HomeMy Public PortalAbout5135 SULTANA AVE_Plumbing__ TSA 667-C Elb1T 10-S9
APPLICATION FOR PLUMBI�RMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUDDING AND SAFETY DZWSION CUMIN
JO N A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OP BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
NUMBER FIXTURE OR ITEM EACH PEE r CROSS ITT 'UL41-t
OWNER
WATER CLOSET $125 J O
MAIC
' BATH TOB 125 ADDRESS
' SHOWER 12S o� cCITY TEL NNSOT LAVATORY 125 3 7 CONTRACTOR
I SIN[ 125 YJ ADDRESS �s LlDISHWASHER 125 CITY TEELL NwyTOR 5
LJLUNDRY TUB _ 125 REGI RATION NO d
CLOTHES WASHER 125 pl RICT y�,� G P 2 N F O BY
WATER HEATER 1 50 / Q U{�
CAS SYSTEM OUTLETS 150 0 1NDUSTBIAL R�
WASTE APPROVAL s
OUTLETS OVER 5 PER SYSTEM .50
INSPECTION RECORD V
A o
8 .4I
1 A LS ATE nBP[CTOR
PERMIT S 2 00 UNDER WORK //V/43..
6 ROUGH PLUMBING
TOTAL FEE K
GAS PIPING K
I HCRmY ACKNOWL[DG[ TNAT I HAVE READ TNI[ AIPLIGTIOj
GAS VENT
AND STATE THAT THC AYOVC 1[ CORRECT AND AOR[[ TO COMP
Wrt ALL COUNTY ORDINANC[[ AND STATE LAWS REGGLATInHOT WATER HEATER
PLUMBING
I HCRCOY CERTIFY THAT 1 AM PROPERLY R[OIBT[R!O AHO/OPLUM BiNG FIXTURES
LIC[NOED AS REOUIR[O BY LO[ ANGELES COUNTY AND STATE V-Ag TESTGLIFONNIA OR THAT I AM TME L[OAL OWN[R OP AMO IMfIM T
wIG[ IN THE ARD B[D "SIDENTIAL PRDIRT1 UTILITY CO NOTIFIED
SIGNATURE /\ l Vl
OF PERMITTEE
FINAL 7
/VIALIDATION ROBERT A WOOD
cK M o GSH SUPERVISING MECHANICAL ENG R
L&LD7 7 5 1Q JAN 21 5 D 16.25-
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