HomeMy Public PortalAbout5943 KAUFFMAN AVE_Plumbing__ 76A667-CE817-8-58
APPLICATION PPLIICATIION FOR PLUMBING PERMIT
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DEPARTMENT OF COUNTY ENGINEER 71 7
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. County Engineer ADDRESS t-5 17
CASSATT D. GRIFFIN,Supt of Building LOCALITY
FOR APPLICANT TO FILL IN NEARE TT. !�
NUMBER FIXTURE OR ITEM
WATER CLOSET OWNERDMIL
BATH TUB ADDRESS —
SHOWER
®O CITY TEL NO.
LAVATORY 0,0 CONTRA OR
SINK t 10 0rADDRESS_
DISHWASHER TEL. NO --0j47
CT S 0STATE
LAUNDRY TUB ISTRA ON NO. l COUNTY ❑
CLOTHES WASHER DISTRICT NO. GROUP ZONE � ..ZWCESSED Bit'
WATER HEATER � .�
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
1'2�'� � 7DZA 4l�il�drip R�ti✓G-�
ell
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Gr9.�R/�i✓c� /I�orFLFCT -Nor✓
APPROVALSG! D
@ $1.00 PER ITEM
OR FIXTURE $ 6 && DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 2100 ROUGH PLUMBING, 2-
TOTAL FEE 1,pv GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT `�
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER 177E7�17dsT1l �F'�
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES r i
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST /�✓ � �6 >/ �fiR"?Dr7Yy � �
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE-OF
CALIFORNIA OR THAT I 'M
THE LEGAL OWNER-OF-THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL ffROPEVY. -
SIGNATURE 2FINAL
OFPERMITTEE
ROBERT A.WOOD.
®P VALIDATION SUPERVISING MECHANICAL ENG'R
CK. M.0. CASH
LAC0 2 4 7 !t SEP 11 1 A 8.0 0