HomeMy Public PortalAbout5405 ENCINITA AVE_Plumbing__ 76A15t7 (CE-817)-4/72
APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
MAKE CHECKS PAYABLE TO FNEAREST
G ��yy
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HARVEY T. BRANDT, COUNTY ENGINEER Y
FOR APPLICANT TO FILL IN (PRINT OR TYPE) T
NUMBER FIXTURE OR ITEM @ FEE
OWNER
WATER CLOSET 1 75
MAIL
BATH TUB 1 75 ADDRESS
SHOWER 1 75 CITY TEL NO
LAVATORY 1 75 CONTRACTOR
SINK4w, � 1 75 ADDRESS
DISHWASHER 1 75 CITY NO
CLOTHES WASHER 1 75 STATE LIC f
LICENSE NO CLASS 1
SWIMMING POOL RECEPTOR 1 75
DISTRICT NO GROUP ZONE ��RQC�SSED BY
LAWN SPRINKLER SYSTEM 1 75 6—,68 _I
WATER HEATER 1 75 INDUSTRIAL
WASTE APPROVAL
GAS SYSTEM OUTLETS 1 75 I SPEC TION RECORD
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OUTLETS OVER
5 PER SYSTEM 30 /y O
U
W
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Plan check fee See Reverse
PLUMBING PERMIT ISSUING FEE $ 3 00
TOTAL FEE
APPROVALS Dj0,TE iNs croR s SIGNATURE
Plan check applicant UNDER SLAB WORK
NamerAln-40101ROUGH PLUMBING
Address GAS PIPING
City Tel No l i ! GAS VENT
� t7 J HOT WATER HEATER
I HEREBY ACK O LEDGE T T I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOV IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMBING I GAS TEST
1 HEREBY CERTIFY THAT LIAM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN THE ABOVE D CRIBED RESIDENTIAL PROPERTY FINAL /
SI GNATU RE ^�
OF PERMITT
PERMIT VALIDATION CK D CASH
PLAN CHECK VALIDATION CK M 0 CASH
lAt',r 2 3 3 L"75 JUL20 5 D QB