HomeMy Public PortalAbout4927 ARDSLEY DR_Plumbing__ 76A667-CE#817 6-65 6 t 1
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APPUCATION FOR PLUMBINtPERMI�
COUNTY'OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS SL
COLEMAN W. JENKINS. SUPT. of BUILDING LOCALITY TE c
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25 I /,� MAIL
BATH TUB 1.25 ADDRESS
CITYTEL. NO. Z 17
SHOWER 1.251 LEM R4
LAVATORY 1.25 d CONTRACTOR Igm"c
SINK 1.25 t ADDRESS
DISHWASHER 1.25 CITY TEL. NO.
STATE LIC
LAUNDRY TUB 1.25
CLOTHES WASHER 1.25 z _ LICENSE NO. CLASS
DISTRICT NO. GROUP ZONE I PROCESSED BY
WATER HEATER 1.50 I „�`�% _Z
GAS SYSTEM OUTLETS- 1.50 V INDUSTRIAL a
WASTE APPROVAL 0
OUTLETS OVER 5 PER SYSTEM .30 INSPECTION RECORD V
O
H
U
W
d
N
Z
APPROVALS DATE INSPECT R'S SIGNATURE
PERMIT $ 2 . 00 UNDER SLAB WORK
�� . ROUGH PLUMBING
TOTAL FEE GAS PIPING
0
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING' HOT WATER HEATER
PLUMBING.
a I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES 00
LICENSED AS REQUIRED BY LOS ANGELES CO Y AND ST E OF GAS TEST
CALIFORNIA OR THAT I THE LEGAL WNE F,AND INT D TO
RESIDE IN, THE ABOVE D 5 RI D RES[ TIA OPE UTILITY CO. NOTIFIED y
SIGNATURE
OF PERMITTEE
FINAL
LIDATIOIV
M.O. CASH
iA` 3.,2 8 0JUN 30 5 D 1 3.7 5,
.r.