HomeMy Public PortalAbout5112 GLICKMAN AVE_Plumbing__ 7oA667-CES i73-59 cTOb " 285
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, County Engineer ADD R SS 5��7 Iq• Glickman
CASSATT D. GRIFFIN, Supt of Building 4 LOCALITY l e pl e City
FOR APPLICANT TO FILL IN NEAREST
CROSS ST,
NUMBER FIXTURE OR ITEM OWNER J• E• Ronstad
2 WATER CLOSET MAIL
ADDRESS 2635 ED' . Baldwin
BATH TUB
SHOWER CITY Z r C a d l a TEL. NO 6— Q
2 LAVATORY CONTRACTOR Belvedere 1-li bin- Co.
1 SINE ADDRESS 11 900 Garvey
DISHWASHER CITY E.]- 1.1 O nt a TEL NO- $I 8-9836
CONTRACTOR'S STATE
1 LAUNDRY TUB REGISTRATION NO. 170,568 COUNTY El
1 CLOTHES WASHER DISTRICTNO. GRO P ONE E B
1 WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
.w`
Pyr o
a $1.00 PER ITEM
10 OR FIXTURE $ 10.00
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE —1-121 oo ROUGH PLUMBING
GAS PIPING P '
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
1 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 RESIDENTIPAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERM 7TEEh'v.,te-L FINAL ,f.
�f 1
®r VALIDATION ROBERT A. WOOD,
Lc-)
M.O. CASH SUPERVISING MECHANICAL,ENG'R
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