HomeMy Public PortalAbout5318 MCCULLOCH AVE_Plumbing__ 7M607-c=81710-60 1/ /
APPLICATION • FOR PLUMBING PERMIT
DEPART TT OF COSUNTY NGGHUM
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY Z. �.
FOR APPLICANT TO FILL IN NEARESTCROSS . r epee'
NUMBER FIXTURE OR ITEM
OWNER C• 0. ��r&I!/U' 6
2- WATER CLOSET mm
J BATS TUB ADDRESS
CITY TEL.NO.
SHOWER
LAVATORY CONTRACTOR. j-Ul 5
SINK ADDRESS . /eepceer"APr
/ CITY . //`�j�`/' TEL.NO. 6
DISHWASHEB [W(FiffY
CONTRACTOR'S STATE
LAUNDRY TUB REGISTRATION NO. AZ 7ef9e COUNTY
CLOTHES WASHER DISTRICT NO. I GROUP ZONE PROCESSED BY
WATER BEATER S F •y- I A'I G Dy Ko
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD ( n'
1 O
pf1 �r---.�y�,?�-=•I.iJ��/ y
42
J •- 'Of
R $1.00 PER ITEM
OR FIXTURE $ 75— APPROVALS /DATE P INNSPPEECTTOOWS SIGNAWRE
PERMIT $ 2100 UNDER SLAB WORK
El
( 6 f
TOTAL FEE ,J?�•��'° ROUGH PLUMBING
GAS.PIPING
P 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
PLUMBING. HOT WATER HEATER _ •/ .
ti •. -
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES .cam
LICENSED A3 REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST 2./ ~�
CALIFORNIA OR THAT 1 AM THE LEGAL OWN R OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED ( -
SIGNATURE
R� OF PERMITTE
FINAL
VALIDATION ROBERT A. WOOD
cK. M.O. CASH SUPERVISING MECHANICAL ENG'R
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