HomeMy Public PortalAbout10409 OLIVE ST_Plumbing__ 78A687 ,
1E•8v APPLICATION FOR PLUMBING PERMIT
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Old MON •OFBUILDING AND SAFETY
Deportment of County En
glaeer
County of Los Angeles J `
WM.J.FOX.COUNTY ENGINEER ADDRESS UILDIN
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CA13SATT D.GRIFFIN.SUPT OF BUILDING
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LOCALITY
FOR APPLIC�ANT TO FILL IN CROSS r. .
OWNER r8/' DISTRICT NO.. GROUP ZONE READY FOR INSPECTION
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ADDRESS .ls '
INDUSTRIAL
CITY TEL. NO.
WASTE APPROVAL
PLUMBER ,¢ r INSPECTION RECORD
ADDRESS de,
CITY 494f7le TEL.NO.
LIC N E NO. �r� 3G'.
NUMBER TYPE OF FIXTURE OR ITEM FEE
WATER CLOSET (TOILET) $ d�
BATH TUB �f
SHOWER D
LAVATORY (WASH BASIN) A�
KITCHEN SINK y
DISHWASHER
LAUNDRY TUB OR TRAY Q/
CLOTHES WASHER
TOTAL NO. ®es es APPROVALS
AS SYSTE OUTLETS @ 1.00 0� DATE INSPECTOR'S SIGNATURE
WATER HEATER @ 1.00 ! 49 UNDE SGCF3 WORK '
ROUGH PLUMBING X
PERMIT $ 7 00 GAS PIPING
TOTAL FEE !• �� GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION HOT WATER HEATER
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ANSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS. REGULATING PLUMBING FIXTURES D'
PLUMBING. y y
1 HEREBY CERTIFY THAT 1 AN PROPERLY REGISTERED AND/OR GAS TEST �I)dJ,•� C r > .i ��+..i
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF UTILITY CO. NOTIFIED 4 �C✓tom'
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL P 0 ERTY
SIGNATURE
OF PERMITTEE FINAL G U�
WILLIAM J.FOX.COUNTY ENGINEER VALIDATION
Hf.09274- Jum 14 3 11 .4 d
BY
1 � DEPUTY -
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