HomeMy Public PortalAbout6403 GOLDEN WEST AVE_Plumbing__ DBS-f7 12.54 APPLICATION FOR PLUMBING PERMIT
085.17
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles
WM. J. FOX, COUNTY ENGINEER BUILDING
CASSATT D. GRIFFIN, SUPADDRESST of BUILDING ^-►-- /J
LOCALITY
FOR APPLICANT TO FILL IN NEAREST O
CROSS ST. L(�
OWNER -j - C^ ;'�_'
'` DIYCT NO.. G P ZONE READY FOR INSPECTION
ADDRESS MAIL
LA ^!
y INDUSTRIAL
CITY U TEL. NO. `I WASTE APPROVAL
PLUMBER L INSPECTION RECORD
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ADDRESS y
CITY '•Z•
TELNO.
LICENSE NO. .. ?
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET)
BATH TUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER
I
LAUNDRY TUB OR TRAY
I
CLOTHES WASHER
1
TOTAL NO. @ 0.80 APPROVALS
DATE + INSPECTOR'S SIGNATURE
GAS SYSTEM OUTLETS @ 1.00
' UNDER SLAB WORK
r WATER HEATER @ 1.00
ROUGH PLUMBING _
PERMIT S I 00 GAS PIPING
TOTAL FEE 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.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED LOS A ELES COUNTY AND STATE OF UTILITY CO. NOTIFIED
CALIFORNIA OR THAT �A TH AL OWNER OF THE ABOVE
DESCRIBED RESIDENTI L P P
SIGNATURE _
OF PERMITTEE !, r FINAL '
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION
'
06 5 8 2 AUG 1 2.0 0
BY
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