HomeMy Public PortalAbout4824 GOLDEN WEST AVE_Plumbing__ 76A667-CE817 12/59
APPLICATIO FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING ��P
BUILDING
AAG AAMBIE COUNTYENGINEEERI ADDRESS W9 I
WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL INNEAREST
CROSS ST. ,f�
NUMBER FIXTURE OR ITEM
WATER CLOSET ADOWNER008
�y
ADDR
BATH TUB ESS �.f 0 8 J 40 .b,-. AJ
SHOWER CITY ��J,( ,d
,;.'-,/TEL. NO. w ��
CONTRACTOR r '
LAVATORY
SIN$ ADDRESS
DISHWASHER CITY TEL. NO.
CONTRACTOR'S l STATE ]
LAUNDRY TUR REGISTRATION NO. 1r3 COUNTY ❑'
/ CLOTHES WASHER DISTRICT NO. GROUP ZONE CESSED BY
WATER HEATER 7
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPE/CION RECORD w
/ pi
l F e
s U
W
P.
z
@ $1.00 PER ITEM
®� OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE
I
PERMIT Si 2100 UNDER SLAB WORK
TOTAL FEE Z(r ROUGHPLUMBING
Hv r
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I 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
I HEREBY CERTIFY THAT I AM PROPERLY-REGISTERED AND/OR PLUMBING FIXTURES i
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT�I AM THE LEGAL OWNER OF THE ABOVE _
LG�
BED RESIDENTI L PR P RTY.
��4 Q l� e � n � UTILITY CO.NOTIFIED
TURE / �s R �^ERMITTEE /�G' t�•.r .r—_"r
FINAL
OF VALIDATION ROBERT A.WOOD,
M.O. CASH SUPERVISING MECHANICAL ENG'R
.,0 4 1 1 1 15ij, Jt;L 'D'7 5 D 1 2 .0 0