HomeMy Public PortalAbout6018 OAK AVE_Plumbing__ 76AG57c (C6 8179) 9/75 i
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APPLICAON FOR PLUMBING PERMIT
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BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN (PRINT OR TYPE) BUILDING O/ O ��
NUMBER FIXTURE OR ITEM @ FEE ADDRESS
WATER CLOSET (rte LOCALITY aA
BATH TUB NEAREST
CROSS ST
1 SHOWER OWNER PjI '
/ LAVATORYMAIL /g
ADDRESS V
SINK CITY Q� TEL NO
DISHWASHER 3 DO CONTRACTOR
CLOTHES WASHER
SWIMMING POOL RECEPTOR
ADDRESS tz7j-?-
CITY TEL NO �e91j
LAWN SPRINKLER SYSTEM �7 'may
WATER HEATER
LICENSE NO 2�l.� CLASS,e2(0
+ _ DISTR CT NO GROUP ZONE PR ESSED BY
GAS SYSTEM OUTLETS Dg Y n V
OUTLETS OVER , rf.� /C 0
5 PER SYSTEM INDUSTRIAL ^� 1
WASTE APPROVAL Ly
~INSPECTION RECORD N
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Plan check fee
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PLUMBING PERMIT ISSUING FEE $ s0 t
TOTAL FEE 9
Plan check applicant
Name APPaW40S DATE INSPE OR 5 SIGNATURE
UNDER RK �'3 7
Address ROUGH PLUMBING
Clty Tel NO GAS PIPING
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THEABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
1 HEREBY CERTIFYLE
PROPERLY RE STERED AND/OR PLUMBING FIXTURES
LICENSED AS REOUIRGELES COU AND STATE OF GAS TEST
CALIFORNIA OR THATGAL WNER OF NTEND TO
RESIDE IN THE ABOVESID NTIAL RO TY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL �3(I
PLAN CHECK VALID TION CK M 0 CASH PERMIT-VALIDATION cK M 0 CASH
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