HomeMy Public PortalAbout6009 GOLDEN WEST AVE_Plumbing__ 76A667-CE*817 4-67 A
APPLICATION FO PLUM -� NG PERMIT
COUNT.Y OF-LOS ANGELES
DEPARTMENT/ OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W JENKINS SUPT OF BUILDING LOCALITY
A
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH F
OWNEF �'CIVr• �
WATER CLOSET $1.2f' MAIL J
BATH TUB 1 ADDRESS
10,
SHOWER 1. CITY > TEL. NO.
LAVATORY 1. CONTRACTOR
SINK 1. ADDRESS
DISHWASHER 1.25 CITY TEL. NO.
STATE LIC
LAUNDRY TUB 1. LICENSE NO CLASS
CLOTHES WASHER 1. 5 DISTRICT NO GROUP ZO PROCESSED BY
WATER HEATER1.50 '�~ Q �—
GAS SYSTEM--OUTLETS— 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD
O
U
O
W
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 200 UNDER SLAB WORK 4
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP CATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
oe
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY ANO STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN, THE ABOV ESCRIBE SIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITT E
FINAL '
,,-�LIDATION JACK R. ALLEN
i CK M O CASH SUPERVISING MECHANICAL ENG'R.
L"3 s '3 4,G X 12 5 D 8-.00-