HomeMy Public PortalAbout9210 LEMON AVE_Plumbing__ '76A667-CE817 12/59 TEMPLE
CITY
APPLICATION "FOR PLUM ING ERMIT �
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDINW ES�gTY RMSION BUILDING
JOHN A. 1 OUNTY NGINEER ADDRES
WILLIAM A. JENSEN, SUPT OF BUILDING
- - LOCALITY � r
FOR APPLICANT TO`FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM - OWNER -0
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WATER CLOSETy
BATH TUB ADDRESS
CITY L % TEL. NO. a
SHOWER
CONTRA{ TOA! �f _
LAVATORY
SINS ADDRESS i
DISHWASHER CITY �'� TEL. NO
CON C 'S 9 STATE
LAUNDRY TUB REGISTRA ION NO. ! COUNTY ❑
CLOTHES WASHER DISTRICT N GR ZPPIE ED BY
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WATER HEATER /o J q
GAS SYSTEM _ INDUSTRIAL '
WASTE APPROVAL '
t INSPECTION RECORD
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W
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$1.00 PER ITEM. I D
OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE-H G 141 Cl
GAS PIPING pp I t
1 HEREBY ACKNOWLEDGE THAT F 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 ��� Nit I�f 1� �•��1°c!'�
PLUMBING. _
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES 4 1 '•`J
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE DE° OF•; GAS TEST
CALIFORNIA OR THAT I AM TILEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL OP 7Y.
UTILITY CO.NOTIFIED \ pp -aa 1r
SIGNATURE /��� �_ _� 1 /1 .+D:277 ; 19.f9
OF PERMITTEE 1 + FINAL .� ��
®P VALIDATIROBERT A. WOOD, V
CK. EI.O. CASH SUPERVISING MECHANICAL ENG'R
J.