HomeMy Public PortalAbout6160 CAMELLIA AVE_Plumbing__ APPCEATION FOR =PLUMBING PERMIT
DIVISION Of SUMDING AND SArErY
D+p=tn*nt of County F-g%—
J 0=4 Od LOa .A.Q BUILDINGJ
WM.J. FOX, COUNTY EN(IIN[LR ADDRER(S k7 ,
CAfiATT D. aRIPFIN, fL/r•T OF AUILDIM•
FOR APPLICANT TO FILL IN NNEAA[ST
� .
OWNER C:✓ DISTRICIA1G1r GROUP ON6
MAIL READY 10laSr[c71w
ADDRESS
i
�A v ? DUBTRIAL '
CITY TEL NO. Ci ✓ P V
PLUMBER
4"
. ^ : INSP=ON RECOED
ADDRESS ✓ D
CITY /'0/ '�-e T EL•'N O.
LICENS ENO.
'NUM.�I `PYPA OR FIXTURI 011 mim FSI
/1 WATER CLOSET (TOILET) S d
MATH'tUd O 0
SHOWER / 0
LAVATORY (WASH]BASIN) 00
KITCHEN SINK O O Q ,ef–/ 1*2 f-' Ay Z f/Y�-
DI8HWA9HER
LAUNDRY TUB OR TRAY
I
I CLOTHES WASHER
/A
I
I
r
TOTAL NO. u O APPROVAL
GAS SY9TEM--/—OLLTLET9 0 1.00
/' 00 DATE INSPECTOR'S SIGNATURE
WATER HEATER 0 1.00 00 UNDER SLAB WORK
ROUGH PLUMBING
pERY17 r
>E- 1 00
' GAS PIPING
TQTAL FEE 9 1 0 D GAS VCS
1 HERFLBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
-D S
ANTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE. LAW, REGULATING PLUMBING FIXTURED
PLUMBING.
I HEREBY CERTIFY THAT I AY PROPERLY REGISTERED D/OR GAII TEST
LICENSED AS REQUIRRD• BY LOS ANGELES COUNTYD ATE OF
CALIFORNIA OR TWAT 1 AM- THE F W or ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL P
SIGNATURE
OF Pg RMITTEE ,
WILLIAM J. FOX, COUNTY ENa1N VALIDATION R.,L WOOD, CHIS Pu G. INST[CTOR
M-57 3 1D.;
h1AR 4 8.0 0 a
m