HomeMy Public PortalAbout4857 HELEO AVE_Plumbing_10/9/1963_WATER HEATER i
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APPLICATION FOR
PER IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRE J_ qplpo
WILLIAM A. JENSEN, SUPT OF BUILDING , LOCALITYTemple City
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. '6-1
NUMBER FIXTURE OR ITEM EACH FEE '
y,OWNER Go' Nelson
WATER CLOSET $1.25
MAIL
BATH TUB 1.25 ADDRESS 480 Heleo
SHOWER 1.25 CITY TP City TEL. NO-
LAVATORY 1.25 CONTRACTOR
SINK 1.25 ADDRESS 1_09�0
DISHWASHER 1.25 C"Tem le City TEL NO. 442-1234
CONTRACTOR'S' p STATE
LAUNDRY TUB 1.25
REGISTRATION NO. 211898 COUNTY
CLOTHES WASHER 1.25 DISTRICT OG P ZONE P O BY
WATER HEATER 1.50
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1.50 INDUSTRIAL �-
GAS SYSTEM OUTLETS WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 U
INSPECTION RECORD
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APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 QQ UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE
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 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRI D RESIDENTIAL P PERTY. UTILITY.CO. NOTIFIED sI
SIGNATURE J'
OF PERMITTEE
FINAL
V LIDATION ROBERT A. WOOD /
CK. M.O. CASH SUPERVISING MECHANICAL ENG'R i
L ,o 1-.2 3 2 w OCT 9 5 0 3.5 0 04