HomeMy Public PortalAbout5602 GOLDEN WEST AVE_Plumbing__ 76A667-CE0817 9/63
APPLICATION FOR PLUMBINd PERMIT
COUNTY OF LOS ANGELES mZ-
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING ,,o
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JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS ,�) !o p .GC�
t - WILLIAM A JENSEN, SUPT OF BUILDING
LOCALITY '
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE '
OWNER
WATER CLOSET $1.25J MAIL
BATH TUB 1.25 ADDRESS
CITY TEL. NO.•
SHOWER 1.25
LAVATORY 1.25 CONTRACTOR
SINK 1.25, ADDRESS
DISHWASHER 1.25 CITY TEL. NO.611 ' ZO
LAUNDRY TUB 1.25 CONTRACTOR'S STATE ❑
REGISTRATION NO. �?0�3 COUNTY ❑
CLOTHES WASHER 1•25
]DISTRN G Z NE P O 6 BY
WATER,HEATER 1.50 ' D
GAS SYSTEM OUTLETS 1.50 INDUSTRIAL d
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 U
INSPECTION RECORD
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• APPROVALS DATE/ INSPECTOR S SIG RE
PERMIT S 2 00 UNDER SLAB WORK MY
ROUGH PLUMBING r
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT IHAVE READ THIS A PLICATION GAS VENT I f
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH AL
COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBIN
I HEREBY,CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST Q�
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED ------
SIGNATURE
-SIGNATURE ,R ,
OF PERMITTEE FINAL
`ALIDATION ROBERT AlWOODI
CK M o. CASH SUPERVISING MECHANICAL ENG'R
Lno805- 2 AR24 5 0 7-25- ti