HomeMy Public PortalAbout9019 RANCHO REAL RD_Plumbing_6/13/1962_gas line, furnace 76A6.67-CE#817 5-8I- .
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY MGM=.
BUII.DIIVG AND SAFETY DIVLSION EUn:Dn�G gplq Rancho Real Rd.
JOHN A.LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BOI.LDING LOCALITY Temle Ci
FOR APPLICANT TO FILL IN NZAREffr
NUMBER FIXTURE OR ITEM OWNER G® G® Goold
WATER CLOSED MAM
RATE TUs Swim9019 Rancho Real Rd.
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�Temple le Ci TRL,NO.
LAVATORY CONM&ACrOR Anthony ro&l s lnc.
arias ADDaEss
5871 it a sto ne Blvd• -
Dzsr3wASNEa c=South Gate Tm No.SPm32210
LAUNDRY TOR M=M ONsNO.190�,79 SCal 3 cOD=Y .
CLOTM WANIER DffiTRICI'NO. OUP E i�BED By
WATER
GAS SYS= IIIIDUSTRI" V
WASTE APPROVAL
,NiS MIMON BECORD
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B .51.00.PER 1TEItQ
OR FIXTURE S I 1 APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT S 2 00 UNDER'SLAB WORK
TOTAL FEE5p ROUGH PLUMQING
3 GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ'THIS APPLICATION
AMD STATE THAT THE.ABOVE IS CORRECT AMDAGREE TO COMPLY GAS VENT
WITH ALL. BOUNTY,ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS.REQUIRED BY LOS•ANGELES C AND STATE OF GAS TEST
CALIFORNIA OR THAT I A 7 THE LEGAL OF THE ABOVE
DESCRIBED.RESIDENTIA�P PIC UTILITY CO.NOTIFIED
SIGNATURE /
OF PERMITTE
ACTUATION ROBERT A.WOOD
EK. M.0. CASH SUPERVISING MECHANICAL ENG'R
X0.2 4. 9% Juml3 5 D- 3.5 ON 4