HomeMy Public PortalAbout4917 FIESTA AVE_Plumbing__ 76A667 CE817 12/59 TEMP-LE CITV
APPLICATION FOR PLUMBING PERMIT �
COUNTY OF LOS ANGELES
DEPARTH94T OF COUNTY ENGINEER
BUILDING SAN IE,S gTY RMSION BUILDING �S r
JOHN A L MBI OUNTY NGINEER ADDRESS
WILLIAM A JENSEN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
ROs ST L s 44L
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET MAIL
ADDRESS
HATH TUB
CITY TEL NO
SHOWER //��
CONTRACTOR AAAI U jF—W
LAVATORY
ADDRESS
SINK
DISHWASHER CI 1t-Z--p 1 NO kpZ2:
CONTRACTOR S STATE
LAUNDRY TUB REGISTRATION NO COUNTY ❑
CLOTHES WASHER DISTRICT NO GROUP ZONE P ESSED BY
WATER HEATER (iAl
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
w
O
U
a
w
P.
cep $1 00 PER ITEM I f r /
OR FIXTURE 7$ !% APPROVALS {yDCT INSPECTOR S SIGNATURE
PERMIT $ I 2100 UNDER SLAB WORK
TOTALFEE t% ROUGH PLUMBING �� A'../-H q I a rSG�I
GAS PIPING -
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT 11 h
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES I , v
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST ay/6 �•'
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF TH ABOVE
DESCRIBED RESIDENTIA ROP RTY UTILITY CO NOTIFIED
SIGNATURE
OF
PERMIT_
FINAL Vel/I
OF VALIDATION ROBERT A WOOD v
cK m O CASH SUPERVISING MECHANICAL ENG R
L" C)z640 0 ,EP 4 5 0 I�