HomeMy Public PortalAbout4942 ENCINITA AVE_Plumbing__ ' 17
DBSAPPLICATION OR PLUMBING ERMIT
DIV1
DIVISION OF BUILDING AND SAFETY
Department of County Engmeer
�.'OUIIty Of LOS AIIgeleB BUILDING
JOHN A'LAMBIE, COUNTY ENGINEER ADDRESS
CASSATT D GRIFFIN,SUP T OF BUILDING ^
LOCALITY �✓
FOR APPLICANT TO FILL IN I NEAREST
CROSS ST
OWNER p, 6-0 t-- DISTRICT NO GROUP ZONE I RE Y FOR INSPECTIO
MAIL /
ADDRESS �7 /h>< / C:
/� INDUSTRIAL
CITY m &- G t t' TEL NO WASTE APPROVAL
PLUMBER G S. IC
��q // ti! INSPECTION RECORD
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ADDRESS /E�Op 1*"� ^—w r '�^ d
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CITY TEL NO G/ 77J
LICENSE NO j O cS
NUMBER TYPE OF FIXTURE OR ITEM FEE
It/ WATER CLOSET (TOILET) @ $100 $ (!
BATH TUB @ $1 00
SHOWER @ $100
LAVATORY (WASH BASIN) @ $1 00 O V
KITCHEN SINK @ $1 00
DISHWASHER @ $1 00
LAUNDRY TUB OR TRAY @ $1 00
CLOTHES WASHER @ $100 I
/ WATER HEATER @ $100 O
/ GAS SYSTEM @ $1 00
APPROVALS
DATE INSPECTOR S SIGNATURE
UNDER SLAB WORK
PERMIT $ 00 ROUGH PLUMBING
GAS PIPING
TOTAL FEE g 64)
GAS VENT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TOICOMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING PLUMBING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR GAS TEST
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THV LEG.#L OWNER OF THE ABOVE UTILITY CO NOTIFIED
DESCRIBED RESIDENTIAL ROPE Y �
SIGNATURE
OF PERMITTEE FINAL O l
JOHN A LAMBIE COUNTY ENGINEER V LIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR
CK m 0 CASH
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