HomeMy Public PortalAbout6262 BURTON AVE_Plumbing__ 76 A 667—CE 817 8/68
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY _
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST ))
CROSS ST. 0 N
NUMBER FIXTURE OR ITEM EACH FEE / G
OWNER"�
WATER CLOSET 1.50
MAIL
BATHTUB I.50 ADDRESS
SHOWER 1.50 CITY Civy 619 TEL. NO. -
LAVATORY 1.50 CONTRACTOR
SINK 1.50 ADDRESS
DISHWASI{ER 1.50 J CITY TEL, NO.
CLOTHES WASHER 1.50 STATE LIC
'LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO, GROUP ZONE I PR $SBED BY Y
LAWN SPRINKLER SYSTEM 2.00 5 _ U
WATER HEATER 1.50 INDUSTRIAL Z
/ a WASTE APPROVAL
GAS SYSTEM OUTLETS 1.50 INSPECTION RECORD I+Ua
OUTLETS OVER
5 PER SYSTEM '30
- Plan check fee 25,E of above. Sce reverse.
PLUMBING PERMIT ISSUING FEE: S 2 00
TOTAL FEE
APPROVALS DATE INSPECTOR SIGNATURE
Plan Check applicant UNDER SLAB WORK
Varve ROUGH PLUMBING
Address GAS PIPING
GAS VENT
Gi11' Tel. No. HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT 'HE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES /
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST L �yjw,Q
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALI FORNtA OR THAT I AM THE LEGAL OWNER OF,AND INTEND TO
RESIDE IN. THE ABOVE DESCRIBED RESIDENTIAL PROPERTTYY.. FINAL
SIGNATURE , JACK R. ALLEN, SUPERVISING MECHANICA R.
OF PERMITTEE / 1/G
- - PERMIT VALIDATION CK. M.0. <ASH
PLAN CHECK VALIDATION CK, M.O. CASH
AUG 4 5 A 3.5 0