HomeMy Public PortalAbout4940 MCCLINTOCK AVE_Plumbing__ DBB-1712.5A APPLICATION FOR PLUMBING PERMIT
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles BUILDINGY�I
WM.J.FOX, COUNTY ENGINEER ADDRESS. / A'( //�
CASSATT D.GRIFFIN.SUPT OF BUILDING �^
FOR APPLICANT TO FILL IN NEARESTT
ROSS ST.
OWNER /D�/ DISTR CT NO. I G P I ZONE�E 8 READY FOR INSPECTION
MAIL
ADDRESS /O Ac0CAP� t,Zt� gr�/ _
/ /y
IN
CITY O ��/ TEL. N). rl Ir- WASTE APPROVAL .
PLUMBER INSPECTION. RECORD
ADDRESS exi�C
CITY TEL. NO.
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE �1 6
WATER CLOSET (TOILET)
l�Y6 r
BATH TUB x
SHOWER' _
LAVATORY (WASH BASIN)
>� KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO. i ® 0.80dr0 APPROVALS
DATE INSPECTOR'S SIGNATURE'
GAS SYSTEM 7:: OUTLETS 0 1.00 It(Q B
UNDER SLAB WORK
WATER HEATER ® i.00 I D® [ E
ROUGH PLUMBING
PERMIT S 1 00 / w'
GAS PIPING
TOTAL FEE p GAS VENT
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER �� _ r
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGVLATING PLUMBING FIXTURES �� t
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OFi
CALIFORNIA OR THAT I AM THE LEGAL-OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE
OF PERMITTEE FINAL
WILLIAM J. FOX,COUNTY E 6 IDATION
.3 3 12 S- mff- 3 -3 - 7.8 0 . n
+,. BY
�.f. DEPUTY