HomeMy Public PortalAbout5415 CLOVERLY AVE_Plumbing__ 76A667 CE817 12/59
APPLICATION FOR PL,UMBIN PERMIT �
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING
BUILDING AND,SAFETY RMSION ADDRESS
JOHN A LAMBI COUNTY NGINEER
WILLIAM A JENSEN SUPT OF BUILDING LOCALITY
FOR APPLICANT TO m IN CROSS ST
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET MAU.
/ BATH TUB ADDRESS
CITY TEL NO
SHOWER
CONTRACTOR d
LAVATORY
/ SINS ADDRESS /
DISHWASHER CITY TEL NO
CONTRA R S /> / _ a 2� STATE
LAUNDRY TUB REGISTRATION NO (o(� COUNTY ❑
/ CLOTHES WASHER DISTRICT NO GROUP ZONE PROCE fD BY
/ WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
/INSPECTION RECORD a
11114A'11i l � IJ
o
7 @ $1 DD PER ITEM [{/
OR FIXTURE $ APPROVALS ATE IN11SPFCT,OR SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK fl 1141 / L
TOTAL FEE QQ ROUGH PLUMBING HI IH `_-4 1 1—H I )
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS'Co
AND AGREE TO COMPLY 1
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER q f
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES ' ON
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA ORTHAT I AM THE LEGAL OWNER OF THE ABOVE GAS TEST
DESCRIBED RESIDEN71 L PROPERTY UTILITY CO NOTIFIED tl4s eTiaS,ryQ�
SIGNATURE r / A d
OF PERMITTEE FINAL
®P VAY O CASH VALIDATION, ROBERT AaWOOD, r
V
SUPERVISING MECHANICAL ENG R
CK
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