HomeMy Public PortalAbout6640 OAK AVE_Plumbing__ tSA667-CE919 12/59
APPLICATION FOR PLUM INCA PERMIT
COUNTY OF LOS ANGELES
DEPARTNffiNT OF COUNTY ENGINEER ADDR ss
BTILDIIVAID SAFETY1ViSION D T C.
OHN A. 1 COUNTY NGINEEB
WILLIAM A.JENSEN,Sy IT of HutIDINa LOCALITY �� p r
FOR APPLICANT TO FILL IN NEAR
NEEREST CE � G
NUMBER FIXTURE OR ITEM
WATER CLOSET OWNER
WRE.SS
SATS TOB
SHOWER CITE'�Z:lh Pfd ')-73m.No.#/
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LAVATORY CONTRACTOR
Sm ADDRESS
DISHWASHER CITY TEL. NO.
CONTRACTOR'S STATE ❑
LAUNDRY TOB REGISTRATION NO. COUNTY ❑
/ CLOTHES WASHER DISTRIC/}NO GRGUP NE PIPCESSED BY
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE.APPROVAL
INSPECTION RECORD
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LUG 246610 07- LEE
7o eha��p�
/ oV 0 $'.00 PSP 1 I /oZ . 12--2,3-go 4,k
1
APPROVA ZOQ,0 DATE INSPECTOR'S SIGNATURE
PERMIT $ 00 UNDER.S WORK7-ZS-/N)
TOTAL FEE I G� ROUGH PLUMBING-1;r).
2 --t
GAS PIPING
1
AN HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
ASTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY y
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER O' '
PLUMBING. �.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER 0 THE ABOVE
DESCRIBED RESIDE TIAL PROPERTY. (�
� UTILITYCO.NOTIFIED
SIGNATURE
OF PERMITiE I
FINAL (a / �Q
5F 0ATION ROBERT A.WOOD,
• CE.
M.0. CASA SUPERVISING MECHANICAL ENG'R
[� 3 9 9 8 ,IUL 5 5 D 1 4.0 0 y"