HomeMy Public PortalAbout5625 WELLAND AVE_Plumbing__ 76A667-CE#817 2-62
'APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION f
ILDING
JOHN A. LAMBIE. COUNTY ENGINEER DRESS
WILLIAM A.JENSEN, SUPT OF BUILDING CALITY .IZ/Inr
Oc
FOR APPLICANT TO FILL IN Ross sT. ;a �,�r�„ Aa
NUMBER FIXTURE OR ITEM EACH FEE
WATER CLOSET $1.25 OWNER
BATH TUB 1.25 ADDRESS 011V"' r
SHOWER 1.25 CITY , . TEL. NO. N�
LAVATORY 1.25
CONTRACTOR Y
SINS 1.25 ADDRESS r
DISHWASHER 1.25 CITY aq,,,L+Le-f- sfty
TEL.NO.
LAUNDRY TUB 1.25 CONTRACTOR'S
NO. COUNTY ❑
CLOTHES WASHER 1.25 DISTRICT O. GROUP ONE P C SSED BY
WATER HEATER 1.509 J r 0
GAS SYSTEM 3 OUTLETS 1.50 d/ INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .$0 INSPECTION RECORD
d.
i u
99
w
IIL
t z
APPROVALS DATE INSPECTOR'S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
p c ROUGH PLUMBING
TOTAL FEE ./. ✓� GAS PIPING
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE 18 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 •��
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO GAS TEST Y111 pt+
/
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE ^�??L/J
FINAL Ll L;?--
VALIDATION ROBERT A.WOOD .
CK. M.o. cnsH' SUPERVISING MECHANICAL ENG'R
UCO 6463 NOV 5 5 D 3.50N