HomeMy Public PortalAbout5651 SULTANA AVE_Plumbing__ 70AG67-C E#517115/6.9
*' APPLICATION FOR PLUMIol�j PERMIT
COUNTY OF LOS ANGELES �J
DEPARTMENT OF-COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUiLD1N
JOHN A. LAMBIE, COUNTY ENGINEER I.ADDRESS .J S A.I
WILLIAM.A.JENSEN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN. NEAREST "
CROSS-ST.
NUMBER FIXTURE OR ITEM EACH FEE OWNER
WATER CLOSET $1.25 MAIL
BATH TUB. 1.25 ADDRESS
SHOWER 1.25 CITY TEL. NO.
LAVATORY 1.25 ,r J>' CONTBA.CTOR I
Sr SINS1.25 ADDRESS n le
DISHWASHER -1.25 CITY � A NO.f,4 j '`6 7
CONTRACTOR'S STATE
REGISTRATION NO. COUNTY
LAUNDRY TUB 1.25 ❑
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE P)ROrkESSED BY
WATER HEATER 1.50
i
Z� OUTLETS 1.50 - 0 INDUSTRIAL 1 a
GAS SYSTEM WASTE.APPROVAL O
OUTLETS OVER 5 PER SYSTEM. .80 V
INSPECTION RECORD
I., J2 A
UK-
\4-q . .
A
A llDATA INSPECTO 'S SIGN T RE
PERMIT 5 2 00 UNDE WORK
ROUGH PLUMBING
TOTAL FEE a.,�. . s .1�''w •�A .I
GAS PIPING a�'�Lg"'� 'v
_ 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT _
AND STATE THAT THE ABOVE IS CORRECT AND AGREE.TO COMPLY ,.j
WITH ALL COUNTY ORDINANCES AND STATE LAWS I{EGULATING HOT WATER HEATER "'
PLUMBING. 17�}.
1HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED' AND/OR PLUMBING FIXTURES , �' st'`"� 0"
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF F �.i
CALIFORNIA OR THAT 1 A LEGAL OWNER OF,AND INTEND TO GAS TESTS �'v?F('?F ?�r�
RESIDE IN,TIRE ABOVE D RESIDENTIAL PROPERTY. �'U.TILLITY CO.NOTIFIED s J y_
SIGNATURE
OF PERMITTEE
/ FINAL
f
DATION ROBERT A.WOOD
• cK. M.o. cnsH SUPERVISING MECHANICAL ENG'R
�z8 3';X x;19 5 D .4-225-- v