HomeMy Public PortalAbout5520 MCCULLOCH AVE_Plumbing__ 78A 867•C E#817 5/63
APPLICATION FOR PLUMBI G PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION4ADI DIN
JOHN A. LAMBIE. COUNTY ENGINEER
7
WILLIAM A.JENSEN, SUPT OF BUILDING
LOCALITY �� L
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
'OWNER
WATER CLOSET $1ct
.25 MAIL
BATH TUB 1.25 ADDRESS (/ 46 ^
r SHOWER 1.25 Z CITY I , TEL. NO. -
Z. LAVATORY 1.25 f O 'CONTRACTOR u L !-
SINS 1.25 Z ADDRESS
DISHWASHER 1.25 CITY - r-cpptAla TEL. NO..
CONTRACTOR S STATE
LAUNDRY TUB 1.25 REGISTRATION NO. C_ COUNTY
CLOTHES WASHER 1.25 DISTRICT N GRO ONE P OCE D Y
WATER HEATER 1.50 Q
a
GAS SYSTEMa OUTLETS LoWASTE INDUSTRIAL
0
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD
w
o.
u(g) OL z
APPROVALS LZAIJE INSPECTOR'S NATURE
PERMIT $ 2 00 UNDER SLAB WORK f ,
ROUGH PLUMBING !J
TOTAL FEE S- O GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 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
PLUMBING. ?: HOT WATER HEATER
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST 'Zj^'L.�-
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO ,
RESIDE IN,THE ASO CRIBED RESIDENTIAL PROP r. UTILITY CO.NOTIFIED -?�Q.-((�.
SIGNATURE
OF PERMITTEE
FINAL
VALIDATION ROBERT A.WOOD
CK. M.O. CASH SUPERVISING MECHANICAL ENG'R
L&2 5 4 3- NOV 13 - 5 D 15.0 0-