HomeMy Public PortalAbout6236 BURTON AVE_Plumbing__ )BAGS)-C E#817 10-32
. APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING Z
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN. SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25 MAIL - -.
BATH TUB 1.25 ADDRESS
SHOWER 1.25 CITY TEL. NO.
LAVATORY 1.25 'CONTRACTOR
SINK 125 'ADDRESS ' SS
DISHWASHER 1.25 CITY ,TETT. NO; 7a6
LAUNDRY TUB 125 CONTRACTOR'S p' STATE 5�
REGISTRATION NO. p' COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP 'ZONE PROCESSED BY
WATER HEATER 1.50 r/ ,
150 INDUSTRIAL
GAS SYSTEM__OUTLETS . 0
WWASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .80 INSPECTION RECORD u
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APPROVALS DATE INSp CTORS SIGt+pTURE
PERMIT S 2 00
UNDER SLAB WORK
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ROUGH PLUMBING �4 Q
TOTAL FEE 1 R5, 00 GAS PIPING '
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GA$VENT #
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
A
1 HEREBY CERTIFY THAT I AM PROPERLY REGIBTEREO ID/OR PLUMBING FIXTURES _Vv
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST OI. G` rr.-.�'
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN. THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE -
OF PERMITTEE _ FINAL /
,-- VALIDATIONROBERT A. WOOD
M.0.
M.o, CASH SUPERVISING MECHANICAL ENG'R
Lfil 0 4 5 9 3 3 14AY'13 - 5, A :1- 5..00-
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