HomeMy Public PortalAbout5536 PAL MAL AVE_Plumbing__ '•A•" APPLICATION FOR PLUMBING PERMIT
1,110 I>I:
DIVISION OF BUILDING AND SAFETY
Dopm6maet of County mlvlowr
COImty of Lw Angela IN
WM J FOX, COUNTY ENaimmm ADDBUILDRgN.G 5536 Pal Mal
CA SSATT D ORIPFIN, SUP T OF BUILDING Temple City
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
OWNER Yr. Jolnsom WIN BY
DISTRICT O aRQUP �6 YunT FOR IN..ffcT 10Y
MAIL T
ADDRESS
INDUSTRIAL
CITY TEL NO WASTE APPROVAL
PLUMBER T. L. Kenptom INSPECTION RECORD
ADDRESS 318 N. Valley Center
CITY Sun Dimas TEL NO Ed . 27811
LICENSE NO 137 506
NUMRRN I TYPR OF FIXTYRX OR ITRM FRS
1 1 WATER CLOSET (TOILET) S 0
1 1 BATH TUB _ 0
SHOWER
1 LAVATORY (WASH BASIN) 80
1 KITCHEN SINK 8�
DISHWASHER
LAUNDRY TUB OR TRAY 8O
CLOTHES WASHER
5 TOT L NO 060 4. 00 APPROVALS
DAT! _.A*PFVOR S SI ATURE
OAB SYSTEM OUTLETS ® 100 1 q00
1 WATER HEATER 100 l 00 UNDER BLAB WORN
ROUGH PLUMBING
PERMIT $ 00 GAB PIPING
TOTAL FEE 7 00 GAS V NT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF UTILITY CO NOTIFIED
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPER
SIGNATURE
OF PERMITTE FINAL
WILLIAM J FOX,COUNTY ENGINEiR VALIDATION
�eo9 8 0 8t^, 07 R 3 Inn e
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