HomeMy Public PortalAbout5031 WILLMONTE AVE_Plumbing__ 76A667—CE817 12159
APPLICATION FOR PLUMB GPEERMI_
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
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WILLIAM A.JENSEN.SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST-
NUMBER NUMBER FIXTURE OR ITEM
WATER CLOSET OWNERMAIL
BATH TOB ADDRESS
CITY
SHOWER TEL.NO.
LAVATORY CONTRACTOR 6 6
Sm ADDRESS -oeS
DISHWASHER CITY ./)Io Of //TEL. NO. STATE
LAUNDRY TOB REGISTRATION NO. 3 Y COUNTY p
CLOTHES WASHER DISTRI T N GRON PRO S D BY
WATER HEATER I.J l 1.
GAS SYSTEM INDUSTBIAL
WASTE APPROVAL
INSPECTION RECORD
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e 0
- F
V
w
M $1.00 PER ITEM
!� OR FDCTQRE $ ! �O APPROVALS DATE INSPECTOR'S SIGNATU
PERMIT $ p.100 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE
GAS PIPING A.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. HOT WATER HEATER
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES Cop
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBEDRESIDEHTI P R UTILITY CO.NOTIFIED
SIGNATURE
OF PH MITTS
FINAL
®v VALIDATION RBBERT A.WOOD.
M.0. CASH SUPERVISING MECHANICAL ENG'R