HomeMy Public PortalAbout10515 KEY WEST ST_Plumbing__ 7GA667 -CE#817 10-62
APPLICATION FOR PLUMB NG PERMI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER isT
BUILDING AND SAFETY DIVISION BUILDING
JOHN A LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET $125 D MAIL
OWNER S�v �Q
BATH TUB 125 ADDRESS
CITY t`T TEL NO QZ
SHOWER 1.25
2 LAVATORY125 CONTRACTOR T�,fB aS �L!/41,
SINS 1.25 ADDRESS ��/
DISHWASHER 125 CITY TEL NO
ATE JK
LAUNDRY TUB 1 25 REGISTRATION NO. I/ �� COUNTY -
j CLOTHES WASHER 1 25 DISTRICT NO GRO ZONE P O S BY
WATER HEATER 1 50 0 r
GAS SYSTEM - OUTLETS 1 50. INDUSTRIAL 0
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD /f V
wo-
r p,
z
APPROVALS dATE !IPEJ-TOR,, SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING ` T
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF II
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO GAS TEST
RESIDE IN, THE ABOVE SCRIBED R-Sl!?EN7fk PROPER UTILITY CO NOTIFIED
SIGNATURE '
OF PERM ITT
FINAL
VALIDATI�./ ROBERT A WOOD
CK M O CASH SUPERVISING MECHANICAL ENG R
_,
9�O 6AG MG19 '5 D 15.00- 4