HomeMy Public PortalAbout5529 GRACEWOOD AVE_Plumbing__ DBS-17 10.55 APPLICATION FOR PLUMBING PERMIT 1
DBS-17
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles BUILDING Y
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS C
CASSATT D. GRIFFIN,SUP'T OF BUILDING
LOCALITY
FOR PLICANT TO FILL IN NEAREST
CROSS ST. Cly-tel"�C
7AD
NER {.. _ DISTRICT_ .O. GR UP Z NE READY FOR INSPECTION
L 17 — '
RESS
INDUSTRIAL
CITY TEL. NO. WASTE APPROVAL
PLUMBER Jack F StarL�r(j INSPECTION RECORD
ADDRESS �'.7.04,0 Palm Ave.
CITY PPI A fl n4UAT` TEL. NO.//ME 0-5945
LICENSE NO. 1549A C� -,3
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) @ $1.00 $ ,G9
BATH TUB @ $1.00 / O
SHOWER @ $1.00
LAVATORY (WASH BASIN) @ $1.00 / n et,
i
KITCHEN SINK @ $1.00 / Q
DISHWASHER @ $1.00 zz
LAUNDRY TUB OR TRAY @ $1.00 'f
CLOTHES WASHER @ $1.00 G
WATER HEATER @ $1.00 / OCP
GAS SYSTEM @ $1.00 G Gztz /w�
APPROVALS
DATE INSPECTORS SIGNATURE
UNDER SLAB WORK
PERMIT $ 1 00 ROUGH PLUMBING
GAS PIPING � (J
TOTAL FEE O 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 .��y'. '
PLUMBING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF r..
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RES NTIAL PROPERTY.
SIGNATURE
OF PERMITTEE -�z ��� FINAL -J 7
JOHN A. LAM COUNTY ENGINEER / �JALIDATION ROBERT A.WOOD, CHIEF PLBG. INSPECTOR
KK.� M.0. CASH
��AO 2 7 7 6 r4ov 2 7 '5 8.0
l �• � �2/.fie'-�.�