HomeMy Public PortalAbout9918 BOGUE ST_Plumbing__ 76A667-CE8,V -}2/59 eGPERM .APPL4ICATIO. I FOR PLUMW : �
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION suILDING / Q G v j--
JOHN A. LAMBI COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST / /�// �J/ _./Z�
CROSS ST. l�
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET
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BATH TUB ADDRESS O !J O e S7
SHOWER CITY TEL. NO./
LAVATORY
CONTRACTOR /Y e l--- /
SINS ADDRESS /U l� i �f� ,}4
DISHWASHER CITY L,p t"''1A O'
CONTRACTOR'S STATE
LAUNDRY TUB REGISTRATION NO. l COUNTY ❑
CLOTHES WASHER DISTRICT NO. G ZONE R BY
WATER HEATER l/
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION ECORD
04
$1.00 PER ITEM I -
OR FIXTURE $ '5-G " 'AP ,OYA S V DATE/,, /INSPECTOR'S-SIGNATURE
PERMIT $
.100 UNDER'$F_AB WORK
�� ROUGH PLUMBING
TOTAL FEE
�i
I GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT """
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 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 1 AM THE LEGAL OWNER OF THE ABOVE _
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED /Vtt 11 yuI r
SIGNATURE '�1I�
�1<. .11�7 ,r ' NYd� :� /'a'
OF PERM ITTEE FINAL
®M ALIDATION ROBERT`A. WOOD,
Cs. M.O. CASH SUPERVISING MECHANICAL ENG'R
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