HomeMy Public PortalAbout6271 GOLDEN WEST AVE_Plumbing__ 76A667-CE617 12/59 u
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY RIVISION BUILDING f / '
JOHN A. LAMBIE. COUNTY NGINEER
WILLIAM A. JENSEN, SUPT of BUILDING
LOCALITY i1 i
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET `
AD
IL
BATH TUB DRESS
SHOWER CITY TEL. NO —io y—f
LAVATORY CONTRA ll �L
SINK ADDRESS
DISHWASHER CITY ' CyIEI TEL. NO.
CON OR'S > STATE
LAUNDRY TUB REGISTRATION NO. A COUNTY ❑
CLOTHES WASHER DISTRICT NO. q2ROUP ZONE
WZ
BY
WATER HEATER �
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
w
0
U
14
0
F
U
W
a
z
$1.00 PER ITEM I �' ✓
OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE 114,-z. ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 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
PR
CALIFORNIA OR THAT 1 AM T LEGAL OWNER OF HE ABOVE
DESCRIBED RESIDEN TIA OP TY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERM IT. FINAL
Mimi
Or VALIDATI ROBERT A. WOOD,
cK. Y.O. (c ASH UPERVISING MECHANICAL ENG'R