HomeMy Public PortalAbout5007 HELEO AVE_Plumbing__ TBA667-CE#817 10-62 75M ALE c- r
APPLICATION FOR PLUMBING. PERMIT
COUNTY OF LOSANGELES
DEPARTMENT OF COUNTY ENGINEER' UILDING
BUILDING AND SAFETY DIVISION 'ADDRESS n
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS ^� O
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY _
FS
OR APPLICANT TO FILL IN NEAREST
CROSS ST. O 3
FIXTURE OR ITEM EACH FEE
OWNER '
R.CLOSET $1.25. •�. MAIL '
TUB 1,25 ADDRESSER 1.25 r CITY TEL. NO.
TORY-_ 1.25 /i CONTRACT R`1,25 V ADDRESSASHER . 1,25 C[iY TEL. NO ���
RY TUB 125 CONTRACTOR'B �J C COSTATE [31
UNTY ❑REGISTRATION NO. �`l JES WASHER 125 DISTRICT NO. ORO P Z�ONE PROC 5 D BY
R HEATER 1.50. ' () Fl VYSTEMOUTLETS 1`50 (� INDUSTRIALOWASTE.APPROVAL
ETS OVER 5 PEA SYSTEM .90 U
/ INSPECTION RECORD
,A4y , mt. o
v IF -
APPROVALS (J RATE `INSFECTOR'SS11A� E
PERMIT $ -2 00 UNDER SLAB WORK _ rj �j3
ROUGH PLUMBING
TOTAL FEE '.r
GAS PIPING
I HEREBY THAT
TH LEDGE THAT O REC READ THIS A O CO ON
AND STATE THAT THE ABOVE IS CORRECT AND AGREE E COMPLY _GAS VENT
WITH' ALL coueTr oaolNAvcEs AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING,-
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AHD/o. PLUMBING FIXTURES L'LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OFGAS TEST �?
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN• THE ABOVt DESCRIBED RESIDENTIAL PROPERTY. UTILITY Co,NOTIFIED ///
SIGNATURE
OF PERMITTEE FINAL
ALIDAB
TION ROBERT A. WOOD•
�rc. M,o. CASH SUPERVISING MECHANICAL ENG'R
LI
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