HomeMy Public PortalAbout9404 EMPEROR AVE_Plumbing__ 76A667-CE817-11-57
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, County Engineer ADDRESS f i
CASSATT D. GRIFFIN, Supt of Building LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER r'
WATER CLOSET
MAIL
BATH TUB ADDRESS
SHOWER
CITY TEL. NO.
I
LAVATORY CONTRACTOSINE ADDRESS 7G/DISHWASHER CITY ' TEL. NO. STATLAUNDRY TUB REGISTRATION NO. Lr yCOUNTY
CLOTHES WASHER DIST RIC GROUP ZONE
READY FOR INSPECTION
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
@ $1.00 PER ITEM DATE INSPECTOR'S SIGNATURE
OR FIXTURE $
UNDER SLAB WORK
PERMIT $ OO ROUGH PLUMBING Z'3/-, 75 0 ET
TOTAL FEE GAS PIPING
GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES _
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEG OWNER OF THE ABOVE UTILITY CO. NOTIFIED —6 -f
DESCRIBED RESIDENT `[y PROPERTY. ^�
SIGNATURE
OF PERMITTEE FINAL
ROBERTA.WOOD.
®F VALIDATION SUPERVISING MECHANICAL ENG'ft
CK.','i M.0. CASH