HomeMy Public PortalAbout6206 GOLDEN WEST AVE_Plumbing__ 76A667-CE817 12/59 �-
APPLICATION FOR I5LU INCA" PERMIT
COUNTY OF LOS ANGELES .2,G
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING /-j� ��
JOHN A. L.AMBIE, COUNTY ENGINEER ADDRESS V /� ItiF/J
WILLIAM A. JENSEN, SUPT OF BUILDING � b/✓_/ / }�
LOCALITY r /
FOR APPLICANT TO FILL IN NEAREST CROSS ST,
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NUMBER FIXTURE OR ITEM OWNER �' Q
WATER CLOSET MAIL
ADDRESS "/ Ce Q WAS/
BATH TUB
SHOWER CITY
LAVATORY CONTRACTOR ,*/� (�' �0.Af
J SING n
ADDRESS y
DISHWASHER CITY 6 /T�i4 W1 NO..6!!/ 7-2-,7j(
CONTRACTOR'S Q // STATE
LAUNDRY TUB REGISTRATION NO. / Y COUNTY ❑
CLOTHES WASHER DIST ICT NO. GjQ11?- ZONEf PRO ESSED BY
WATER HEATER \") 1�1 I I 1
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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I @ $1.00 PER ITEM
OR FIXTURE $ ,�!� APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ P.100 UNDER SLAB WORK
TOTAL FEE cla ROUGH PLUMBING
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
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTI L PRO ERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITT �'� !il� ".�
FINAL f._
®P 1VALIDATION ROBERT A. WOOD,
C ` M.O. CASH SUPERVISING MECHANICAL ENG'R
L (.; 8 9 6 7 =1 ? 1 5 0 9.00 r�