HomeMy Public PortalAbout5534 MCCULLOCH AVE_Plumbing__ 766APPLICATION FOR PLUMBING PERMIT 1
•17 9-SS
1385617B517
DIVISION OF BUILDING AND. SAFETY
Deportment of County Engineer
County of LOS Angeles BUILDING ti e
WM.J.FOX, COUNTY ENGINEER ADDRESS c
CASSATT D.GRIFFIN,SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
f
OWNER DISTRICT NO. GROUP ZON READY FOR INSPECTION
MAIL F'" I� _
_ADDRESS � � -•�'
' INDUSTRIAL
CITY TEL.NO. WASTE APPROVAL
PLUMBER / INSPECTION RECORD
ADDRESS
CITY TEL.NO. ,
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET)
BATHTUB r
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
.� TOTAL NO. @ 0.90 APPROVALS
++�� DATE INSPECTOR'S SIGNATOR
GAS SYSTEMs�OUTLETS @ 1.00 o
WATER HEATER @ 1.00 UNDER'SLAB WORK
PERMIT S 1 00 ROUGH PLUMBINGf
: GAS PIPING.
TOTAL FEE I 7
for ' GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER A" ya
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY n r �
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES �T
PLUMBING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST �•���rt;-ti:`�
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 RESIDENTI%qROPER Y. k
SIGNATURE
OFPERMITTEE
FINALRam 'm
WILLIAM J.FOX,COUNTY ENGINEER VALIDATION R.A.WOOD,CHIEF PLBG.INSPECTOR
jC05 3 3 0 Ili l .NL 5 3 . 7-00 m
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