HomeMy Public PortalAbout4846 HALLOWELL AVE_Plumbing__ 76A667-CE#847 6-65
APPLICATION FOR PLUM ING PER IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING `'�J
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS b /
COLEMAN W JENKINS, SUPT OF BUILDING
LOCALITY ro In
FOR APPLICANT TO FILL IN NEAREST
cxosS ST. o w —IZ A z S R
NUMBER FIXTURE OR ITEM EACH FEE / J
-OWNER
WATER CLOSET $1.25 MAIL /
BATH TUB 1.25 ADDRESS y S L L D Gl! L G, S
SHOWER 1.25 CITY �In / 4 1,-: C 1 T TEL. NO. 7 7
LAVATORY 1.25 CONTRACTOR
SINS 1.7.5 ADDRESS
DISHWASHER 1.25 CITY TEL. NO.
STATE LIC
LAUNDRY TUB 1.25 LICENSE NO. CLASS
CLOTHES WASHER 1.25 DISTRIICCT NA.i GR Z N P OC BY
WATER HEATER 1.507
(JY
GAS SYSTEM OUTLETS 1'50 WASTEP APPROVAL 0
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD V
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APPROVALS DATE INSP TOR'S SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK O r
ROUGH PLUMBING I
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING A
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST ZIP 6
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN, THE ABOVE DES BED RE DENTI L PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE
FINAL
ALIDATION
M'O CASH
x;11,0 1 9 7 9- mAY 12 5 D 5.7 5