HomeMy Public PortalAbout5423 WELLAND AVE_Plumbing__ 76A667-CE817 6-60
APPLICATION OR. PL MI3I G PERMIT
OF LOS ANGELES Z Z--
DEPCOUNTY
ARTIVlENT OF COUNTY ENGIlVEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
WILLIAM A.JENSEN.SUP-T OF BUILDING
LOCALITYLa
FOR APPLICANT TO FELL IN NEAREST `
CROSS ST.
NUMBER FIXTURE OR ITEM OWNS
WATER CLOSET SIL
BATH TOB ADDRESS '
CITY TEL.NO.
SHOWER
LAVATORY CON7RACTORAlert Plbs & Htg
anus ADDRESS '13933 S,
Crenshom Blvd
DISHWASHER crff Aawthome rte N0. OS, 9-3691-
CONTRACTOR'S STAVE
LAUNDRY TUB REGISTRATION NO. 193617 0-36 COUNTY.
CLOTHES WASHER DISTgIC NO. GROUP ZONE I PROCESSED BY
WATER HEATER ��OO// QI Aft
(`/ Lr
GAS SYSTEM INDOSTRULL
WASTE APPROVAL
DISPECTION RECORD
G PER ITEM
OS FDa RE $ I 7 (t0
APPROVALS DATE,
,1NSP C�TOR'S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK 4c, /r.i
TOTAL FEE o ROUGH PLUMBING 40L,4691
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS.VENT
AND 87ATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER i.
I HEREBY It
THAT I AM PROPERLY REGISTERED AND/OR 'PLUMBING FIXTURES
LICENSED AS REQUIRED BY 108 ANGELES COUNTY AND STATE OF GAS TEST I.
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE, ABOVE
DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED a w Q'Jf9-
SIGNATURE i 7A
OF PERMITTE FINAL
�v Al ATION ROBERT A.WOOD.
M.0. CARR SUPERVISING MECHANICAL ENG'R