HomeMy Public PortalAbout6217 KAUFFMAN AVE_Plumbing__ .76A667-CE81712/59 TEMPLE CITY
APPLICATION FOR PLUMBING PERMIT 9
COUNTY OF LOS ANGELES
DEPARTNENT OF COUNTY ENGINEER
BUILDING AND SAFETY 2MSION BUILDING
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JOHN A. LAMBI COUNTY NGINEER ADDRESS �. )
WILLIAM A. JENSEN, SUPT OF BUILDING
- 4 LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET �L
l
BATH TUB ADDRESS_
CITYeU-ITEL NO.
SHOWER
CONTRACTOR
LAVATORY
SINK ADDRESS a
DISHWASHER CITY TEL. NO.
CONTRACTOR'S STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY ❑
CLOTHES WASHER DISTRICT NO. GROUP Z m PR E DBY
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD y
a
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U
1 O"
97� C P fpm S ►2 ► YAG Q W
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-6 31, /" r g z
.� @ $1.00 PER ITEM
5 OR FIXTURE $ 6 0® APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK " N
TOTAL FEE U ROUGH PLUMBINGTt).
GAS PIPING /pV CCXQ J
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
PWITH ALL LUMBING, COUNTY ORDINANCES AND STATE LAWS REGULATING 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 �/ /3'L -/3'�a �0
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE �$
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTE e, &", FINAL "1p
®p VALIDAT19NZ:� ROBERT A. WOOD,
CK. M.0. & c`asB j SUPERVISING MECHANICAL ENG'R �, oA O�
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