HomeMy Public PortalAbout6231 KAUFFMAN AVE_Plumbing__ 76A667-CM17 3-59
APPLICATION FOR PLUMBING PIERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING '?
JOHN A. LAMBIE, County Engineer ADDRESS J
CASSATT D. GRIFFIN, Sup t of Building LOCALITY
FOR APPLICANT TO FILL IN NEARSROSS TT .
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
CITY
40- SHOWER TEL
LAVATORY CONAACTA r
/ SINK ADDRESS
DISHWASHER CITY O TEL NO. 2
CONTRACTOR'S /' STATE
LAUNDRY TUB REGISTRATION NO. / COUNTY
CLOTHES WASHER DISTRICT NO. GROUP ZONE ESSEDBY
WATER HEATER -
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
evtw
I/G/!fl
-"w 0"c � fit%
® $1.00 PER ITEM n /� �y • /
OR FIXTURE $ I 70 APPROVALS DArTEE�.- INSPECTOR'S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK V,
TOTAL FEE Lo) ROUGH PLUMBING 776 -
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT -�
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING. �-
I HEREBY CERTIFY THAT IOANM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES rY
LICENSED AS REQUIRED 8 OS GELES COUNTY AND STATE OF GAS TEST /
CALIFORNIA OR TH LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDEN P Y. ,UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTE
FINAL Z�
OF AUDATION ROBERT A. WOOD,
cK. M.O. CASH SUPERVISING MECHANICAL ENG'R
� 0 3 7 2- 41"',' OCT 5 A9:C fi b)