HomeMy Public PortalAbout10258 RANDWICK DR_Plumbing__ 76A687•-CEr 817 5-61•
APPLICATION FOR, PLUMBING PERMIT
COUNTY OF LOS ANGELES . 'fl .
DEPARTMENT OF COUNTY ENGINM
BUILDING AND SAFETY DNLSION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS O a- � -
WILLIAM A. JENSEN, SUPT OF'BUILDING
LOCAL= , L
FOR APPLICANT TO FILL IN NEAREST
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NUMBER FIXTURE OR ITEM OWNER
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WATER CLOSET MAtL
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BATH TOB ADDREBB if
SHOWER CITY TEL NO.
LAVATORY
CONTRACTOR
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SINS ADD
DB3HWASIIER
CITY TEL.NO.
LADNDRY.TOR REG BIRA�TIORN NO. ••1 J+ CpUNTIT
CLOT WASHER DIST C:1'NO. GROUP yy P SED BY
WATER IISATRR
GAS INDUSTEM V
WASTE APPROVAL
INSPECTION RECORD , /► 0
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PERMIT 5 2 00 UNDERL-�A ;WORK
TOTAL FEE ROUGH PLUMBING i f � r r
GAS PIPING 'C/g i%/l IT.
I HEREBY ACKNOWLEDGE THAT•I HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS.VENT !r
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/.OR PLUMBING FIXTURES A
LICENSED AS REQUIRED BY LOS•ANGELES CaUNTY AND STATE OF GAS TEST �,� .,J,/��/,e••1/, d
CALIFORNIA. R THAT I AM TFIE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. o UTILITY CO.NOTIFIED I.5„7 i✓ -,rw.,�.pi
SIGNATURE
OF PERMITTE
FINAL � �'�� •�
A_ LINATION ROBERT A.WOOD
M.o. CASH SUPERVISING MECHANICAL ENO'R
Ao '7 8 1 8% DEC 4• 5D