HomeMy Public PortalAbout5616 MCCULLOCH AVE_Plumbing__ 76A607-CE9171.6
APPLICATION - FOR PLUMBING PERMIT'. .
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY -ENGINEER _
BUILDING AND SAFETY DMSION , BUILDING -112
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS `fit �� _
WILLIAM A. JENSEN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST. .
NUMBER FIXTURE OR ITEM OWNER ,
WATER CLOSET
RATE TUR ADDRESS
CITY TSL.NO.
SHOWER
LAVATORY CONTRACTOR
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SINS, ADDRESS f f---
DLSHWAmm cnrr 17TEL.NO:
CONT CTOR'S. STATE
LAUNDRY TUR REGISTRATION NO. �� COUNTY
CLOTHES WASHER DISTRICT NO. GROUP ZONE CE88ED BY
WATER MATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
/ INSPECTION RECORD O
S $1.00 PER ITEM I ..., _
OR FmTURE - $ APPROVALS DATE -INSPEcTO SSIGNATURE
PERMIT $ 2 [09 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING / 7�J: ;°fir* ".,..f•,- ^
GAS PIPING
1 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 HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES •
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND-STATE OF GAS TEST 1 �^' f„j.•
CALIFORNIA OR THAT 1 AM THE LEGA WNER OF THE ABOVE /
DESCRIBED RESIDENTIAL,PROP 1 UTILITY CO.NOTIFIED f �/) .I _zVi�fi''%Y.
SIGNATURE lrAA��i� y d 17, 1 ^ '
OF PERMITTE ...J/// `y
FINAL
VALMATION. ROBERT A. WOOD
M.o. CASH SUPERVISING MECHANICAL ENG-Ft.
� �., 2. 825 SEP 20 5 D 11 .00 Ir