HomeMy Public PortalAbout5025 WILLMONTE AVE_Plumbing__ V' r~
76A667-CE817 12/59
APPLICATION FOR PLUMBING PERMI_
COUNTY OF LOS ANGELES
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DEPARTN�NT OF COUNTY
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B oIHININGt_AndBIE crTinr ENG NEOERr ADDRE�SSG SO Sr�`ih s rt/!�
WILLIAM A.JENSEN,SUPT OF.BUILDING
LOCALITY T
FOR APPLICANT TO FILL IN NEE�ST. �S
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NUMBER FIXTURE OR ITEM
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OWNER. e.
WATER CLOSET MAIL
BATH TUB ADDRESS
CITY TEL.NO.
SHOWER
LAVATORY CONTRACTOR
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DISHWASHER CITY /If 0NoOdl1` TEL NO.
CONTRACTOR'S STATE
LAUNDRY TUB REGISTRATION NO. 6 COUNTY ❑
CLOTHES WASHER DI��ICT NO Z NE P ES BY
WATER HEATER Ar
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPAQTION RECORD
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J @ $1.00 PER ITEM
OR FD'TIT88 $ I (( D APPROVALS DATE INSPECTOR'S SIGNATUR
PERMIT $ E 00 UNDER SLAB WORK 11-14-00
TOTAL FEE ` �� ROUGH PLUMBING
GAS PIPING \J A
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
I HEREBY CERTIFY THAT .1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST ✓� ''
CALIFORNIA OR THAT i AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIALj!FDPIjff. TILITY CO.NOTIFIED
SIGNATURE 'I
OF PERM!7TE FINAL
�• ALIDATION ROBERT A.WOOD.
X.O. CASH SUPERVISING MECHANICAL ENG'R
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