HomeMy Public PortalAbout4926ALESSANDRO AVE_Plumbing (2) i
DES
I7 7Y2 34 7 APPLICATION FOR PLUMBING PERMIT
DBS
bDIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles BUILDING ] / ^►�
WM J FOX COUNTY ENGINEER ADDRESS '}r &" f „/J t-,)
CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY
FOR/ APPLICANT TO FILL
IN CNEAREST
ROSS ST G�Gu !IS
OWNER (cy//��/�/ /�.� DISTRICT NO GRO O /1 READY FOR INSPECTION
MAIL
ADDRESSINDUSTRIAL
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CITY wV�.� �,/9' TEL NO "I G7'.� / WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS
CITY
TEL NO
LICENSE NO
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) $
BATH TUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO @ 080 APPROVALS
GAS SYSTEM OUTLETS @ 100 DATE INSPERTOR S SIGNATURE
WATER HEATER @ t 00 UNDER SLAB WORK I
ROUGH PLUMBING IZ
PERMIT $ 1 00 GAS PIPING_
TOTAL FEE Q GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ( p
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES l
PLUMBING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY 0 }
SIGNATURE I I µ
OF PERMITTEE �� FINAL �
WILLIAM J FOX COUNTY ENGINEER VALIDATION
_G44161R Jm 7 3 " "" 260 �
BY
O ` DEPUTY
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