HomeMy Public PortalAbout5710 ENCINITA AVE_Plumbing__ 76A667-CE=8 1'! B-65 0- 17—Y
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APPLICATION FOR PLUMBING PERMIT
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING /�M� �;
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS Q C
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALIT
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FOR APPLICANT TO FILL IN NEAREST j�
CROSS ST. _ V
NUMBER FIXTURE OR ITEM EACH FEE OWNER -
WATER CLOSE[ $1.25
MAIL
BATH TUB 1,25 ADDRESS Iq
SHOWER 1.25 CITY y TEL. NO. T -SQ C
LAVATORY 1,25 CONTRACTOR ,?
SINK 1.25 ADDRESS Cr11
DISHWASHER 1.25 CITY TEL. NO.STATE LIC
LAUNDRY TUB 1.25 LICENSE NO. C CLASS
CLOTHES WASHER 1.25 DISTRICT NO. GPI;Lup NE P ESSED BY
WATER HEATER 1.50 ✓ �� / /
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GAS SYSTEM OUTLETS 1.50 INDUSTRIAL O
WASTE APPROVAL
OUTLETS OVER 5 PER SYSTEM .20 INSPECTION RECORD u
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APPROVALS DATE INSPECTOR'5 SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS A PLICA ION GAS VENT
AND STATE TNAT THE ICORRECT AND AGREE COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR PLUMBING FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF GAS TEST J
CALIFORNIA OR THAT 1 AM THE LE AL OWNER .AND INTEND TO
RESIDE IN,THE ABOV CRIB (I SI DENTIA PERTY. UTILITY CO. NOTIFIED
SIGNATURE
OF PERMITTEE FINAL
/--)VALIDATION
UK' M.O. CASH
LA' ..0e165iZ�, APR21 5 D 4.75- a