HomeMy Public PortalAbout5009 CAMELLIA AVE_Plumbing__ 76AG67-CE.817 10-67
APPLICATION . FOR PL��U(MM I GJ PER rT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMSIE, COUNTY ENGINEER ADDRESS
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 1.50
MAIL
BATHTUB 1.50 ADDRESS QO
SHOWER 1.50 CITY J TEL. NO.
LAVATORY 1.50 CONT11ACTOA
SINK 1.50 ADDRESS
DISHWASHER 1.50CITY �
CLOTHES WASHER 1.50 STATE LIC
LICENSE NO. CLASS
SWIMMING POOL RECEPTOR 1.50 DISTRICT NO. GRO IO E P O S D BY
LAWN SPRINKLER SYSTEM 2.00 O �, O
WATER HEATER 1.50 INDUSTRIAL - CJ
WASTE APPROVAL
O
GAS SYSTEM OUTLETS 1.50 INSPECC.(TION
T RECORD U
OUTLETS OVER / J� W
5 PER SYSTEM .30 � N
Z
Plan check fee 2590 of above. See reverse.
PLUMBING PERMIT ISSUING FEE $ 2 00
TOTAL FEF..
APPROVALS DATE INSPECTOR'B SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel. No. HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST
PLUMBING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR UTILITY CO. NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 A T E LEGAL OWNER OF.AND INTEND TO `
RESIDE IN. THE ABOV SRI EO RESIDENTIAL ROPERTY. FINAL /
SIGNATURE JACK R. ALLEN, SUPERVISING MECHANICA R.
OF PERMITTEE
PERMIT VALIDATION CK. M.O. GASH
PLAN CHECK VALIDATION CK. M.O. CASH..
LALO 4 4 9 4 IMAY 1 5 D 3-50—
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