HomeMy Public PortalAbout5322 1/2 ENCINITA AVE_Plumbing__ 7GA667(AC97 APPLICATION FOR `PLUMBING PERMIT
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IVISION OF BUILDING AND SAFETY
Depcatment\of County-Engineer
County of Los Angeles BUILDING !
JOHN A. LAMB IE.-COUNTY ENGINEER ADDRESS Z
CASSATT D. GRIFFIN,'SUP•T OF BUILDING 1
LOCALITY'
FOR APPLICANT TO FILL IN NEARESTCROSS r l P
z
OWNER % // DISTRICT NO. GROUP (.ZONE READY FOR INSPECTION
MAIL � r ��- T' e� - i
ADDRESS •Y� '� "
�j n INDUSTRIAL
CITY i/ ` - TEL NOZ?/, '�� WASTE APPROVAL
PLUMBER ' „r INSPECTION RECORD
ADDRESS P c �_1
CITY �O.- eeTEL. NO. Q-�
LICENSE NO.
NUMBER TYPE OF FIXTURE OR ITEM - FEE
WATER CLOSET (TOILET) , @ $1.00 $ '
BATH TUB @ $1.00
SHOWER @ $100
LAVATORY (WASH BASIN) @ $1.00
KITCHEN SINK @ $1.00
DISHWASHER •@ $1.00
LAUNDRY TUB OR TRAY @ $1 00
CLOTHES WASHER @ $1.00
WATER HEATER @ $100
GAS S400%649 5lm�vfC, @ $100
APPROVALS
DATE INSPECTOR'S SIGNATURE
UNDER SLAB WORK
PERMIT $ 00 ROUGH PLUMBING ^6�
O� GAS PIPING / w�
TOTAL FEE / ��
GAS VENT
LER EBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION HOT WATER HEATER
TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
LL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING FIXTURES /f
G. '
EBY CERTIFY THAT I AM .PROPERLY REGISTERED AND/OR GAS TEST Lb
D AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF �J
NIA OR THA�=ER GAL 0 OF E ABOVE UTILITY CO NOTIFIED
ED REST „ ,
U ITTEE FINAL
JOHN A. NTY ENGINEER gALIDATION, ROBERT A.WOOD. CHIEF PLBG. INSPECTOR
' CK /. !I.0. CASH
LACo 6 2 7 5 L-� 00T.31 5. A 3.0 0 ,v
.. y 1y `�tl� • �V V � • , `aV%i?\
76A667-CE817-11-57
APPLICATION FOR PLUMBING PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION FBUILDINGJOHN A. LAMBIE, County Engineer ESSCASSATT D. GRIFFIN, Suptof Building LITY �r
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NUMBER FIXTURE OR ITEM -
OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
SHOWER CITY TEL. NO.
LAVATORY CONTRACTOR
SINK ADDRESS
DISHWASHER CITY TEL. NO.
LAUNDRY TUB CONTRACTOR'S STATE El
REGISTRATION NO. COUNTY ❑
CLOTHES WASHER DISTr_::j GROUP E READY FOR INSPECTION
WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
APPROVALS
PER ITEM DATE INSPECTO IG TURE
OR FIXTURE $
UNDER SLAB WORK f
PERMIT $ 1 00 ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING. PLUMBING FIXTURES
1HEREBY 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 THE LEGAL OWNER OF THE ABOVE UTILITY CO.NOTIFIED
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE
OF PERMITTEE FINAL
ROBERT A.WOOD.
®F VALIDATION SUPERVISING MECHANICALENG'R
CK. M.0. CASH
IRC65274x' SEP 29 5 A 8.00 e