HomeMy Public PortalAbout4900 CLOVERLY AVE_Plumbing__ 76A667 -CE0817 4 64
_ APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER gU1LDING
BUILDING AND SAFETY DIVISION ADDRESS (/� (/
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE OWNER l
WATER CLOSET ;1 2S Z SO MAIL
BATH TUB 12S ADDRESS
SHOWER 125
CITY TEL NO
� -
Z LAVATORY 125 CONTRACTOR
SINN 125 Z _ ADDRESS ! kQ
DISHWASHER 125 CITY Cavi' TEL NO !�
ATE
LAUNDRY TUB 125
CONTRACTOR
NO /3 s COUNTY T ❑
CLOTHES WASHER 125 Z DISTRICT NO GROUP ZONE PROCESSED BY
�
WATER HEATER 1 50 s J
1 SO INDUSTRIAL p},
GAS SYSTEM OUTLETS WASTE APPROVAL
OUTLETS OVER S PER SYSTEM 30 INSPECTION RECORD O
O
W
a
N
Z
APPROVAlQS DAT _ INSPECTOR S 51GNAT�RE�
PERMIT 5 2 00 UNDER6LWB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT s
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER 1 10N _
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
9
SIGNATURE 1
OF PERMITTEE .a C,t
FINAL SIL
C/�ALIDATION ROBERT A4'WOOD
M o CASH SUPERVISING MECHANICAL ENG R
y VCO 2 0 9 0 (SAY 2 8 5 D 15-00,
�