HomeMy Public PortalAbout5038 GLICKMAN AVE_Plumbing__ 76A667-CES17 3-59
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING �' G rc c!f �n ,
JOHN A. LAMBIE, County Engineer ADDRESS1,1
CASSATT D. GRIFFIN, Sup t of Building LOCALITY T.
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM OWNER
/ WATER CLOSET MAIL
BATH TUB ADDRESS
CITY TEL. NO.
SHOWER
LAVATORY CONTRACTOR r r
SINK ADDRESS 510 4
DISHWASHER CITY C1 1w0 V TEL. NO. — f :S'
STATE
LAUNDRY TUB REGISTRATION NO, c j
V COUNTY ❑
CLOTHES WASHER DISTRICT NO. SUP ZONE I PRO SSED BY
WATER HEATER `/7� I-A
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL r
j INSPECTION RECORD 77 O
0 $1.00 PER ITEM
OR FIXTURE $ 7(�
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMITUNDER SLAB WORK '7_ p fYL`
TOTAL FEE I 2 00"3 ROUGH PLUMBING i
- GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER G.1 aj C
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES -3"'1G'L� �`�-e
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPE •� UTILITY CO.NOTIFIED -r"�_..
SIGNATURE1
OF PERMIT--- FINAL ✓-
®E / VALIDATION ROBERT A. WOOD,
C Y.O. CASH SUPERVISING MECHANICAL EMG'R
'3(� •� n
- 471 1. .0 0