HomeMy Public PortalAbout4846 HELEO AVE_Plumbing__ 12,
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76A667-CE817 6-60
IT
APPLICATION FOR PLU BING PE, IT
DEPARTMENT OF COUNTY ENGINEER -
BUILDING AND SAFETY DIVISION BUILDING
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 MAIL
4
BATH TUB ADDRESS
SHOWER `
CITY TEL.
r.
CONTRACT
LAVATORY
SINS ADDRF�S t W
_{ DISHWASHER CITY TEL NO.
CON C OR'S � ATE If .` :
LAUNDRY TUB REGISTRATION NO. bUr 19 COUNTY
r '
CLOTHES WASHER DISTRICT NO T
P XE 7PRES BY F
WATER HEATER c 0 !/{% �
GAS SYSTEM INDUSTRIAL
h, WASTE APPROVAL
' INSPECTION RECORD
a
V
0
F
U
W
a
' r
$1.00 PER ITEM
OR FIXTURE $ I APPROVALS DATE INSPF,q�TOR'S§IGNATURE
PERMIT $, 2 00 UNDER SLAB WORK / `"
P I I TOTAL FEE I�I0V 1-1 ROUGH PLUMBING y
GAS PIPING {
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION I:
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLYGAS VENT t/`Gd
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING r;, 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 GAS TEST
�d CALIFORNIA OR THAT I AM THE LEGAL OWNE OF THE ABOVE
y, DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE . n 7 fl I�
OF PERMITTE +
FINAL
®P VALIDATIO ROBERT A. WOOD,
CK. IJ.O. CASN SUPERVISING MECHANICAL ENG-Ft
US` 4 9 8 9 AR 6 5 U 9.0 0
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76A667-CE817 6-60
APPLICATION ICOR PLU BIND PE, IT
DEPARTMENT
BUILDING AND COUNTY
ER BUILDING
COUNTY OF LOS ANGELES
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS � t .
WILLIAM A. JENSEN.SUPT OF BUILDING
_ ,� � LOCALITY
sm �:
FOR APPLICANT TO FILL IN NEARES
CROsssT
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET tADDR
BATH TUB c
TEL. NO.A7
SHOWER
_
LAVATORY "
SINS r J y
DISHWASHER �( TEL. NO.
OR'S ATE Wl
LAUNDRY TUB REGISTRATION NO. �J(Is Gry COUNTY
CLOTHES WASHER DISTRICT NO. GR2WP TF PR E S BY
WATER HEATER t L a
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
a
0
U
a
0
H
U
W
a
rn
r
0 $1.00 PER ITEM I 7
a OR FIXTURE $ APPROVALS //DATE INSPECTOR'S SIGNATURE r
UNDER SLAB WORK
PERMIT $ 2100-H
TOTAL FEE ROUGH PLUMBING
GAS PIPING I pI
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 ;.
PLUMBING. HOT WATER HEATER r+ ��
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR i; PLUMBING FIXTURES �� ��t'n c 4
„y LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF '= GAS TEST J/!i l�
a CALIFORNIA OR THAT 1 AM THE LEGAL OWN OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. _ F: UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTE ✓ i ' �;
FINAL
Or VALIDATION ROBERT A. WOOD,
cK. M.o. GASB SUPERVISING MECHANICAL ENG'R
Ulf" 4 9 8 9 AFP% 6 7 D 9.013
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