HomeMy Public PortalAbout5204 WILLMONTE AVE_Plumbing__ "19 TANT OF MMMING AM BAMY APPLICATION FOR PST
COUNTY OF LOB A PLUMBING
WILLIAM J. FOX. CHIEF ENGINRRR
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMrr NO.
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APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADDR BUILDING
ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER
CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
4 CROSS ST. 1 I c
NUMBERFIXTURE OR ITEM
WATER CLOSET
OWNER
BATH TUB ADDREs .PV �9d /
SHOWER CITY ® . TEL:NO.
LAVATORY CONTRACTOR Ed(a/ .,rAC:4-S �gilNj�9li G
SINK ADDRESS'S JV , Vj A —t—
DISHWASHER CITY TEL.NO.'s Y
LAUNDRY TUB CONTRACTOR'S .may a� STATE
REGISTRATION NO. / J ® COUNTY ❑
CLOTHES WASHER
.DISTRICT NO. GROUP ZONE READY FOR-INSPECTION
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
' fAa
:I
APPROVALS
�y @ $1.00 PER ITEM IYATF. IN%UXJDJCS SIGNATURE
OR FIXTURE $ UNDER SLAB WORK
PERMIT 6 1106
ROUGH PLUMBING
-
- GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THA;7I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATELAWS REGULATING .PLUMBING FIXTURES
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TESTI
LICENSED AS REQUIRED LOS ANGELES UNTY AND STATE OF
CALIFORNIA OR THAT M THE GA NER OF THE ABOVE UTILITY CO. NOTIFIED
DESCRIBED RESIDEN ROPER
SIGNATURE 1
OF PERM ITTE FINAL
QDS - VALIDATION ROBERT A. OOD,
SUPERVISING MECHANICAL ENG'R
CR M.0. CASH
L&2.4059 JN30 5 A 3.00 1