HomeMy Public PortalAbout5427 WELLAND AVE_Plumbing__ 76A667-CE817 12/59TEMIr"LE ITV
APPLICATION FOR PLUMBING ,E - MIT QI
COUNTY OF LOS ANGELES �`
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A. JENSEN, SUa•T OF BUILDING
LOCALITY E =:/
FOR APPLICANT TO FILL IN NEAREST
NUMBER
NUMBER FIXTURE OR ITEM CROOWNER �/�L.
WATER CLOSET MAIL
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BATH TUB ADDRESS v !/c
CITY t�D TEL. NO.
SHOWER
LAVATORY CONTRACTOR
SINK ADDRESS ld
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DISHWASHER CITY TEL. NO.
CONTRACTOR'S STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY ❑
CLOTHES WASHER DISTRICT NO. GMT! ZONE PROCESSED BY
WATER HEATER
GAS SYSTEM INDUSTRIAL f
WASTE APPROVAL w
INSPECTION RECORD O
U
W
O
a
F
$1.00 PER ITEM I '
OR FIXTURE $ APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. 1 / UTILITY CO.NOTIFIED
SIGNATURE r/(� �a 1j�//1! 1
OF PERMITTEE i w/�i[�
FINAL
OF VALIDATIO ROBERT A. WOOD,
:ECIC. M.O. SUPERVISING MECHANICAL ENG'R
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7US67-CE817 6-60 L�j 1 11
APPLICATION R PLUMBING PE I`I' �
COUNTY OF LOS ANGELES � '
DEPARTMENT OF COUNTY ENGINEER
$JOH�NIA. LAMB E.SAFETY
OUNTY ENGINEER ON ADDH K a•7 t
WILLIAM A.JENSEN.SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO RM IN
OWL e
.4 7711
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET MAIL
BATH TUB
ADDRESS ;
CITY TEL NO.
SHOWER
LAVATORY CONTRACTOR
SINS ADDRESS
DISHWASHER CITY Hawthorne TEL. NO. OS 9-3691 :
TTE
LAUNDRY TOB REGISTRACTION NO. 193617 C-36 cODUNATTY D
CLOTHES WASHER DISTRICT NO. GROUP ZONE I PRO SED BY
WATER HEATER D O
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD '
,+ /'
1i / L'_w r .,. .a. V
r' i.j �. '�C/ ,.•1�.+/ t - -ems---'.:7i'-- i• a
Q
oil
$
7 " APPROVALS DATEa INSPECTOR'S SIGNATURE
PERMIT $ a 00 UNDER SLAB WORK
TOTAL FEE ROUGH PLUMBING
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
HOT WATER HEATER A�� V`'
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I M THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTI P PERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMiRE AL IRI7i2 �• ,.1fa�/f
�. VALIDATION ROBERT A.WOOD,
M.O. am SUPERVISING MECHANICAL ENG'R
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