HomeMy Public PortalAbout9736 VAL ST_Plumbing__ Deee7T3 ee APPLICATION FOR PLUMBING PERMIT
DIVISION OF BUILDING AND SAFETY
Dep��leat of Coaatp Engineer /�
COOnt Of l.Oi Angel" BUILDING �{'
WM J FOX COUNTY ENGINEER ADDRESS / 4
CASGATT D GRIFFIN SUP T OR 1u1Lo1Ha
�wr
LOCALITY
NT
FOR APPLICATO FILL IN NEAREST
R 5 ST
OWNER DISTRICT O GROU^ X NE READY MR INSPECTION
MAIL 5
ADDRESS C
-s INDUSTRIAL
CITY O WABTEA ROV L
PLUMBE INSPECTION RECORD
ADDRESS
CITY ZXZ TEL NO
LICENSE NO
HUMMER TYPE OF FI%TUR[OR ITEM FE!
WATER CLOSET (TOILET) §
BATHTUB
SHOWER fYLSO 0/, AMY, L✓�U_
LAVATORY (WASH BASIN) C /
KITCHEN SINK
DISHWASHERPAR,U`-
LAUNDRY TUB OR TRAY �(/'F_LK' AN>!-J'/P/iy�✓ ✓f}LYF
CLOTHES WASHER
aF:H7VA11i�� L✓-
/3EL/W��H TA4,9PT.pAP
TOTAL 1 ® 080 Z, APPROVALS
DATE INSPECTOR SSIGNATURE
WATER HEATER 1 00 / (� UNDER SLAB WORK
PERMIT S 1 00 ROUGH PLUMBING
GAS PIPI NO
TOTAL FEE GAS VENT
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION 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
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFONN IA OR THAT 1 AM THE LEGAL OWNER Of THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL P PERTY
SIGNATURE
OF PERMITTEE AL
WILLIAM J FOX,COUNTY ENGINEER VALIDATION R A WOOD CHIEF PLUG INSPECTOR
.CD 4 9 0 8In JON 21 3 4.4 T-0�y 0
/�