HomeMy Public PortalAbout5843-5845 GOLDEN WEST AVE_Plumbing__ 76A 667,.0 E#BITS/fi3
APPLICATION OR. PLUMBI G_ PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN, SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NARES'
r. A
NUMBER FIXTURE OR ITEM EACH FEE
OWNER pa
WATER CLOSET $1.25 MAIL
BATH TUB 1.25 ADDRESS
•CITY TEL. NO.
SHOWER 1.25
LAVATORY 1.25 CONTRACTOR A4AY
SINK 1.25 ADDRESS ,,> 4),,5-
DISHWASHER
,,5-DISHWASHER 1.25 CITY � TEL. 110,61.7
LAUNDRY TUB 1.25 CONTRACTOR'S STATE
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER' 1.25 DISTRICT NO GROUP ZONE ESSE_D BY
WATER HEATER I 1.50 }
1.50 INDUSTRIAL n'
GAS SYSTEM OUTLETS WASTE APPROVAL 0 /
OUTLETS OVER 5 PER SYSTEM .30 AINS�yPECTION RECORD
0
LU
CL
e` ,ice In
- Z
APPROVALS DATE IN c OR S SIGNATURE
PERMIT $ 2 -00 UNDER SLAB WORK
ROUGH PLUMBING v ,
TOTAL FEE
GAS PIPING
1 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 HOT WATER HEATER 4.4PLUMBING //
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TESTS (�
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
P
SIGNATURE ' I
OF PERMITTEE '��' FINAL
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VALIDATION ROBERT A WOOD
CK M o cnsH SUPERVISING MECHANICAL ENG R
LALO 214 ,8�2 NOV 1 5 D 18.00-
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