HomeMy Public PortalAbout5521 ENCINITA AVE_Plumbing__ 78A887 -CE#�17 9/63
APPLICATION FOR PLUMBING PER IT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING !�
JOHN A LAMBIE. COUNTY ENGINEER ADDRESS a
WILLIAM A JENSEN SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS SS
NUMBER FIXTURE OR ITEM EACH FEE
OWNER �
WATER CLOSET $1 25 MAIL
BATH TUB 125 ADDRESS
SHOWER 125 CITY TEL NO
LAVATORY 125 CONTRACTOR
SINK 125 ADDRESS
DISHWASHER 125 CITY
T&f NO ,1
LAUNDRY TUB 125 CONTRACTOR'S n STATE
REGISTRATION NO pL COUNTY ❑
CLOTHES WASHER 1 25 DISTRICT NO- GR UP ZONEPR
CESSED BY
WATER HEATER 1 50 / Q l
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GAS SYSTEM OUTLETS 1 50 INDUSTRIAL D-
WASTE APPROVAL O
OUTLETS OVER 5 PER SYSTEM 30 INSPECTION RECORD U
OC
O
H
U
W
a
Z
APPROVALS DATE INSPECTOR S SIGNATURE
PERMIT $ 2 00 UNDER SLAB WORK y
ROUGH PLUMBING f `
TOTAL FEE GAS PIPING �✓ l
I 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
LICE NSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST ` Yr
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO 1` i✓
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY UTILITY CO NOTIFIED
SIGNATURE
OF PERMITTEE
r FINAL RT+sTilJ�f`� ;
ALIDATION ROBERT A WOOD
cK M O CASH SUPERVISING MECHANICAL ENG R
�r+t�o 6 5 5 4 0 GSC 7 5 D n