HomeMy Public PortalAbout5537 PAL MAL AVE_Plumbing__ 76A. 7 APPLICATION FOR PLUMBING PERMIT 1
tieelvWII/ISIND ON OF BUWMG ASAFETY
N .D Department of Canty Engineer
County of Los Angel" BUILDNG
F WM J FOX COUNTY ENGINEER ADDRESS
CABBATT O GRIFFIN SUP T OF BUILDING
LOCALITY A
FOR APPLICANT TO FILL IN NEAREST
se AT
OWNER AL4 DISTRICT GROUP I READY POE INSPECTION
MAIL
ADDRESS
INDUSTRIAL
CITYL 414% WASTE APPROVAL
PLUMBER INSPECTION RECORD
ADDRESS
CITY TEL NO
LICENSE NO
NUMBER TYPE OF FIXTURE OR ITEM FSE
WATER CLOSET (TOILET) s d
BATH TUB U
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER O
TOTAL NO 60 080 APPROVALS
TEMOUTLETS 100 DATE INSPECTOR S SIGNATURE
GAS SYSDo
WATER HEATER 100 1
UNDER SLAB WORK i
PERMIT f 7 00 ROUGH PLUMBING O
GAS PIPING
TOTAL FEE O GAS VENT
i HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP LIGATION HOT WATER HEATER
AN STATE THAT THE ABOVE IS CORRECT AND AGEEE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AMD/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 P P
SIGNATURE
OF PERMITTEE F FINAL
WILLIAM J FOX.COUNTY ENGINEER VALIDATION R A WOOD CHIEP PLUG INBPECTOR
AC06979iS AUG22 s 7.80
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