HomeMy Public PortalAbout6036 BURTON AVE_Plumbing__ 76A667-CE817-8-58
APPLICATION ION FOR PLUMBING PERMIT
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DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION O 3 6 V
]OHN A. LAMBIE, CountF Engineer
CASSATT D. GRIFFQL Sup t of Building yOCALITY FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER O
WATER CLOSET MAN.
BATH TUB ADDRESS
SHOWER CITY TEL. NO.
LAVATORY CONTRACTOR
SINKADDRESS l
DISHWASHER CITY ,yr, �/twl TEL. NO./f)'4f Z25'3
CONTRACTOR'S .-7 STATE
LAUNDRY TUB AEGISTEATION NO. OUNTY ❑
CLOTHES WASHER DISTRICT NO. GROUP I N( 'I R CESSED BY
WATER HEATER q�js,L(�j
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
!s !
APPROVALS
/ $1.00
H PFIXTURIE� I, / DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2 00 ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
a AN STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
' PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESID IAL PROP TY.
SIGNATURE FINAL
OF PERMITTEE,,
ROBERTA.WOOD.
®r VALIDATION SUPERVISING MECHANICAL ENG'R
CK. M.0. CASH
i." 0 6 6 5 ^` ..."
Ljc . � j S P, 3 .00 LT