HomeMy Public PortalAbout8617 GARIBALDI AVE_Plumbing__ DBS-17 10-55 APPLICATION FOR PLUMBING PERMIT 1
DBS-17
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS , {Q 1 ►Y tT
CASSATT D. GRIFFIN,SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST r
CROSS ST. F Al
Ll
OWNER DISTRICT NO. GROUP ZONE I READY FOR INSPECTION
MAIL
ADDRESS
INDUSTRIAL
CITY TEL. NO. WASTE APPROVAL
PLUMBER tJ A , -n�Z/�►b`A� �+-� INSPECTION RECORD
ADDRESS�/4I D ( p19 \ t��F�„� C '���Z�_ 5 z A/O'7- W-A- !Z -4 &� 4 2 —
CIT Ci/w J F.�f. / 14 1 TEL. NO. r�( I/ t�F�'✓T F_ n J
LICENSE NO. ,
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 /$ L
IV
BATH TUB @ $1.00 f
SHOWER @ $1.00
,I LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ $1.00
DISHWASHER @ $1.00
LAUNDRY TUB OR TRAY @ $1.00
CLOTHES WASHER @ $1.00
WATER HEATER @ $1.00
GAS SYSTEM @ $1.00
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
Lp
PERMIT $ 00 ROUGH PLUMBING ,tom
GAS PIPING
TOTAL FEE
GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE 1S CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES C
�.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER)OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIA,�T�IZ PERT
SIGNATURE I
OF PERMITTEE FINAL
JOHN A. LAMBIE, C jTY ENGINEER CALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR
CK. b.•. CASH
Lo462s 7 5 A 8.00