HomeMy Public PortalAbout10549 LOWER AZUSA RD_Plumbing__ T
76A667-CE817 12/59 TE M 0L V"
- FOR PLUMBING PERMIT
APPLICATfON
` COUNTY OF LOS' ANGELES,
DEPARTMENT OF'COUNTY ENGINEER
BUILDING..AND E,SAFETY IVISION "ADDU L ESs�Q$`+' j �l QSS
JOHN A. LAMBI •, COUNTY NGINEER :
WILLIAM A. JENSEN, SUPT OF'BUiLDiN�. -
LOCALITY
FOR APPLICANT'TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM
OWNER
Alb 16
. WATER CLOSET`.
MAIL`
BATH TUB ADDRESS G3 �e " v/T Q S e ;
CITYTEL. NO. y �D�S
SHOWER
LAVATORY CONTRACTORee
SINS ADDRESS
�.r. DISHWASHER
CITY TEL. NO.
a CONTRACTOR'S STATE ❑
LAUNDRY`TUB REGISTRATION NO. COUNTY ❑
DISTRICT NO. GROUP ZONE
CLOTHES-WASHER ` CESSED BY
WATER HEATER
GAS SYSTEM INDUSTRIAL'
WASTE APPROVAL
INSPECTION.RECORD, w
U
E.O
P.
rn
z
@. $1,00 ER ITEM.
OR FIXTURE $ (�
APFj '."V. LS DATE. INSPECTO 'SS_N NURE
PERMIT: $ 2 00 UNDER WORK � `P/ `
. - TOTAL FEE. n ..
ROUGH PLUMBING yd. ) "11-
ll GAS PIPING �j{8• r r -
I HEREBY -ACKNOWLEDGETHAT 1 HAVE.READ THIS,AP LICATION
AND STATE THAT THE,ABOVE IS.CORRECT AND AGREE'TO COMPLY. GAS VENT
WITH' ALL COUNTY ORDINANCES: ANO.STATE LAWS REGULATING
PLUMBING. - HOT WATER HEATER
. -_ ' r- '
I HEREBY CERTIFY'THAT 7 AM PROPERLY"REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS•.REQUIRED,BY-,LOS ANGELES COUNTY AND STATE QFGASTEST
CALIFORNIA OR`THAT. I AM THE LEGAL OWNER OF THE ABOVE p
DESCRIBED.RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED. / .m_Ffib
'SIGNATURE
OF PERMITTEE.
FINAL �lO�,//A,� . !' ca .°✓'fr"'.f
OF V LIDATION ROBERT AA WOOD. .`.
' ds. m.'o. CASH SUPERVISING MECHANICAL ENG'R
'5- .Q 1 9:OON .a;