HomeMy Public PortalAbout5216 SERENO DR_Plumbing__ `Z4�- e9�
76A667-CE917 12159
P�
APPLICATION FOR PL MBING PERMIT
COUNTY OF LOS ANGELES
DEPA7j ApNNODrF gCAO�UNTYpENINEER
B�tl�C'L.ATit-giE:EouNn C�'NVVOI1�sNl+falR ADORERS a/G -ref-<'-70
WILLIAM A JENSEN SUP T OF BUILDING
LOC u—
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITHM
OWNER III C✓
WATER CLOSET BOAR
BATH TOB ADDRESS
�OWEH CITY TBI. NO
LAVATORY CONTRACTOR II
�a ADDeBssl 9 So. Crenshaw Blvd
]DISHWASHER CRT TEd. NO.
LAUNDRY TDB acEocrereAnox No 1684 coDIm
t CLOTEM WASHES DI✓STRI[C7 NO O'13(pl1P LANE PR FIaBED BY
WATER HEATER V O ✓"
GAB enmm IRDOSTHIAT.
WASTE APEBOVAL
HTSPECTION RECORD
< F U U
0
oa rimamm s
APPROVALS DATE IN9PE OR 9 SI GIIATURV
PERMIT S OO UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS PPLICATIOM
ARD STATE THAT THE ABOVE 19 CORRECT AND AOR!! TD COMPLY OAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING HOT WATER HEATER
I HEREBY CERTIFY THAT 1 AY PROPERLY REGISTERED AND/OR PLUMBING PIXTURES 17
LICENSED AS NBOUIRED By
LOS ANGELES COUNTY AND STATE OF �S TEST 'GO
CALIFORNIA OR THAT 1 AY THE IB OWBER OP THE ANOVE
DESCRIBED RESIDENTIAL PROPS UTILITY CO NOTIFIED S�
BIGNATUREOP PERM ITT! /(// FINAL 0-07*-to In
0r /- A NATION ROBERT A WOOD,
IS CASH SUPERVISING MECHANICAL ENO R
UC23212 "I' 16 5 D 900 r
I J
76AW7 Ch17 12150
APPLICATI FOR PL MING PERMIT
D 0 OF O ANG
D�Df0 7
J LAMtlI OUNTYRNGNN�Rr :^/ sc
WILLIAM A JENBHN, BurT or BUILDING LOCALRT C/v! //•
FOR APPLICANT TO FRS I RMT a `_
NUMBER FIXTURE OR ITEM OWNBBe
WATER CLOS MAM
DATE TUB DBESD y e
saowER
cRr CO / E`TNo C—'o
LILVATOET CONTRACTOR
MR
DISHWASBER CRY TEL NO
CONTRACTORS A
LAUNDRY TUB REGISTRATION NO COUNTY
016
CLOTBEB WA88H4 D18rTRICT G'-R7O�y'P TJ��.NE P EBB BY
]HEATER
ATER LJ •o y. r/
GAR SYSTEM INDUSTRIAL
WASTE APPROVAL
� INSPECTION RECORD
U
0
EM
OR F=TUE00 FEE EoZ-O'D
s APPROVALS DATE INSPECTOR 931GNATURE
PERMIT S 2 OO UNDER SLAB WORK
TOTAL FEE 0 O ROUGH PLUMBING I/
GAB PIPING ^�
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION i
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAB VENT
WITH ALL
COUNTY ORDINANCES AND RATE LAWS REGULATINGPLUMBING HOT WATER HEATER
1 HERE" CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICERSED AS REQUIRED BY LOS ANGELES CODRTY AND STATE OF GA9 TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIALPROPERTY
UT LITY CO NOTIFI
SIGNATURE /K • /Yj�. !! //���OF
INAL $$$ (,D
®� VN.IDATIOBERT A WOOD.
u B p pup UPERVIBINO MECHANICAL ENG R
UU7SEP 2y 5 D 4C` C i"