HomeMy Public PortalAbout6256 BURTON AVE_Plumbing__ 76A667-CE817 12/59
APPLICATION FOR PLUMBING PERMIT, �]
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING rn�ND SAFETY T�IVISION
JOHN A. LAM SIE. COUNTY CNGI NEER ADDRESS {_�Aj /V IJ I��O�
WILLIAM A. JENSEN. SUPT OF BUILDING
' LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET SIL
BATH TUB ADDRESS
CITY TEL. NO.
SHOWER _ L
CONTRACTOR
LAVATORY
SINE
ADDRESS S U D
DISHWASHER CITY D L1(GTEL. NO.
CONTRACTOR'S / STATE
LAUNDRY TUB REGISTRATION NO. +� COUNTY ❑
CLOTHES WASHER DISTRI CT NO. GROUP ZONE P PRO B
WATER HEATER
GAS SYSTEM INDUSTRAT. 1
WASTE APPROVAL
INSPECTION RECORD
0
c, V
o
H
U
I� f 51.00 PER ITEM
OR FIXTURE $ >7 APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEEV ROUGH PLUMBING . ..J ..�
GAS PIPING -
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY 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 COUNTY AND STATE OF GAS TEST �• ��/C>Gn ,r5n_..., !/
CALIFORNIA OR THAT 1 AM TH LEGAL OWNER OF THE .ABOVE ee
DESCRIBED RESIDENTIAL P PER UTILITY CO.NOTIFIED P /
SIGNATURE
OF PER"TTEE FINAL 'I� •/yZ
VALIDATION ROBERT A. WOOD.
C5)/ M.0. CASH SUPERVISING MECHANICAL ENG'R
t_AIJo6 3 5 4 F. SEP 1 '3 5 A
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