HomeMy Public PortalAbout6032 CAMELLIA AVE_Plumbing__ 76A667-:E#8171-.1,
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING , A
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING _
LOCALITY T r
FOR APPLICANT TO FILL IN NEAREST
NUMBER
NUMBER FIXTURE OR ITEM
OWNER
Z WATER CLOSETDam-
BATH
p T
I BATH TUB ADDRESS
CITY TEL NO. % ,Ved
SHOWER
Z LAVATORY CONTRACTOR
SINS ADDRESS
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DISHWASHER CITY &4&-, TEL. NO. C 3 7'I 2-
CONTRACTOR'S STATE
LAUNDRY TUB REGISTRATION NO. G-3 6 /3 31710 COUNTY
CLOTHES WASHER DISTRICT NO. GROUP ZONE PROCESSED BY
WATER HEATER _ ,•S�I / r `-� �t a
' GAS SYSTEM INDUSTRIAL i " A V
WASTE APPROVAL
INSPECTION RECORD 9x
0
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$1.00 PER ITEM _
OR FIXTURE /1 �' APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT 5 2100 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
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GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITHALL COUNTY ORDINANCES ANC] STATE LAWS REGULATING
PLUMBING. _HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIX
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT i AM THE LEG L OWNER OF E ABOVE GAS TEST
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE
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ALIDATION ROBERT A. WOOD
cic.
M.0. CASH SUPERVISING MECHANICAL ENG'R
�NI.. . C: 4 :r; SPR _- 5 D 1
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