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HomeMy Public PortalAbout6413 GOLDEN WEST AVE_Plumbing__ BS-17 12.54 OAPPLICATION FOR PLUMBING PERMIT DBS-17 DIVISION OF BUILDING AND SAFETY Department of County Engineer County of Los Angeles BUILDING / i//5 WM.J. FOX, COUNTY ENGINEER ADDRESS {O '7" CASSATT D.GRIFFIN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. ADDRESS s - DISTRICT NO. I GR I ONE I READY FOR INSPECTION MAIL INDUSTRIAL CITY TEL. NO. WASTE APPROVAL PLUMBER �1 INSPECTION RECORD ADDRES - OI CITY TEL. NO. LICENSE NO. /IJ( /J,41O( NUMBER TYPE OF FIXTURE OR ITEM FEE WATER CLOSET (TOILET) $ O O '^• •'; C BATH TUB I G O SHOWER 00 ,7 S LAVATORY (WASH BASIN) OG - KITCHEN SINK OU J DISHWASHER e7 _r / LAUNDRY TUB OR TRAY CLOTHES WASHER dO b~-^�---- 1 TOTAL NO. IO @--e,.ae 10_ APPROVALS DATE INSPEGTOR'S SIGNATURE GAS SYSTEM OUTLETS @ .1.00 d 0 _ UNDER SLAB WORK I I ,, WATER HEATER @ 1.00 / C rl - ROUGH PLUMBING PERMITt: l 1 00 GAS PIPING TOTAL FEE Q'= 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. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST LICENSED AS REQUIRED BY LOS NGELES OUNTY .AND STATE OF UTILITY CO. NOTIFIED CALIFORNIA OR THyyT I AM LEGAL OWNER OF THE ABOVE -- DESCRIBED RESIDEpITI L PRO R SIGNATURE {� !-• FINAL OF PERMITT WILLIAM J. FOX,COUNTY ENGINEER VALIDATION ,3 3 6 05- Mff1D 3 13,00 BY O � 2C DEPUTY 76A667-CE817-8-57 COUNTY OF LOS APPLICATION FOR PLUMBING PERMIT ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS JOII-IN A. LAMBIE. COUNTY ENGINEER CA SATT D. GRIFFIN. SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST. UMBER FIXTURE OR ITEM ..�..__ OWNER WATER CLOSET MAIL -.- { BATH TUB ADDRESS SHOWER CITY Vii; TEL.NO. LAVATORY CONTRACTOR J SINK ADDRESS DISHWASHER CITY r� TEL NO. LAUNDRY TUB CONTRACTOR'S :- STATE REGISTRATION NO. COUNTY El CLOTHES WASHER DISTRICT NO. GROUP. ZONE READY FOR INSPECTION WATER HEATER �`-w }--� JY GAS SYSTEM INDUSTRIAL WASTE APPROVAL INSPECTION RECORD APPROVALS @ $1.00 PER ITEM DATE INSPECTOR'S SIGNATURE OR FIXTURE $ UNDER SLAB WORK PERMIT S 1 00 ROUGH PLUMBING GAS PIPING TOTAL FEE / GAS VENT 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APP (CATION HOT WATER HEATER AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES PUMBING. d I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST i.I CENSED 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.—, !— -- - OFPERMiTTEE "-� r' - FINAL VALIDATION ROBERT A. WOOD. © _ SUPERVISING MECHANICAL ENG'R CK. M. 0. CASH