HomeMy Public PortalAbout10517 KEY WEST ST_Plumbing__ 76A887-CE#81710.82
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION rNEAREST
LDING
JOHN A LAMBIE, COUNTY ENGINEER DRESS le-5-1 7
WILLIAM A JENSEN, SUP T OF BUILDING CALITY
FOR APPLICANT TO FILL IN 0-1OSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER'�/ !TELNO
WATER CLOSET $1.25MAIL
BATH TUB 125 DDRE N J /SHOWER 125 CITY LAVATORY 125 CONTRACTORSINK 1,25 ADDRESS
DISHWASHER 1.25 CITY
LAUNDRY TUB 1 25 Z CONTRACTOR'S STATE ❑
J REGISTRATION NO COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT NO GROUP ZONE PROCESSED BY
WATER HEATER 150 Ss D—8J A_r 6OLOV iCO•
1 50 INDUSTRIAL
GAS SYSTEM OUTLETS 0
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM 30 INSPECrTION RECORD /l,,, 0
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING l k�
TOTAL FEE 3 GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ,THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITHALL 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 GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBED RESIDE IAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
VALIDATIO ROBERT A WOOD
CK M O CASH SUPERVISING MECHANICAL ENG R
LriCo 3 0 '7 5 G APR Q 5 D 3.25-
Q'
., j