HomeMy Public PortalAbout5478 HILTON AVE_Plumbing__ 76A607LE817 10-60
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION [AZV &ms
UDDING
JOHN A. LAMBIE, COUNTY ENGINEER DDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING 5478 Nil
OCAL Tomale Cit
FOR APPLICANT TO FILL IN EEAA�TT. LS"�
NUMBER FIXTURE OR ITEM WNER '
WATER CLOSET BATH TOB 5478 HiltOn
SHOWER
Cm TEL. NO.
TpmpiA — —
LAVATORY CONTRACTOR
SIIiH ADDRESS
316 W- Valley
DLSHWASHER ° B iel TS' No- At--4--4655
CONTRACTOR'S - STATE
LAUNDRY TUB REGISTRATION NO. 2jjCOUNTY
CLOTHES WASHER DISTRICT NO. GRO SSED BY/
WATER HEATER
GAS SYSTEM INDUSTILLU
WASTE APPROVAL }
WSPECTION BECORD D_
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® $1.00 PER ITEM 51
OR FIXTURE $ / APPROVALS DATE INSPECTORS SIGNATURE
PERMIT $ Z Too UNDER SLAB WORK
TOTAL FEE '}. ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE R6pp TH19 APPLICATION
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY GAS VENT /I
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST I
CALIFORNIA OR HAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED REST NTUL ROPE UTILITY CO. NOTIFIED q
SIGNATURE
OF PERMITTE -
FINAL
07ALMATION ROBERT A!WdOD
cK
M.0. CASH . SUPERVISING MECHANICAL ENG'R
Ao,2,.3 3 7"� ,Ja30 5 D 350-