HomeMy Public PortalAbout5620 PAL MAL AVE_Plumbing__ 76A667-CE817 12/59 'L�C
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APPLICATION FOR PLU ING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING iNDEStnTY VIVISION BUIiDTNG
JOHN A. L MBI OUNTY NGINEER ADDRESS L
WILLIAM A. JENSEN. SUPT OF BUILDING
- LOCALITY At.�P L f C / 7-
FOR APPLICANT TO FILL. IN NEAREST
CROSS y O f
NUMBER FIXTURE OR ITEM
OWNERID, !_/ G
WATER CLOSET MAIL
BATH TUB ADDRESS
SHOWER CITY L TEL NO.
LAVATORY CONTRACTOR CIA ti c s ^ V v
SINE ADDRESS ki q7b SoNd
DISHWASHER CITY L, TEL. NO. A a 7
CONTRACTOR' +J 1 0 (1 9 COUNTY ❑
STATE
LAUNDRY TUB REGISTRATION NO. J d V
CLOTHES WASHER DISTRICT N G UP Z NE R D BY
WATER HEATER O l.
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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TAF
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0 SIAO PER ITEM / ��
OR FIXTURE $ ! APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 OO UNDER SLAB WORK
TOTAL F� ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTE FINAL
®� OVALIDATION ROBERT A. WOOD.
cE.
111.0. CASH SUPERVISING MECHANICAL ENG'R
U, ;8703 FEB 23 5 D 3.00 M
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