HomeMy Public PortalAbout6217 GOLDEN WEST AVE_Plumbing__ 76A667 -CE#81-7 2-62 TEMPLE 91"Y -
APPLICATION FOR ;'PLUMBING PERMIT ,
COUNTY OF LOS ANGELES 66 ) 1 -7
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION 1BUILbING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN. SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN 3 * Cao SSST.
NUMBER FIXTURE OR ITEM EACH FEE ,
J OWNER
�. WATER CLOSET $1.25 D - MAIL
BATH TUB 1.25 s ADDRESS
CITY TEL. NO.
SHOWER 1.25 J �s
" LAVATORY 1.25 ✓o CONTRACTOR
SINK 1.25 ADDRESS
DISHWASHER' 1.25 CITY TEL. NO.
LCONTRA OR'S STATE
LAUNDRY TUB 1.25
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER 1.25 r DISTRICT NO GROUP ZONE P ED BY
WATER HEATER 1.50 O r e
GAS SYSTEM OUTLETS 1.50 �� INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORA
Y Z- fit/ ` O
Lu�-
W
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z
�eQ O�w ,ems �o G3
APPROVALS DATE INSPECT R'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
7-4f-161
TOTAL FEE 1500 GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 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
PLUMBING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES '
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM T LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE SCR E RESIDENTIAL P E Y UTILITY CO NOTIFIED
SIGNATURE /
OF PERMITTEE FINAL 'T
VcKALIDATION ROBERT A WOOD
M CASH SUPERVISING MECHANICAL ENG'R
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APPLICATION FOR PLUMBING, PERMIT
COUNTY OF LOS ANGELES I
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A JENSEN, SUPT OF BUILDING
LOCALITY • ! '
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER 'FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25
BATH TUB 1.25 ADDRESS y�
SHOWER 1.25 5 CITY o TEL. NO----.
LAVATORY 1.25CONTRACTOR S
SINK 1.25 ADDRESS 15
DISHWASHER 1.25 CITYl6
LAUNDRY SUB 1.25
CONTRACTOR' STATE
REGISTRATION NO. S- 6 y COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PROY
WATER HEATER 1.50 �/Q (/F�J�
G 1"50 INDUSTRIAL a
AS SYSTEM OUTLETS
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD U
O
G
W
a
N
Z
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE 3S GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESID NTIAL PROP TY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
Ll
DATION ROBERTA WOOD
cK M O CASH SUPERVISING MECHANICAL ENG R
i�'il;o 2 5: 1 9� JA 9 5 0 3.25- v