HomeMy Public PortalAbout5222 DALEVIEW AVE_Plumbing__ �-8-57
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APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES _
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS � 4.
JOHN A. LAMBIE. COUNTY ENGINEER
CASSATT D. GRIFFIN. SUPT of BUILDING _ LOCALITY
FOR APPLICANT TO FILL I NEAREST.
ST.
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET MAIL F -
BATH TUB ADDRESS �..
SHOWER CITY TEL. NO.
LAVATORY CONTRACTOR
SINK ADDRESS
DISHWASHER
CONTRACTOR'S ��/�(� ATELJ
LAUNDRY TUB
REGISTRATION NO. T'I-6 '�(! NTY
CLOTHES WASHER
DISTRICT NO. GROUP ZONE READY FOR INSPECTION
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
y. INSPECTION RECORD
. r
APPROVALS
@ $1.00 PER ITEM ✓/ DATE INSPECTOR'S SIGNATURE
OR FIXTURE S (/(/ UNDER SLAB WORK
ROUGH PLUMBING �� q ry j'/ F�✓ti✓�
PERMIT 5 1100 ''ll
GAS PIPING
TOTAL FEE ILIdo GAS VENT
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER 0 �wf•
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING. q
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST M7• /,"{ ��,,, Y1.. . I/
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF /!
CALIFORNIA OR THAT AM THE LEGAL OWNE F THE gBOVE UTILITY CO. NOTIFIED 9i d
DESCRIB'_D RESIDE AL ROPERTY.
SIGNATURE
OF PERMITTEE FINAL
VALIDATION ROBERT A. WOOD,
SUPERVISING MECHANICAL ENG'R
[N! M.0. CASH
1 nPp 2.0.5 APR 24 3--A 10-.00