HomeMy Public PortalAbout8746 BURGHARDT RD_Plumbing__ 76A667-CE"17 4-61
APPLICATION FOR PLLU/MBING�JPE ��IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADD'ESG
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM (EACH FEE
OWNER
WATER CLOSET $1.25 MAIL
BATH TUB 1,25 ADDRESS
SHOWER 1.25 CI L.
LAVATORY 1.25 CONTRACTOR
SINK 1,25 ADDRESS
DISHWASHER 1.25STATE LIC
C f TEL. NO
LAUNDRY SUB 1.25 uCENSE CLASS
CLOTHES WASHER 1.25 DISSTBICT NO, G' ZONE PROLE SE�ED�;;BY
WATER HEATER 1.50 V O i L7 �CYG ii
/ 1
GAS SYSTEM_ /--OVTLETS 1.50 INDUSTRIAL
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .00 INSPECTION RECORD a
CDU
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Z
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I
APPROVALS DATE INSPECTOWS SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE
GAS PIPING
HEREBY THAT
THE
THAT HAVE READ THIS APPLCOMPLN GAS VENT
AND
OSTATE THAT TXE ABOVE IS CORRECT AND AGREE TO COMPLY `
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER / LII
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANOIOR PLUMBING FIXTURES V ,
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST f A
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF.ANO INTEND TO
RESIDE IN,THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. UTILITY GG. NOTIFIED
SIGNATURE -�n�
OF PERMITTEE6�0FINAL 1. "�J` -A //�il7�lQ n T-A
cN.ti(ALIJACK MALLEN
.'0. CnsH SUPERVISING MECHANICAL
ENG-R.
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76A667 -CEg817 12-64
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST E
CROSS ST. G
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET $1.25 O MAll
BATH TUB 125 ` ADDRESS Z.
SHOWER 125 ` 'CITY TEL. NO
LAVATORY 125 a CONTRACTOR
SINK 1. ADDRESS 6e rl 52-1
DISHWASHER 1.25 CITY
TEL. NO.
LAUNDRY TUB 1.25 CONTRACTOR'S 'STAT
REGISTRATION NO. 3 COUNTY
CLOTHES WASHER 1.25 DISTRICT NO. GROUP ZONE P ESBEO BY
/ WATER HEATER 1.50
CAS SYSTEM OUTLETS 1.50 A INDUSTRIAL
WASTE APPROVAL d
OUTLETS OVER 5 PER SYSTEM .SO d' INSPECTION RECORD LO.1
m
O
F
L)
W
a
co)
Z
APPROVALS DATE INSPE TOR'S EIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK
ROUGH PLUMBING •J
TOTAL FEE
GAS PIPING ' r
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ TRIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRE. BV LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE INS THE ABOVE OESCRI EO RESIDENTIAL PR TY. UTILITY CO.NOTIFIED (�
SIGNATURE tf
OF PERMIT
FINAL
VALIDATION ROBERT A. WOOD
CK. M.o. CASH SUPERVISING MECHANICAL ENG'R
LAuo 5 1 4 . P.UC 31 5 A 16.55-