HomeMy Public PortalAbout5211 PAL MAL AVE_Plumbing__ 76A 97-CE81710-60
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APPLICATION- FOR PLUMBING PERMIT
COUNTY OF'LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BOH AR AMB E CoENTY ENNixE�ER I rADDrmsumDm „L Ij
VIA-
WILLIAM A:,JENSEN, SUPT OF BUILDING
OCAT.ITY
FOR APPLICANT TO FILL IN NEJuIEST
CROSS .
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET =-v: .4
MAIL ,r
SATS TUB ADDRESS
CITY �u L TSL.NO. � : siz o
SHOWER 1 _ •
LAVATORY CONTRACT. �-o-
w SIIdB ADDRESS I' OJI
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DISHWASHER ' CITY TELNO. ,i✓� 5
CONTRACTOR'S STATE El-
LAUNDRY TUB REGISTRATION NO. 1 ! y COUNTY ❑
CLOTHES WASHER DISTRICT NO. I GROUP ZONE,
CESSED.BY
WATER HEATER
GAS SYSTEM ` INDUSTRIAL
WASTE APPROVAL �-
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/U INSPECTION RECORD
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OR F PER xr E
APPROVALS DATE INSPECTOR'S SIONATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING -^ j
TOTAL FEE
GAS PIPING
I 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 r
? PLUMBING. - -
t HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES -
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST I
f CALIFORNIA OR THAT I AM THE LEGAL' OWNER OF THE ABOVE
',. DESCRIBED RESIDENTIAL PR PERTY. UTILITY CO.NOTIFIED J
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SIGNATURE ����
OF PERMITTE
_ - FINAL - t�{��/!•r'' T',.=�':'`lr/
VkLMATZON ROBERT A. WOOD �.
cK.
M.0. CASH SUPERVISING MECHANICAL ENG'R
�3 6 9-”?o FEB 2 3 5 .D 3,0 0
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING ^.
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
WILLIAM A.JENSEN, SUP'T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE OWNER .4L
WATER CLOSET $1.25 MAIL 1� p
BATH TUB 1.25 ADDRESS 7l
o 0
SHOWER 1.25 CITY TEL. NO.
LAVATORY 1, CONTRACTO
SINS 1.25 ADDRESS
DISHWASHER 1.25 CITY TEL.
LAUNDRY TUB 1.25 CONTRACTOR'S ATE [IREGISTRATION NO. CO El
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE PRO ESS BY
WATER HEATER 1.50
GAS SYSTEM OUTLETS 1.50 —Q INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .90 INSPECTION RECORD
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19
D
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to
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY r1
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF �/-
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST IX� r��'�
RESIDE IN,THE ABOVE`SCRIBED RESIDENT ROP RTY. UTILITY CO.NOTIFIED e
SIGNATURE 19 J
OF PERMITTEE FINAL
C/'1VALIDATION ROBERT A(WOOD
M.O. CASH SUPERVISING MECHANICAL ENG'R
/ LAGO 1 3 1. 4 Go FEB 2 5 5 D 3.5 : N
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