HomeMy Public PortalAbout4902 ENCINITA AVE_Plumbing__ DBS 17 12 54 APPLICATION FOR PLUMBING PERMIT
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los"Angeles
WM J FOX COUNTY ENGINEER BUILDING ADDRESS 4002 Ne Enclnita
CASSATT D GRIFFIN, SUP T OF BUILDING
LOCALITY Temple City
FOR APPLICANT TO FILL IN CROSS sT
OWNER Roland Sholty DISTRICT NO GROUP F ZONE I READY FOR INSPECTION
MAIL
ADDRESS1295 Dominion S I 14 -1
INDUSTRIAL
CITY Pasadena TEL NO WASTE APPROVAL
PLUMBER Belvedere Plumbing Co. INSPECTION RECORD
ADDRESS 'L11900 E . Garvey Ave .
CITY El Monte TEL NO FO 89836
LICENSE NO 54932
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) •80
BATH TUB 80
SHOWER �y
Z LAVATORY (WASH BASIN) .8a0
Z KITCHEN SINK 8o
DISHWASHER d
LAUNDRY TUB OR TRAY 80
CLOTHES WASHER
disposal .80
TOTAL NO 6 @ o Bo $0 APPROVALS
DATE IN PE/C�TO�R S SIGNATURE
1 GAS SYSTEM--3-_OUTLETS @ 1 00 1.00 UNDER SLAB WORK
Z WATER HEATER @ 1 00 1 OO
_ ROUGH PLUMBING 3
PERMIT S I X1OO GAS PIPING
7
TOTAL FEE / 80 GAS VENT
I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION HOT WATER HEATER_ _
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
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 RESIDENTI4L PROPERTY
SIGNATURE
OF PERMITTEE / A/i/ FINAL
WILLIAM J FOX, COUNTY ENGINEER VALIDATION
_'r00 4 4. 0 S fn,j 1 3 7.80 ss
BY
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