HomeMy Public PortalAbout5334 SULTANA AVE_Plumbing__ OSSA°173 BB APPLICATION FOR PLUMBING PERMIT 1
DIVISION OF BUILDING AND SAFETY
Depmtnmt of Co tp E gl"u `
CoBntp of Los Angeles BUILDING
WM J FOX COUNTY ENGINEER ADDRESS
CASSATT D GRIFFIN SUP T OF BUILOINO JJ
LOCALITY � PL.E `l
FOR APPLICANT TO FILL IN NEAREST
RES,
21
OWNER I L. DISTRICT NO GROUP N
MAIL r REARr FOR IRv[CTloe
.500iADDRESS O
T TEL NO INDUSTRIAL
CITY
' WAST APPROVA
PLUMBER INSPECTION RECORD
ADDRESS
CITY TEL NO
LICENSE NO pG,
NUMBER "PROF FIXTURK OR ITEM FCQ
WATER CLOSET (TOILET) S
BATH TUB
SHOWER
LAVATORY (WASH BASIN)
KITCHEN SINK
DISHWASHER
LAUNDRY TUB OR TRAY
CLOTHES WASHER
TOTAL NO o eo APPROVALS
GAS SYSTEM__OUTLEIS a loo Q DATE INSPECTOR S SIGNATURE
WATER HEATER p I op 040 UNDER SLAB WORK
ROUGH PLUMBING
PERMIT s 1 00
GAS PIPING
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT 1HAVE READ THIS AP ICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES
PLUMBING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST Z� SG
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE UTILITYCO NOTIFIED J V
DESCRIBED RESIDENTIAL PROPERTY
SIGNATURE
OF PERMITTER FINAL
WILLIAM J FOX, COUNTY ENGINEER VALIDATION R A WOOD.CHIEF PLSG INSPECTOR
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