HomeMy Public PortalAbout6435 GOLDEN WEST AVE_Plumbing__ Ty
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
I JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY .
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM OWNER /
WATER CLOSET Z,SO MAIL
BATH TUB /� j,s ADDRESS
f CITY TEL NO.
SHOWER ,yJlalley um .AFI.,
.y�(` CONTRACTOR t;
LAVATORY ADD442 QeWOOCf a
SINS / )
DISHWASHER
CITY TEL. NO. Ed b
CONTRACTOR'S _i A ❑
LAUNDRY TUB �, ) S REGISTRATION NO. COUNTY
CLOTHES WASHER ?-�� DISTRICT NO. GROUP I ZONE PROCESSED CBY
WATER HEATER 5, o R I I -
GAS SYSTEM j",ti. "' ,�a INDUSTRIAL V
WASTE APPROVAL
INSPECTION RECORD
0
Q v
W
CL
i/f
Z
@ $1.00 PER ITEM
OR FIXTURE $ U APPROVALS DATE INSPECTOR'S SIGNATURE
� PERMIT $ 200
UNDER SLAB WORK
TOTAL FEE I O ROUGH PLUMBING
GAS PIPING _
1HEREBY 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 HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
BGAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE AOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE y J `
OF PERMITTEE '
FINAL
ALIDATION ROBERT A. WOOD
O. CASH CK.
M. SUPERVISING MECHANICAL C L ENG'R+
1 � 9 5 D 1 8.10 N