HomeMy Public PortalAbout6217 LOMA AVE_Plumbing__ 7BA667-CE817&59
APPLICATION FOR R 11MB�C P RMIT
COUNTY OF LOS ANGELES a2 I
DEPARTMENT OF COUNTY ENGINEER 77
BUMDING AND SAFETY DIVISION BUILDING J
Vag
JOHN A. LAMBIE, County Engineer ADDRESS
CASSATT D. GRIFFIN, Supt of Building LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER
WATER CLOSET MAIL
ADDRESS i
BATH TUB
CITY NO.
` SHOWER _
CONTRACTO
LAVATORY
SINS ADDRESS
DISHWASHER CITY TEL. NO. - �J
CONTRACTOR'S STATE
LAUNDRY TUB REGISTRATION NO. COUNTY
a
J CLOTHES WASHER DIST ICT NO GROUP ZONE [;��E
/ WATER HEATER
J GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
d
-2- �� r7/a6, f#7�EST
/)-N T/Z 0215—
//►/L/ lr rf/w o
/ l' QLD I 2Z4
@ 01.00 PER
ITEMOR
RE
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 7100 UNDER SLAB WORK LEl
/l
TOTAL FEE ROUGH PLUMBIN
e GAS PIPING S—
t 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 -12HOT WATER HEATER �
PLUMBING. O
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST ��
CALIFORN[A OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTE
` FINAL O
®r DATION ROBERT A. WOOD,
m,0, C"R SUPERVISING MECHANICAL ENB'R Q
.�o 2 4 7 5 -1 5 D .0 sal ,�