HomeMy Public PortalAbout5716 ENCINITA AVE_Building__ 16A661-CEa817 6-65
APPLICATION FOR PLIJIMBING PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBIE. COUNTY ENGINEER ADDRESSI,
COLEMAN W. JEN KINS. SUPT. OF BUILDING LOCALITY ,E_/,V,01��L- Ty
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
F
FIXTURE OR ITEM EACH FEE
OWNER - E.- CNOLE�P
WATER CLOSE[ $1.25 MAIL X ,
BATH TUB 1.25 ADDRESS V /6 ENC/N T 6
SHOWER 1.25 Cl TEL.
TY E�7 �E' Ty NO �
LAVATORY 1.25 CONTRACTOR oor ClFlC NSSTALLEiP�
SINK 1.25 ADDRESS/O9�6
DISHWASHER 1.25 CITY .�ITJP/LE �JQ7Y TEL. 11 . �QJQ
SATELIC
LAUNDRY TUB 1.25 LICENSE NO/J2-//O / O CLASS
CLOTHES WASHER 1.25 DISTRICT NO GROUP ZONE PRO EBBED BY
WATER HEATER 1.50 / _GF J'�L y 2
CAS SYSTEM OUTLETS 1'50 INDUSTRIAL }
WASTE APPROVAL 2
OUTLETS OVER 5 PER SYSTEM .00 INSPECTION RECORD O
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12 w .u: "
APPROVALS DATE INSPECTORS SIGNATURE
PERMIT S 2 00 UNDER SLAB WORK
ROUGH PLUMBING
TOTAL FEE GAS PIPING
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GAS VENT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING HOT WATER HEATER
PLUMBING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANDIOR PLUMBING FIXTURES
LICENSED AS REOU BY LOS ANGELES COUNTY AND STATE OF GAS TEST
CALIFORNIA OR AT 1 M THE LEGAL OWNER OF.AND INTEND TO
RESIDE IN.THE BOY D{iy�Cp/IBED ESI ENTIAL PROPERTY. UTILITY CO.NOTIFIED
SIGNATURE ! ) / / i-
OF PERMIT �/ ( `
FINAL
}VALIDATION
(vKJ M.O. CASH
�luo 9 0 8 6 JUN 14 5D 3.5 Q
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