HomeMy Public PortalAbout5409 ENCINITA AVE_Plumbing__ 76A667 n 5-49® APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY PLUMBING
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COUNTY OF LOS ANGELES
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
PLUMBER RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS l
BUILDING
CITY '.I TEL. NO. ADDRESS
COUNTY {/ LOCALITY
LICENSE NO. / EXPIRES
NEAREST
PERMIT FEES CROSS ST.
NUMBER TYPE OF FIXTURE OR ITEM FEE OWNER
MAIL
WATER CLOSET (TOILET) Q 0.50 $ ADDRESS
BATH TUB @ 0.50 CITY TEL. NO.
SHOWER @ 0.50 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
LAVATORY (WASH BASIN) @ 0.50 APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
KITCHEN SINK @ 0.50 STATE LAWS REGULATING PLUMBING.
1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
LAUNDRY TUB OR TRAY @ 0.50 ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
GAS SYSTEM OUTLETS @ 0.50 SIGNATURE OF
WATER HEATER @ 0.50 PERMITTEE
SLOP SINK @ 0.501 INSPECTION RECORD
FLOOR SINK @ 0.50
FLOOR DRAIN @ 0.50
DISHWASHER @ 0.50
DRINKING FOUNTAIN @ 0.50
URINAL @ 0.50I= „J
J_J HOUSESEWER @ 0.50 Q
Z
MISCELLANEOUS U'
LY
I
I�
APPROVALS
DATE INSPECTOR'S NAME
ROUGH PLUMBING
GAS PIPING
L GAS VENT
CESSPOOL @ 1.00 CESSPOOL
SEPTIC TANK: SEPTIC TANK
DRAIN ( ) PIT ( ) @ 1.00 SEWER
PERMIT 1.00 GAS TEST
UTILITY CO. NOTIFIED
TOTAL FEE $ �_ l
FINAL