HomeMy Public PortalAbout5624 ENCINITA AVE_Plumbing__ 76AB67-CES17-8-58 y 7
APPLICATION FOR.. PLUMBING PERMIT
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DEPARTMENT OF COUNTY ENGINEER
BUII.DING AND SAFETY DIVISION nDDasss .�4 4:,,A.., i A9
IOHN A. LAMBIE. County Engineer
CASSATT D. GRIFFIN,S.p t of Building �.00ALITY '
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FOR APPLICANT TO FILL IN NEARESTRT. �SSi D �✓
NUMBER FIXTURE OR ITEM
/ WATER CLOSET OWNER eSTe.0 AA,•, a-3
MAIL
BATH,TUB ADDRESS
SHOWER CITY TEL. NO.
/ LAVATORY cONTRI{E*gTANA FI_U.N.ln!NG CONTRACTORS
SINK ADDRESS
DISHWASHER CITY City of Ir,c_; y, Ca1ffEL. NO. ED. 7-7226
CONTRACTOR'S #96496 STATE ❑
LAUNDRY TUB REGISTRATION NO. COUNTY El
CLOTHES WASHER DISTRICT O. GROUP Z NE ESSED BY
WATER HEATER
% GAS SYSTEM INDUSTRIAL
WASTE APPROVAL
INSPECTION RECORD
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APPROVALS 4",%
OR DEr�URE If DATE INSPECTOR'S§IGNATURE
UNDER SLAB WORK n�
PERMIT $ 2 00 ROUGH PLUMBING'
TOTAL FEE 1W GAS PIPING 11
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS PLICATION GAS VENT J v� Q
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY - HOT WATER HEATER
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 60 m"' A
PLUMBING. PLUMBING FIXTURES [ten ,vim V
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR GAS TEST ��dA'I_ '"J- -J '1 �_M / DL7
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE - UTILITY CO.NOTIFIED
DESCRIBED RESIDE AL PROPERTY.
SIGNATURE FINAL 7 Z3'cn
OF PERMITT
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®� ALIDATION SUP/L/RVISING MECHANICAL ENG'R /�
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M.0. CASH 1 I W/1fA/SYV CD,AW5C re fo
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~`,l05544r; APPR ? 2 5 A . 9.00
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