HomeMy Public PortalAbout4915 HELEO AVE_Plumbing__ 76A667-CE0817 9/63 Y�
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY e le C 1ti
1 FOR APPLICANT TO FILL IN NEAREST
CROSS ST. /L
NUMBER FIXTURE OR ITEM EACH FEE
OWNER Bill Knight.WATER CLOSET $1.25
MAIL
BATH TUB 1.25 ADDRESS 1102 Fairview
I CITY Arcadia TEL. NO. L 90
1 SHOWER 1.25 1 2
` 2 LAVATORY 1.25 9
CONTRACTOR Belvedere Plumbing Co.
SINK 1.25 ADDRESS
DISHWASHER 1.25 CITY Yl _ TEL. NO. 1
LAUNDRY TUB 1.25 CONTRACTOR'S STATE El
REGISTRATION NO. COUNTY ❑
1 CLOTHES WASHER 1.25 1DISTRICT NO. GROUPNE P ESSED BY�
WATER HEATER 1.50 -�' e) o
GAS SYSTEM--5_OUTLETS 1.50 INDUSTRIAL
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM .30 u
INSPECTION RECORD
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APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ L16
L25
UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY 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.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES -
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE
INAL
VALIDATION ROBERT A. WOOD
J CK. M.O. CASH SUPERVISING MECHANICAL ENG'R
o" �aJL 6 1 6.') 5 E,.
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