HomeMy Public PortalAbout4836 CLOVERLY AVE_Plumbing__ 78A887 -CE#817 9/63 �f 1
y APPLICATION FOR'
PLUMBING P RMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING,AND SAFETY DIVISION BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST fa
NUMBEW FIXTURE+OR ITEM EACH FEE
` OWNER
WATER CLOSET $12S �� MIL
' BATH TUB 1 25 , S ADDRESS
' SHOWER 1 25 w ,� CITY TEL NO
LAVATORY 125
J CONTRACTOR241-11,
' SINK 25 ADDRESS S'
DISHWASHER 1 25 CITY Q�j TEL NO ,!�(![�-0 O 77
ATE
LAUNDRY TUB 1 25 REGISTRAT RACTOR ON NO ( / / COUNTY ❑
CLOTHES WASHER 1 25 DISTRICT NO GROUP ZONE 1. P ESS D BY ,
WATER HEATER R- 1 50 ' 0 ,? 'T
GAS SYSTEM A OUTLETS 1 50 INDUSTRIAL O
WASTE APPROVAL
OUTLETS,OVER 5 PER SYSTEM 30 j INSPECTION$RECORD U
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J � 3
a APPROVALS DATE] INSPECTOR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE �5 �D GAS PIPING
I HEREBY ACKNOWLEDGE THAT IHAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
_
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES lV W-1I
LICENSED AS REQUIRED LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AMM THE LEGAL OWNER OF AND INTEND TO �/-
RESIDE IN THE ABOVE DESCRI D RESIDENTIAL P PE RTY UTILITY CO NOTIFIED ' 6
SIGNATURE vll
OF PERMITTEE
FINAL ti, !'f'
V LIDATION ROBERT�A WOOD
cK M O CASH SUPERVISING MECHANICAL ENGR
LA1,0 3 1 9 51 AUG 2 7 5 D ' 15.00-
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