HomeMy Public PortalAbout5033 DOREEN AVE_Plumbing__ 'BABAPPLICATION FOR PLUMBING PE'RiViIT
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DBS-17
DMSION OF BUILDING AND SAFETY
Deportment of County Engineer "
County of Los Angeles _
WM. J. FOX, COUNTY ENGINEER BUILDING
CASSATT D. GRIFFIN. SUF•T oP BO]LDING. ADDft E55 —� D'3 �nre�e/1N y-
LOCALITY
FOR APPLICANT TO FILL IN CROSS sT. w
OWNER DISTRICT NO.. I _GROUP, I' Z NE I READY FOR INSPECTION
MAIL
ADDRESS
INDUSTRIAL
CITY TEL. NO. WASTE APPROVAL
PLUMBER. yn/'� 'RJSPECTION RECORD. 3.yysj
ADDRESS 4,14
CITY 727_o,a TEL. NO. '-.7 g3 arS 1—Lh
11
LICENSE NO. Cir I �� /
NUMBER TYPE OF FISTURE OR ITEM- FEE
WATER CLOSET (TOILET)
BATH TUB
SHOWER
LAVATORY (WASH BASIN) _
KITCHEN SINK
DISHWASHER'
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO. @. 0.e0 APPROVALS
DATE INSPEQTOR'S SIGNATURE
GAS SYSTEM- OUTLETS @ 1.00 I Da
-- UNDER SLAB WORK
WATER HEATER @ 1.00
ROUGH PLUMBING
'PERMIT. E 1, 00 GAS PIPING
�t p0
TOTAL FEE T r GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE•READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TOCOMPLY '
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES (1
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST ZT
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF UTILITY CO. NOTIFIED
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PR PERTT.
SIGNATURE
OF PERMITTEE p FINAL
WILLIAM J. FOX. COUNTY ENGINEER VALIDATION -
1 7 8 5'S MAR 21 3_ 4.0 0 �
BY
DEPUTY