEM OUTLETS WASTE APPROVAL u0
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD
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APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE U GAS PIPING
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1 O HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT °, ...
ANSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITHALL 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,AND INTE TO
RESIDE IN,THE AS E DESCRIB RESIDENT L PROPERTY. UTILITY CO. NOTIFIED L�pR-
SIGNATURE a
OF PERMITTEE
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FINAL 71 j
VALIDATI ROBERT A. WOOD
CK. M.O. CASH SUPERVISING MECHANICAL ENG'R
3 7 2 6 DEC 2 0 5 D 3.50-
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