HomeMy Public PortalAbout4904 GLICKMAN AVE_Plumbing__ 7SA667-CE817 3-59
APPLICATION FOR PLUMBI G PERMIT
COUNTY OF LOS ANGELES (�
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION F
DING
ESS �C ��Gr�JOHN A. LAMBIE, County Engineer CASSATT D. GRIFFIN, Sup't of BuildingLITYFOR APPLICANT TO FILL IN EST
SS ST.
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
CITY TEL. NO.
SHOWER
( CONTRACTOR e/
LAVATORY "
SING /ADDRESS ,„7 3
DISHWASHER CITY / 7tlla ysJ �" TEL. No.
CONTRACTOR'S 14tj G � STATE
LAUNDRY TUB REGISTRATION NO. J COUNTY
1 CLOTHES WASHER D1S�CT NGR Z/O ROCESSED BY
WATER HEATER � • ®O. ,_ )a
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
V
Q $1.00 PER ITEM
OR FIXTURE $ APPROVALS+�A DATE INSPEGITOR'S SIGNATURE
PERMIT $ 00 UNDER SLAB WORK
TOTAL FEEROUGH PLUMBING
GAS PIPING
[ HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS A L CCATION GAS VENT i
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING /F
PLUMBING. HOT WATER HEATER '*#
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE -
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL
®P VALIDATIO ROBERT A. WOOD,
CK. H.O. CASH UPERVISING MECHANICAL ENG'R
I it '71 1 6 9 -,i ,..+i'� .L . . 'c