HomeMy Public PortalAbout6403 LOMA AVE_Plumbing__ 76A6W-CE817 6-60
APPLICATION FOR PLUMBING PERM
DEPARTMENT OF COUNTYGENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS O O /A-
WILLIAM A. JENSEN, SUP'T OF BUILDING LOCALITY ,r `
Ci FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM OWNER
RA E &a-i- -
WATER CLOSET MAIL
ADDRESS
BATH TUB
CITY TEL NO.
SHOWER
LAVATORY CONTRACTOR C OG L
SINS ADDRESS SG PJ G 3
DISHWASHER CITY / TEL NO.
CONTRACTOR'S j STATE Y]
LAUNDRY TUB REGISTRATION NO. COUNTY
CLOTHES WASHER DISTRII��CT G OUP ZONE PR ES BY
WATER HEATER / (;
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
� INSPECTION RECORD
7.
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@ $1.00 PER ITEM �q�Q
/ OR FIXTURE $ I /",go, APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE I 1100 ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 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
PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM T LEGAL WNER OF THE ABOVE
DESCRIBED RESIDENTIAL PRO Y UTILITY CO. NOTIFIED
SIGNATURE i t n
OF PERMIT' FINAL J-SIJ Y \iW+��SL9Sd
Or VALIDATION ROBERT A. WOOD,
c[.
111.0. "Sit SUPERVISING MECHANICAL ENG'R
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807 I D 3