HomeMy Public PortalAbout10627 BOGUE ST_Plumbing__ ,76A667 '=E813 12/59
r ti. APPLICATION FOR PL MIBINC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING kAND SAFETY ]DIVISION BUILDING
JOHN A. L MBIE, COUNTY NGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET MAIL
ADDRESS
BATH TUB
CITY � TEL. NO.
SHOWER
LAVATORY CONTRACTOR Alert Plbg & Htg.
SINK ADDRFAS3933 boo Crendhaw Blvd.
DISHWASHER CITY I-HawthErne TEL. NO. QS 9-3691
CONTRACTOR'S p l' STATE 19
LAUNDRY TUB REGISTRATION NO. 168479 COUNTY ❑
CLOTHES WASHER DISTRICT NO. GROUP ,ZONE PR ESSED BY
WATER HEATERD I
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL „ //
�ip INSPECTION RECORD
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711- 00
/! aiG�.d" CI
97,�17.uv�ra 1 o
w
@ $1.00 PER ITEM
OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 00 UNDER SLAB WORK �`��dd 1Lill
TOTALFEE ROUGH PLUMBING -7b ' 04�LA .�,-ei._,.��j
GAS PIPING
4STATE
ACKNOWLEDGE THAT 1 HAVE READ THIS PPLICATION
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WICOUNTY 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 LE L OWNER-OF THE ABOVE
DESCRIBED RESIDENTIAL PROPEB11. UTILITY CO.NOTIFIED
4 Af
SIGNATURE / ��ryis/ 1
OF PERM ITTEE FINAL
N 7
®P VALIDATION ROBERT A. WOOD,
cK. N.0. CASH SUPERVISING MECHANICAL ENG'R
UO2 3 •1 9 J1611 16 5 D 9."tj
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