HomeMy Public PortalAbout5624 1/2 GRACEWOOD AVE_Plumbing__ 78A667-CE817-11-57,
APPLICATION FOR PLUM IN_ G E IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BUILDING
JOHN A. LAMBIE, CountEngineer ADDRESS
CASSATT D. GRIFFIN, Supt of Buildiag LOCALITY
FOR APPLICANT TO FILL IN NEAREST
NUMBER FIXTURE OR ITEM CROSS ST.
WATER CLOSET OWNER
MAIL
BATH TUB ADDRESS
SHOWER CITY TEL. NO.
LAVATORY CONTRACTOR
,
SINK ADDRESS qL.(
DISHWASHER CITY YTEL. NO. L=D 7 U-vn
CONTRACTOR'S STATE
LAUNDRY TUB REGISTRATION NO. �v� �� COUNTY
CLOTHES WASHER DISTRICT O: GR ONE READY FOR INSPECTION
WATER HEATER J% �A — 1
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
1
APPROVALS
$1.00 PER ITEM DATE INSPECTOR'S SIGNATURE
OR FIXTURE $ 77 490
UNDER SLAB WORK
PERMIT $ 00 ROUGH PLUMBING y'
TOTAL FEE GAS PIPING T
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 /7
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST7 - _
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF -
CALIFORNIA OR THAT I AM THE LEGAL NER OF THE ABOVE UTILITY CO.NOTIFIED /
DESCRIBED RESIDENTIAL PR RTY. -
SIGNATURE
OF PERMITTEE • �Y"- FINAL
ROBERT A.WOOD.
®F VALIDATION SUPERVISING MECHANICALENG'RI
CK. M.0. CASH
I ACo 5 8 8 0 n OCT 2 0 5 A 9.0 v
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