HomeMy Public PortalAbout4866 ENCINITA AVE_Plumbing__ •, DEPARTMENT OF COUNTY ENGINEER PLUMBING 11
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES w
WILLIAM J. FOX, COUNTY ENGINEER ADDRESS
FOR APPLICANT TO FILL IN LOCALITY
BUILDING NEAREST
ADDRESS 4566 Enc inita CROSS ST
LOCALITY `temple City DISTRICT NO GROUP ZONE PERMIT NO.
NEAREST (/� Jp•�
CROSS ST RECEIVED BY Ready for Inspection DATE ISSUED
OWNER -T. F . Stevens —:-
MAIL INDUSTRIAL E
ADDRESS WASTE APPROVAL
CITY TEL No INSPECTION RECORD
PLUMBER Belvedere plumbing Co. -
ADDRESS 11900 E . Garvey Blvd.
CITY Bl Monte TEL.NO FO 59536
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E]STATE
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LICENSE NO ri 4V EXCOUNTI
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PERMIT FEES z
NUMBER TYPE OF FIXTURE OR ITEM FEE u,
1 WATER CLOSET(TOILET) @ 080 $ 50
1 BATH TUB @ 080 . 80
SHOWER @ 080
1 LAVATORY (WASH BASIN) @ 0 80 -'.8o
1 KITCHEN SINK @ 0 80 .80
1 LAUNDRY TUB OR TRAY @ 0 80 .50
SLOP SINK @ 0 80
FLOOR SINK @ 080
FLOOR DRAIN @ 080
DISHWASHER @ 0 80
DRINKING FOUNTAIN @ 080
URINAL @ 080
1 GAS SYSTEM - -OUTLETS_ @ 1 00 1 .00
l WATER HEATER @ 1 00 1 .00
MISCELLANEOUS
APPROVALS
I�ATf INSPEC,TU_R'S SIGNATURE
UNDER SLAB WORK -7 (O A-4/ _ "1
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE
.00 GAS PIPING G
/
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- GAS VENT
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE HOT WATER HEATER
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING PLUMBING PLUMBING FIXTURES
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED Q�
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY GAS TESTAND STATE OF OR THAT I AM THE
ER OF THE ABOVELIFORNIA DESCRIBED RESIDENTIAL PROPEGAL TY OWN UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
76A667 DBS 17 1/63 151 Y