HomeMy Public PortalAbout5216 DALEVIEW AVE_Plumbing__ 7BASE7_,E917 S59 �/' ' L b ��i�/�
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, County. Engineer ADDRESS
CASSATT D. GRIFFIN, Supt of Building
LOCALITY
FOR APPLICANT TO FILL IN NEAREST pp
CROSS ST.
NUMBER FIXTURE OR ITEM
I OWNER
WATER CLOSET
MAIL
. BATH TUB ADDRESS
CITY TEL. NO.
SHOWER
LAVATORY CONTRACTORFONTANA PLUMBING CONTPLACTORS
BINE ADDRESS 13329 E. Ecco- Street
DISHWASHER CITY Cify of lnc,ortr•.
CONTRACTOR'S yL STATE ❑
$
LAUNDRY TUB REGISTRATION NO. 96496 COUNTY ❑ .
CLOTHES WASHER DISTLRICCjNO. GR P ZONE I PR CESSEO BY
WATER HEATER
GAS SYSTEM - INDUSTRIAL
WASTE APPROVAL
i INSPECTION RECORD
O $1.00 PER ITEM ' s
OR FDITURE S APPROVALS ] DATE INSPECTOR'S(SIGNATURE
PERMIT $ 2 001 UNDER SLAB WORK p� //C
�' ROUGH PLUMBING f-f-� I 1'-7
TOTAL FEE "/
C(J / . -
GAS PIPING
I HEREBY
O ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT /f
ANSTATE THAT
THE ABOVE IS CORRECT AND AGREE TO COMPLY -
WITH ALL COUNTY ORDINANCES AND STATE LAWS'REGULATING
PLUMBING. HOT WATER HEATER
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES A
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR T T I AM THE LEGAL OWNER OF THE ABOVE •e
DESCRIBED REBID IAL P PERT/YY . UTILITY CO. NOTIFIED /.�/7�C'p I/CC�..wiCnn
SIGNATURE Q-
OF PERM "-�G_ I FINAL6j^ �wYyyv�yy{,�
�7RLI C ROBERT A. WOOD,
0. G
M.a 5N SUPERVISING MECHANICAL ENG'R
JEO8 5 4 5 5 i4P,R g p 5 A 9.01
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