HomeMy Public PortalAbout9412 DAINES DR_Plumbing__ 76A607-CE817 10-66 !JJ
APPLRCAT�QN FOR PLUMBING PERMIT
COUNTY OF LOS.ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DM3ION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS S
WILLIAM A. JENSEN, SUPT OF BUILDING - -
` LOCALIT
R FOR APPLICANT.TO FILL IN NEAREST
CROSS ST:
NUMBER FIXTURE OR ITEM OWNER
�. WATER CLOSET
MAIL
ADDRESS
BATH TUB
CITY �- TEL. NO. .
SHOWER
LAVATORY CONTRACTOR < Z • v G
ADDRESS
SINK
DISHWASHER CITY' r TEL..NO:' 8/
CONTRACTOR'S SPATE
LAUNDRY TUBREGISTRATION NO. �� - COUNTY
CLOTHES WASHER, DISTRI NO. GROUP. NE PR04CES w D BY
WATER HEATERD.
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL }
J,"INSPECTION RECORD,I'lo A 1v If a
9- /
$1.00 PER ITEM
/ OR FIXTURE $ rA
APPROVAL ,DATE/,_:INSPECTO/R/'S SIGNATURE
PERMIT $ `c2 00 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING r
GAS PIPING -
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION -
AND STATE THAT THE ABOVEIS CORRECT AND AGREE TO COMPLY GAS VENT I J /1
WITH ALL COUNTY ORDINANCES AND STATE LAWS'REGULATING
PLUMBING. •t HOT WATER HEATER'. C/ r, fl'�• -, �'y+A'�'r'�'.�(
1 HEREBY CE THA I AM PROPERLY REGISTERED AND/OR I PLUMBING FIXTURESF
LICENSED A9 EQUIRED B LOS ANGE�� QB AND STATE OF jj n
CALIFORN/ OR THAT 1 AM THE L£G �L OW R OF TH£ ABOVE GAS TEST _-
�+ DESCRIBE RESIDENTIA PROPER•GY. / / UTILITY CO. NOTIFIED
SIGNAT E
OF PER _ FINAL lG.
ALIDATION ROBERT A. WOOD .
cK. M.O. CASH SUPERVISING.MECHANICAL ENG'R
i 5 2 Afi8 D' 1 .00