HomeMy Public PortalAbout5462 ENCINITA AVE_Plumbing__ .6 A 66�- CE 817 7-69 �j/ /�' 1 T
• APPLICATION FOR PLUMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
JOHN A LAMBIE, COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN (PR NT OR TYPE) NEAREST '
CROSS ST
NUMBER FIXTURE OR ITEM EACH FEE OWNER `
WATER CLOSET 1 s0 MAIL
BATH TUB 150 ADDRESSCX/rvL�
SHOWER 1 50 CITY TEL N
LAVATORY 1 50 CONTRACTOR
SINK 1 s0 ADDRESS
DISHWASHER 1 50 CITY TEL NO
CLOTHES WASHER 1 50 STATE LIC
LICENSE NO CLASS
SWIMMING POOL RECEPTOR 1 50
DISTRICT N GRIDNE OCES BY
LAWN SPRINKLER SYSTEM 2 00 ...�
WATER HEATER 1 50 - INDUSTRIAL APPROVAL
GAS SYSTEM OUTLETS 1 SO INSP TI ORD t)
OUTLETS OVER 30 arl
5 PER SYSTEM Aa z
at At" I W
CL
N
z
Plan check fee 25% of above See reverse
PLUMBING PERMIT ISSUING FEE 8 2 00
TOTAL FEE
APPROVALS DATE INSPECTOR 5 SIGNATURE
Plan check applicant UNDER SLAB WORK
Name ROUGH PLUMBING
Address GAS PIPING
GAS VENT
City Tel NO HOT WATER HEATER
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY PLUMBING FIXTURES
lei
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS TEST _
PLUMBING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR UTILITY CO NOTIFIED
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR T I AM THE LE OWNE D INTEND TO
RESIDE IN THE A OV DESCRIBED 81 NTIA P Y '
FINAL ��, i 1
SIGNATURE � - t JACK R. ALLEN, SUPERV Is ING ANICAL EN G'R
OF PERMITTE
PERMIT VALIDATION c M O CASH
PLAN CHECK VALIbATION CK (� O CASH