HomeMy Public PortalAbout5102 CAMELLIA AVE_Plumbing__ DffiPAST2EENT OF COUNTY 3F.N(3NFWR
PLUMBING 1
y DIVISION OF HUMDING AND SAFETY PERMIT APPLICATION
COUNTY OF IAS AN(IFA, t
WILLIAM J. FT
OX, COUNTY ENOINECR ADDRESS
FOR APPLICANT TO HLL IN LOCALITY = .o
BUILDING NEAREST
ADDRESS CROSS ST.
D""IOT NO. GROUP ZOYE PERMIT NO.
LOCALITY � x�
NEAREST ✓
CROSS ST. R IVSD BY Bea1r for I SU
�■ DATE ISED
OWNER J-
�
PAIL �\ /� DUSTRIA
ADORERS ��V L" WAST[APP A
TEL N0. INSPECTION RECORD
PLUMBER G/V
ADDRESS
CITY TEL NO.
El ATS
LICENSE NO. F1 000KTY J
PEl= FEES Z
4ummE1 TMT[ OF FDCTJR[ OR fT[M FL! O
WATER CLOSLT(TOILET) Q 1.53
BATH TUB • 0./0
O
SHOWER Q o e3
LAVATORY(WASH BASIN) Q 3.SS O
KITCHEN SINK Q 0.10
LAU N D RY TU B 0 R TRAY • 0.10
SLOP SINK • 0.91
FLOORSINK • 0.81
FLOOR DRAIN • 1.10
DISHWASHER Q 0.10
DRINKING FOUNTAIN • 0_80
URINAL • 0-80
OAS rfSTEM OUTLETS • 1.10
WATER HEATER • 1.01
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'SBIGNATURE
UNDER BLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING ? s r%
TOTAL FEE GAS PI INe a -L
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- 9A6 VENT
CATION AND STATE THAT THE ABOVE IS CORREOT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AN PROPERLY REGISTERED
AMD/OR LICENSED AS RE ED BY ANGELES COUNTY GAS TEST
AND STATE OF QALIFO A THE LEGAL OWN-
ER OF THE ABOVE DE E IAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE
OF PERYITTE
FI L lav
76AOOT DBS 17 1/63