HomeMy Public PortalAbout5303 CAMELLIA AVE_Plumbing__ " -7"`�°PLUMBING 1
DEPA ME" OF COUNTY 161 C0gLM
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BDDRE'Sb O
WILLIAM J4. FOX, Coun-rY ENOIHE£q
FOR APPLICANT TO FILL IN LOCALITY
BUILDING NEAREST
ADDRESfQ,��,rgj, CROSS ST'
DISTRICT NQ. GROUP I ZONE PERMIT R0.
LOCALITY �`/
NEAREST
DROSS ST. c BECEIV D BY R.sb fir DATE 1 ED
e
OWNER
J
TAIL INDUSTRIAL
ADDitus �� d WASTE APPROVA
aTY �6 A TEL 110.iJG 27 d INSPECTION RECORD
PLUMBER LE.vG`o AILD°. (0
ADDRESS
OITY ,k� �L• TEL.N0.
FISTATE
LICENSE NO. � 1Q•000NTY J
PERMIT FEES
qumax1 TMP[ OF FDCTUIQ CR IT'[M FL[ O
WATER CLOSET IL • L" $ Q 0
BATH TUB 0L SL
SHOWER • LSO
LAVATORY ASH BASIN • L.LL O
KITOHEN SINK • 11.110
LAUNDRY TUB OR TRAY cm
SLOP SINK • L.SO
FLOOR SINK a-"
FLOOR DRAIN • LOO
DISHWASHER • 'LSO
DRINKING FOUNTAIN • 0m
URINAL • am
GAS SYSTE OUTLET/ IJO
WATER HEATER IAO
MISCELLANEOUS
APPROVALS
DATE INSPEOTOR'1 SIGNATURE
UNDER SLAB WORK
PERMIT s 1 00 ROUGH PLUMBING / C
TOTAL FEE GAS PIPING C l l
IHEREBY ACKNOWLEDGE THAT 1 HAVE R[AD THIS A PLI- GASVENT
CATION AND STATE THAT THE ABOVE 18 CORRECT AND-AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
1 [REBY CERTIFY THAT I AM PROPERLY REGISTERED
AHDrOR LICENSED AS R QUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF OALIF A OR THAT I AM E LEG OWN-
ER OF THE ABOVE D BESI ENTI PROP[ UTILITY OO.NOTIFIED
SIGNATURE
OF PERNTTTE
F1NA
TEAAST DBS" Ob 12-53