HomeMy Public PortalAbout9249 GARIBALDI AVE_Plumbing__ 7BAPPLICATION FOR PLUMBING PERMIT 1
DBS-17
3-55-f7
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles
WM.J. FOX, COUNTY ENGINEER SUtt_DING
ADDRESS
CASSATT D. GRIFFIN, Suwr of BUILDING
LOCALITY -
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
OWNER
MAIL DISTRICT NO. GROUP .NE READY FOR INSPECTION
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ADDRESS
INDUSTRIAL
CITY !�'r�7->--^. ¢.- ''- TEL. NO. WASTE APPROVAL
INSPECTION RECORD
ADDRESS
CITY - TEL,.,No. "
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) $
BATH TUB
SHOWER -
LAVATORY (WASH BASIN) --
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
'p CLOTHES WASHER
046
TOTAL NO. @ 0.80
APPROVALS
GAS SYSTEM OUTLETS @
'DATE INSPECTORS SIGNATURE
WATER HEATER @ 1.00 1.00 -
UNDER SLAB WORK
III
ROUGH PLUMBING
PERMIT $ 1 00 — -
GAS PIPING
TOTAL FEE �71 oe GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 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. -- y
1 HEREBY CERTIFY THAT 1 AM PROPERLY -REGISTERED AND/OR GAS TEST >'{'
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE _UTILITY CO. NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY. -
SIGNATURE
OF PERMITTEE '`d'� '.t
FINAL
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION R.A.WOOD, CHIEF PLBG. INSPECTOR
,0099 MV17 3 204
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