HomeMy Public PortalAbout5832 OAK AVE_Plumbing__ 76AGG7 CE9817 9/63
APPLICATION FOR PLU ING PER T
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DMSION
JOHN A LAM IE COUNTY ENGINEER ADDRESS r
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET 812S
BATH TUB 12S ADDRESS '
SHOWER 125 CITY TEL NO 4• f_f1l
LAVATORY 125 CONTRAC
SINK 125 ADDRESS
DISHWASHER 125 CITYCT STATE
LAUNDRY TUB 125 REGISTRAT NO COUNTY ❑
CLOTHES WASHER 125 DISTRICT NO WE PR
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WATER HEATER ISO
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GAS SYSTEM OUTLETS 150 INDUSTRIALWASTE APPROVAL 0
OUTLETS OVER S PER SYSTEM 90 INSPECTION RECORD U
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APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING y�
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT y
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER i
3 ..A
I NERENY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES PN
LICENSED AS REQUIRED LOS NGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 11 LEGAL OWNER OF AND INTEND TO GAS TEST
RESIDE IN THE ABOVE SCRI D RESIDENT AL PRO Y UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTE FINAL 11) pi
VALIDATISOBERT A WOOD
CK M o �CAS �UPERVISING MECHANICAL ENG R
LAAO 3 6 8 74 M 15 5 U 3 5 0 N r