HomeMy Public PortalAbout5105 PAL MAL AVE_Plumbing__ ILI
76X667-CE817 Mo
APPLICATION F R PLUMBING PERMIT �
DEPARRMT OF COUNTY ENGINEER .q
BUILDING
JO HNIA. LAMBIE.COUNTY ENGINEERTY BMLDDIG
ADDRESS V ����- r�is' ���� C
WILLIAM A.JENSEN.SUPT OF BUILDING
LOCALITY f`'`/..'�vf�'l'r%
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET
ADDRESS
DATE TUB DRESS
-
�_
clrr .,•f- TEL.NO.
SHOWER
LAVATORY CONTRACTOR .� '
SiNB ADDRESS t:c
DISHWASHER CITYt°/,t'arv�c� TEL NO. 6X 3-%&`/e
CONTRACTOR'S c STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY
CLOTHES WASHER DJTRI GRO ZONE R BY
WATER HEATER
GAS SYSTEM INDUSTEIAI.
WASTE APPROVAL
DWECTION RECORD
0
v
as
0
6 $1.00 PER ITEM
OR FEKTUME APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ Z 00 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING .�
GAS PIPING �"•,if /
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT t
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER-HEATER
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 OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE i
OF PERMITTEE
FINAL
VALIDATION ROBERT A.WOOD,
Gam- M.0. OAW SUPERVISING MECHANICAL ENG'R
U t o 3 6 9 5 D 3.0 0 t
MM67-CE617 NO
APPLICATION FOR PLUMBI G PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION BuuDmIG
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A.JENSEN.SUPT OR BUILDING ,
LOCALITY
FOR APPLICANT TO FILL IN lt�, d
NUMBER FIXTURE OR ITEM
OWNER'
WATER CLOSET MAIL ,
BATH TUB ADDRESS
CITY TEL.NO.
SHOWER
LAVATORY CONTRACTOR
SII18 ADDRESS
DISHWASHER CITY TEL. NO 3577..8
CONTRACTOR'S ����® STATE ❑
LAUNDRY TUB REGISTRATION NO. OJ� COUNTY
CLOTHES WASIHER DISTRICT NO. GRO'P ZONE P O I Y
WATER HEATER 15-109,
GAS SYSTEM IIMUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
0
w -
- o
N
8> $ `
APPROVALS' DATE INSPECTOR'S SIGNATURE
PERMIT $La
UNDER.SLAB WORK
TOTAL FEE ROUGH PLUMBING +'
GAS PIPING /
[AND
EREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT r�7�`21'"J Ann E 1 �:�_�
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ALL COUNTY ORDINANCES AND 87ATE LAW8 REGULATING HOT WATER HEATERBING.
EREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES IJJI��& f 1r�NSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OFGAS TESTFORNIA OR THAT 1 AN THE LEGAL OWNER OF THE ABOVERIBED RESIDENTI L PROPERTY. UTILITY'CO.NOTIFIED / WIii F..+• .rATURE PERMITTE
FINAL 7� ..
®r VALIDATION ROBERT A.WOOD. `
cs. M.0. CAsu SUPERVISING MECHANICAL.ENG'R
(o 5 0 6 8ZOE' A°11 7 5 D 9.c 0