HomeMy Public PortalAbout4958 SERENO DR_Plumbing__ 7eA"7 CERS17 5/e3
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APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER D
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JoVZGLFmfIE oF�TN]�' DI�II.N4IEON RE ja
WILLIAM A JENSEN SUP T OF BUILDING LGCALTTY
FOR APPLICANT TO FILL IN ME^TgT
CB038 BT
NUMBER FIXTURE OR ITRM EACH P!! OWNS�
WATER CLOSET $115
MAIL /
BATH TUB 145 ADDRESS
SHOWER 175 CYTS TEL NO
I LAVATORY 155 CONTRACTOR
8TH[ 175 ADDRESS
DISHWASHER 175CTTT NO q S
LAUNDRY TUB 145 CONTRACTOR 8 STATE
REGISTRA7 0H NO COUNTY
CLOTHES WASHER 175 DISTRI N Z E P REED BY
WATER HEATER 150 c
so a
GAS SYSTEM—Al—OUTLETS- 1APASTL PROVAL Q
OUTLETS OVER 5 PER SYSTEM 50 INSPECTION RECORD
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APPROVALS DATE imemcpaw• TuR[
PERMIT i E OO UNDER SUB WORK �/
ROUGH PLUMBING I I
TOTAL FEE zg
GAS PIPING
I NEIR[v wcRNowL[DGe THAT 1 HAVE w[AD TNI[ AIFLIUT1oN GAS VENT
AND [TAT[ THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
ITMe NOALL COUNTY ORDINANCES AND STATE Uwe R[auuTlnO HOT WATER HEATER 4
1 HBREIY CLRII FT THAT I AM PROPERLY REGISTERED ANO/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AMD STATE OP
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF D INTEND TO GAS TEST
"SIDE IN THE ABOVE D[SCwu[D RESIDENTIAL PSOP r UTILITY CO NOTIFIED
SIGNATURE
PERMITTEE OF PlRM1TTEE E
FINAL �G
/VALIDATION ROBERT A WOOD
cR/// M o cweH SUPERVISING MECHANICAL ENG R
L,1,o 8 9 5 1� I I,lr 18 5 0 1 1 .2 5