HomeMy Public PortalAbout6258 GOLDEN WEST AVE_Plumbing__ 7GA667-CE#6174-64 v ,
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER y�
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS �/� LGA •
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
3
WATER CLOSET $1.25 MAIL
�` BATH TUB 1,25 ADDRESS
SHOWER 1.25 CITY TEL. NO. f 16
LAVATORY 1.25 CONTRACTOR
SINK 1.25 ADDRESS
DISHWASHER 1.25 CITY TEL. NO.CONS Q—s-tia�
LAUNDRY TUB 1.25 REGISTRATION NO. COUNTY CT:)R'S STATE 0
CLOTHES WASHER 1.25 DISTRICT NO. GRPUP ZONE C SSED BY
WATER HEATER 1.50 ✓
GAS SYSTEM�OUTLETS 1'50 INDUSTRIAL n
WASTE APPROVAL O
—4—iOUTLETS OVER S PER SYSTEM .30
INSPECTION RECORD
U
e W
P d
h C7 A ..1�' tL- E {-' �A. Z
n `
APP V S PATIE INSPECTOR'S SIGNATU E
PERMIT S 2 00 UNDER WORK (rj
ROUGH PLUMBING )
TOTAL FEE G GAS PIPING ry
1 HEREBYACKNOWLEDGE THAT 1 HAVE READ THIS PPLICAT10N GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
LRESIDE
s
CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURESS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
OR THAT i AM THE LEGAL OWNER OF,AND INTEND TO GAS TESTHE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED 4E
ITTEE FINAL
VALIDATION ROBERT A. WOOD
CK. M.O. CASH SUPERVISING MECHANICAL ENG'R