HomeMy Public PortalAbout4924 ENCINITA AVE_Plumbing__ d 7C t1 667—CE 817 468
' APPLICATION FOR PLUMB G PER�
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION FNEAREST
JOHN A LAMBIE. COUNTY ENGINEERCOLEMAN W JENKINS SUP T OF BUILDING FOR APPLICANT TO FILL IN (PR NT OR TYPE)
NUMBER FIXTURE OR ITEM EACH FEE
OWNER
WATER CLOSET 150 I [BAIL
BATH TUB 1 50 ADDRESS
� SHOWER 150 CITY NO
Lj— LAVATORY 1 50 CONTRACTOR
SINK 1 50 ADDRESS `
DISHWASHER 150 CITY TEL Ngrr,r
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1 50
D�.J I C�T N GU P ON P OB
LAWN SPRINKLER SYSTEM 2 00 �
WATER HEATER 1 50 INDUSTRIAL V
WASTE APPROVAL
GAS SYSTEM OUTLETS 1 50 INSPECTION RECO A z
OUTLETS OVER (, O
5 PER SYSTEM 30 7
^ W
O.
/ p Z
2 �
Plan check fee 25% of abpve See reverse
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE
APPROVALS DATE INSPECTOR S SIGNATURE
Plan check applicant UNDER SLAB WORK 7-12--,11?
Name ROUGH PLUMBINGjd
Address GAS PIPING
GAS VENT
City Tel No
HOT WATER HEATER
1 HEREBY ACKNOWLEDGE THAT 1 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 LES COUNT D STATE OF
CALIFORNIA OR THAT I AM OWN �D INTEND TO
RESIDE IN THE ABOVE DE IBE j N RTY FINAL
SIGNATURE ` JACK R. ALLEN, SUPERVISING CHANICAL ENG'R
OF PERMITT
PERMIT VALIDATION cK M o CASH
PLAN CHECK V IDATION CK M o CASH
�1^_ 1 0 0 4 JUL 17 5 D 23,00- IT
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