HomeMy Public PortalAbout6155 CAMELLIA AVE_Plumbing__ DEPARTMENT OF COUNTY ENGINEER PLUMBING 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS �l
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FOR APPLICANT TO FILL IN LOCALITY -(.A.NEAREST
BUILDING s s CROSS ST.
ADDRESS Al,
DISTRICT NO. GROUP ZONE PERMIT NO.
LOCALITY
NEAREST
CROSS ST. RECEIVED BY Ready for Inspection // DATE ISSUED
OWNER %/S/LOLCL`. 1AIL
MAIL J INDUSTRIAL
ADDRESS 9I-76 es, `/� 7z ul/4S WASTE APPROVAL
CITY j i TEL.NO. % 7- `7 s�' INSPECTION RECORD
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PLUMBER S j23 /Df>" j1/"J/.3//Ua
ADDRESS FOx 2S6
CITY �� L y (/ TEL.NO.
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[]STATE
LICENSE NO. �S S!^ COUNTY J
PERMIT FEES a
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AUMP.ER TYPE OF FIXTURE OR ITEM FEE (�
y WATER CLOSET(TOILET) @ 0.80 s
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j BATH TUB @ 0.80
SHOWER @ 0.80
LAVATORY(WASH BASIN) @ 0.80
KITCHEN SINK @ 0.80
LAUNDRY TUB OR TRAY @ 0.80
SLOP SINK @ 0.80
FLOORSINK @ 0.80
FLOOR DRAIN @ 0.80
DISHWASHER @ 0.80
DRINKING FOUNTAIN @ 0.80
URINAL @ 0.80
GAS SYSTEM... __.-_OUTLETS @ 1.00
WATER HEATER @ 1.00
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE O 6n GAS PIPING
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING. PLUMBING FIXTURES
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGEI_FS COUNTY GAS TEST "�,' %/i
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY CO.NOTIFIED > .
SIGNATURE // � yZ
OF PERMITTEC:7 :. ...........l.....--_.�L........__........._..------------.
FINAL J(1 , :tu171 Z
76A661 DBS 17 1/53