HomeMy Public PortalAbout5803 CLOVERLY AVE_Plumbing__ r 7
76A667 -CE#S17 4-64
a < �
I �
• - APPLICATION FO , PLUMBING PERMIT
COUNTY OF LOS ANGELES Jen
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
O c
JOHN A LAM IE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING r►'�
LOCALITY
FOR APPLICANT TO FILL IN CROSS ST L
NUMBER FIXTURE OR ITEM EACH FEE
GAJ
WATER CLOSET $I 25 OWNER Lw
BATH TUB 125 ADDRESS 4D
SHOWER 1 25 CITY�^' TEL NO
LAVATORY 125 CONTRACTOR f
SINS 125 ADDRESS L510 9
DISHWASHER 125 CITY , TEL NOA
LAUNDRY fUB 1 25 R GIS HA?ON �, CSTATEOUNTY
CLOTHES WASHER 1 25 DISTRICT N GROUP J 'ZONE � RPC7/ 6By
WATER HEATER
GAS SYSTEM OUTLETS 1so
INDUSTRIAL a
WASTE APPROVAL 0
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD U ,
r-- x 11
/ AA
.ae - a
h
Z
APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK J v
ROUGH PLUMBING
TOTAL FEE GAS PIPING-
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANG L COUNTY AND STATE OF GAS TEST 1O`gyp
CALIFORNIA OR THAT I AM THE LEG L O NER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED R IDE IA ROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
1/0
ALIDATION ROBERT A WOOD r
CK M O CASH SUPERVISING MECHANICAL ENG R
Li,��u 3 3 2�.— AUG 2 8 5 D 1125-
I
125