HomeMy Public PortalAbout10629 OLIVE ST_Plumbing__ 76A607-4=81710-BO
APPLICATION FOR PLUMBING PERMIT �
COUNTY OF LOS' ANGELES
DEPARTMENT OF COUNTY ENG24M
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. L AMBIE. COUNTY ENGINEER. ADDBESS
WILLIAM A. JENSEN, SUIi'T OF BUILDING e
LOCALITY
FOR APPLICANT TO Fi.L IN ' NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM 01AlNF8
2- WATES CLOSET
MAIL .
BATH TUB ADDRESS:
CITY TEL NO.
SHOWER
six LAVATORY CONTRACT
SR$S ADDRESS �.
DISHWASHERCONTBACTOR
LAUNDRY TOB REGISTRATIONNO. u1qTX3 Ry
CLOTHES WASHES DISTRI,rar NO. GROIJ$� ONE P ES�Eq BY
WATER BEATER - V' �\ /
GAS SYSTEM INDUSTRIAL-
WASTE APPROVAL �.
I INSPECTION RECORD / 0
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$1.00 PER ITEM
OR FDCTUBE I 9 d APPROVALS • DATE + INSPECTOR'S SIGNATURE
PERMIT $ 2- 00 UNDER SLAB WORK_
TOTAL FEE AA ROUGH PLUMBING
V. GAS PIPING I�/•v v E;�.�tf•3}a
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
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AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT / j„� fl •�-'/J:'+j
WITH ALL.COUNTY ORDINANCES AND STATE LAWS REGULATING'
PLUMBING.. HOT WATER HEATER ` ,�
I HEREBY CERTIFY THAT 1 AM -PROPERLY REGISTERED AND/OR PLUMBING FIXTURES 9%.29Z6912. T.��VA... .J f
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED
GNATURE RESIDENT' PROP= L UTILITY CO.NOTIFIED , �g�- �,j,�. _,,.�,�„•�y-3y �r'y
SI
OF PERMI
FINAL.
VALIDATION ROBERT A WOOD
CK+ M.o. CAS -SUPERVISING MECHANICAL ENG'R
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