HomeMy Public PortalAbout5624 GRACEWOOD AVE_Plumbing__ 76A6V-CE817-11-57
APPLICATION FOR PLUMBING PE IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION fADDRXSS
UILDING
JOHN A. LAMBIE, County Engineer
CASSATT D. GRIFFIN, Supt of Building OCALITY
FOR APPLICANT TO FILL IN NEAREST w p
NUMBER FIXTURE OR ITEM CROSS ST.
WATER CLOSET OWNERMAIL
BATHTUB ADDRESS
SHOWER CITY `
LAVATORY CONTRACTOR
SINK ADDRESS q
DISHWASHER CITY I&L
NO. 7 Y
CONTRACTOR'S / p �o�� STATE
LAUNDRY TUB
REGISTRATION NO. t7 2 30 COUNTY 11
CLOTHES Em
WASHER DISTRICT NO. GR-OODU'P 707-7
ADY FOR INSPECTION
WATER HEATER /
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
t'p INSPECTION RECORD
APPROVAL
71
@ $1.00 PER ITEM DATE INSPECTOR'S SIGNATURE
OR FIXTURE $ 0
UNDER SLAB WORK
PERMIT S OO ROUGH PLUMBINGif lcfl
TOTAL FEE GAS PIPING 1&r7— !tj"
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES _
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
CE
LINSED AS REQUIRED BY LOS ANGELES OUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGA NER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTI OPER
SIGNATURE
OFPERMITTE Y FINAL t Ci
L;�L ROBERTA.WOOD.
OF VALIDATION SUPERVISING MECHANICALENG'R
CK.
M.0. CASH
Acc E 8 1 IR OCT 2 0 5 A 9.0 0