HomeMy Public PortalAbout4833 GLICKMAN AVE_Plumbing__ 76A667 APPLICATION FOR PLUMBING PERMIT 1
DBS-17IDi VISION OF BUILDING AND SAFETY
Department of County Engineer
T
County of Los Angeles BUILDING � �
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS /
CASSATT D. GRIFFIN,SUPT OF BUILDING
[LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
OWNER DISTRICT NO. GROUP yZOI READY FOR INSPECTION
MAIL /�• /!A'_�y/
ADDRESS
INDUSTRIAL
CITY `{ TEL. NO. WASTEAPPROVAL
PLUMBER �Rf'/�-Q/- !q INSPECTION RECORD /'I
ADDRESS
CITY EL. NO K� &L
LICENSE NO. / Ap 15--& %- �z
NUMBER TYPE OF FIXTURE OR ITEM FEE
1 WATER CLOSET (TOILET) @ $1.00 $
BATH TUB @ $1.00
SHOWER @ $1.00
LAVATORY-(WASH BASIN) @ $1.00 y
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
PERMIT $ 1 00 ROUGH PLUMBING r,
7� GAS PIPING "
TOTAL FEE GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER • .4'.'
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES y
PLUMBING.
IHEREBY 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 RESIDENTIAL P OPERTY. n C- `
SIGNATURE ,� ^ // �,/
OF PERMITTEE w!N /7 FINAL
JOHN A. LAMBIE, COUNTY ENGINEER ALIDATION ROBERT A.WOOD, CHIEF PLBG. INSPECTOR
CK. N.O. CASH