HomeMy Public PortalAbout5425 ENCINITA AVE_Plumbing__ 1
76A667-CE817 6-60
APPUCA` 909 FOR PLtJMBN PERIL T
RENTFTYGGDEPATTMENOCOUNENINEER
BUILDING AND SAFETY DMSION BUILDING
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JOHN A LAMBIE, COUNTY ENGINEER ADDRESS '
WILLIAM A JENSEN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NUMBER FIXTURE OR ITEM OWNER
WATER CLOSET MAIL
BATH TUB ADDRESS
SHOWER
CITY TEL NO. \
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LAVATORY CONTRACTOR PIA, b
SINK ADDRESS
DISHWASHER CITY TEC NO.,,,
STATE
I LAUNDRY TUB REGISTRATION NO _ICOUNTY
CLOTHES WASHER DISTRICT NO GROUP I ONE =oCE D BY
j WATER HEATER
GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD i
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l�i,t' �'�'.r�taF3�Grt� €t+ r�J`,% 'a��'`n �<i� �f�I�OCJ�I� ��;{.' e•��'�
/1 $100 PER ITEM
V OR ggWRE $ ( APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2100 UNDER SLAB WORK 7/'6,/
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TOTAL FEE ROUGH PLUMBING I /Q C`t�G� a
GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY GAS VENT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST
F CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENT ROPERTY , UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTE FINAL
Or ESL_ d,' ATION ROBERT A WOOD,
C[ M.0 c"B SUPERVISING MECHANICAL ENG'R
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