HomeMy Public PortalAbout5729 ROWLAND AVE_Plumbing__ 76AV7-Co'kE817-l2 59
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APPLICATION. FOR PLUMBING PERMIT.
COUNTY OF LOS ANGELES .
DEPARTMENT OFCOUNTY�ENGINEER
B a.�ArT1TY,r 1�HVGIISNIEON BUILDING S 7
WILLIAM A.JENSEN.SUPT OF BUILDING
II7 "O��a�wV
FOR APPLICANT TO FILL IN cRo E s. j,,'.";
NUMBER FIXTURE OR ITEM
OWNER P •,.�3.
WATER CLOSET
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IL
BATH TUR ADDRESS Z--?s- /
CITY1 T I-a*(,
SHOWER C y(� TEL.NO.
LAVATORY CONTRACTOR Is
d.ev-y.sL�
S>HS ADDRESS
DISHWASHER CITY TEL NO.
CONTRACTOR'S STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY ❑
CLOS WAR DISTRICT NO. GROUPlo-pm P ESSEDBY
WATER HEATER O \
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL_
INSPECTION RECORD y,
P.
O
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3- T , H
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W OROPER ITM
FIXTIJ88 $
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
TOTAL FEE I / I ROUGH PLUMBING
`ry GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AAD/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 PERT\ UTILITY CO.NOTIFIED
SIGNATURE yy� I
OF PERMI FINAL375-67
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�P VALIDATION ROBERT A.WOOD.
cK. M•.0. : �F SUPERVISING MECHANICAL ENG'R
LA" Q 7 1 $ a JAN 5 5 D 6.0 0 0