HomeMy Public PortalAbout5819 CLOVERLY 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
FOR APPLICANT TO F L IN LOCALITY
ADDRESS ' Y Q NEAREST
CROSS ST
DISTRICT N GROUP ZONE PERMIT NO
LOCALITY
NEAREST y
CROSS ST4 ' RE EIVED BY Ready for Inspection AT ISSUO
OWNER
INDUSTR
$A
MAIL WASTE AP OAL
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ADDRESS
CITY TEL NO INSPECTION RECORD
PLUMBER
ADDRESS
CITY TEL NO
/ ❑STATE
LICENSE NO ,jam 2�rCDUNTY J
PERMIT FEES a
_z
�JMGER TYPE OF FIXTURE OR ITEM FEE ut
WATER CLOSET(TOILET) @ 080 $ D:
O
BATHTUB @ 080
SHOWER @ 080
LAVATORY(WASH BASIN) @ 0 80
KITCHEN SINK @ 080
LAUNDRY TUB OR TRAY @ 0 80
SLOP SINK @ 0 80
FLOOR SINK @ 080
FLOOR DRAIN @ 080
DISHWASHER @ 080
DRINKING FOUNTAIN @ 080
URINAL @ 080
GAS SYSTEM OUTLETS @ 100 s
WATER HEATER @ 1 00
MISCELLANEOUS
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDERSLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE Z100 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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TEST
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN.
ER OF THE ABOVE D SCRIBEa RESIDEN AL PROPEfTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE f
FINAL ��-
76A667 DBS 17 1/53
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